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04-103253 • • rAy Services rcornrnUflilyDeseioPrnefltMechanical Permit #:04 - 103253 - 00 - ME 33530 1st Way S Federal Way,WA 98003-6210 Ph:253 661.4000 Fax 253 661 4129 Inspection request line: 253.835.3050 Project Name: AN Project Address: 3765 SW 319TH St' Parcel Number: 873198 3130 Project Description: Replacement of edisting gas furnace Owner Applicant Contractor Gw An &Chun J An AFFORDABLE GAS SERVICE AFFORDABLE GAS SERVICE 3765 SW 319TH ST AFFORDABLE GAS SERVICE AFFORDABLE GAS SERVICE FEDERAL WAY WA 12955 22ND AVE NE 12955 22ND AVE NE 98023-2154 SEATTLE WA 98125 (206)367-5333 Mechanical Valuation 1900 Over the Counter Permit. Yes Mechanical Fixtures Description Quantity I_ Description !Quantity Description __JQuantity Furnaces J 1 PERMIT EXPIRES February 13,2005. Permit issued on August 17,2004 I hereby certify that the above information is correct and that the construction on the above described property and the occupancy and the use will be in accordance with the laws,rules and regulations of the State of Washington and the City of Federal Way. Owner or agent:_ AIA / is Date: • ,y a 1 f(°" l‘t"/Q 1 w THIS CARD IS TO REMAIN ON-SITE CITY OF ' Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT#: 04-103253-00-ME Owner: GW AN Address: 3765 SW 319TH ST FEDERAL WAY, WA 98023-2154 This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as possible(read left to right,top to bottom.). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the lack of this card. ElMechanical Rough-in(4165) ,❑ Gas Piping(4125) ❑ Final-Mechanical(4065) Approved Approved to release test Approved :•' Date By Date By G„ coi Dat, .g ,© 1 I •e Fecder la Wa RECEIVED - _ Way PERMIT ?�� SF MFC E LPL DE EN Fr 00.0UN17YDEVELOPMENTSERVICES 33530 FIRST WAY SOUTH•Pa BOX 9778 A't(' 1 7�o,p L I C AT I O N FEDERAL WAY,WA 98063-9718 AUGFr. / / 253-667-4115•FAX 253661-1129 www.dftioffederdwau com OF FEDERAL T AY The ollowin, is re•uireCITYg' ? _do Inco •lete a.•lication will not be acce•ted. Please •rint le•ibl (in ink)or . PROPERTY INFORMATION SITE ADDRESS 3 76 S 5 3/ a ' ST SUITE/UNIT# ASSESSOR'S TAX/PARCEL# - - _ _ LOT SIZE(4) LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) (Attach sepo,ate pail for ray legal desmpCon) • PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING 0 PLUMBING rd 'ECHANICAL 0 DEMOLITION 0 ELECTRICAL n ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work include on this permit onlu) Rep 4(...c.04 aw o.� e xt s e5 j�S ImaCe PROJECT NAME(Name of Business or Owner Last Name) I t g 4/1 , PEOPLE INFORMATION PROPERTY NAME / PRIMARY PHONE OWNER ( O 1,4)‘f H/��J (7--s 3) 3-3,5 - 9/o( MAILING DDRESS / CITY,STATE,ZIP 3 76 5- S r.,) 30 q ST /C-ei Illy Lc� So 2-3 CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE r>✓zg..41-c 6 ksS✓✓rc.e. j-c2GC 13PIA A (ZoC 1 367 - S3 3 3 MAILING ADDRESS CITY,STATE,ZIP CELL PHONE 2 9 cs 2.2- , Nj.= S--e-u 771.t_ tt)4 9s-/zs' ( ZeG) ?sr- 0(-/0 3 CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER 20 -01-1 D Z g 62 6_- B tL (L / 3 ( / oy (7 '4) 3 '7 - o3sy CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE A Forz & s0 -7_ 2.1,5: 3 / /7 / o › APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE 54lMAILING ADDRESS CITY,STATE,ZIP CELL PHONE ( ) - RELATIONSHIP TO PROJECT / FAX NUMBER 0 Architect ❑ Tenant ❑Agent ther(Describe) (OM'.%/4 C-l'� ( ) CONTACT NAME PRIMARY PHONE VII L/ .ii a A,C j�`h E-MAIL ADDRESS 'f'� !!n a (?06 ) ih7 - .�3 33 LENDER Per RCW 19.27.095: Lender information is NAME required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP DETAILED BUILDING INFORMATION EXISTING USE PROPOSED USE EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ / �/OD, 6-e., 1 SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) PROJECT FLOOR AREAS • AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL BASEMENT FIRST • SECOND THIRD FOURTH ADDITIONAL FLOORS(DESCRIBE) DECK(COVERED?) GARAGE/CARPORT HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ FIXTURES Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. MECHANICAL Value of Mechanical Work $ /9 019 c AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS BBQS FANS HOODS(Commercial) WOODSTOVES BOILERS / FIREPLACE INSERTS RANGES MISC(Describe) COMPRESSORS ✓ FURNACES GAS WATER HEATERS DUCTS GAS PIPE OUTLETS PLUMBING BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS rroa<q MISC(Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS LAVS(Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS DISCLAIMER/SIGNATURE BLOCK /.certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and further, that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred in the investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the City of Federal Way,but only where such claim arises out of the reliance of the city,including its officers and employees,upon the accuracy of the information supplied to the city as a part of this application. NAME/TITLE DATE 'F/7 77D Li ign lure / (Title) RELATIONSHIP TO ROJ 0 Owner 0 Agent [ retractor 0 Architect 0 Other FOR OFFICE USE ONLY ❑NEW a ADDITION ❑ALTERATION a REPAIR ❑TENANT IMPROVEMENT BUILDING SHELL ONLY? o YES o NO BASIC PLAN? ❑YES ❑NO ZONING DESIGNATION CHANGE OF USE? o YES ❑NO NEW ADDRESS REQUIRED? a YES ❑NO UP/SEPA/SU? a YES o NO PLATTED LOT? ❑YES a NO DEMO PERMIT REQUIRED? a YES ❑NO r Bulletin#100—March 30,2004 Page 2 of 4 k\Handouts—Revised\Permit Application