05-103541 City of Federal Way ' Mechanical Permit#: 05 - 103541 - 00 - ME
Community Development Services
P.O.Box 9718
Federalh: Way,WA 98063-(253 Inspection request line: (253) 835-305C
Ph:(253)835-7000 Fax:(253)835-2609 P 9
Project Name: UPSAHL
Project Address: 127 S 297TH P1 Parcel Number: 776420 0120
Project Description: Replace gas furnace with new piping;also adding(2)gas piping for future fireplaces
Owner Applicant Contractor
Alan H Upsahl &Maureen I Upsahl GAS APPLIANCE GAS APPLIANCE
127 S 297TH PL 600 STEWART SUITE 1903 600 STEWART SUITE 1903
FEDERAL WAY WA SEATTLE WA 98101 SEATTLE WA 98101
98003-3629 (206)245-9171
Mechanical Valuation 2000 Over the Counter Permit Yes
Mechanical Fixtures
'(: ,ti" Description'
" Quantity
Furnaces 1 JGas Piping 3
PERMIT EXPIRES January 16,2006.
Permit issued on July 20,2005
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:. _C ' Date: 7A4-
t
THIS CARD IS TO REMAIN ON-SITE
CITY OF A Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE# (253) 835-3050
PERMIT#: 05-103541-00-ME
Owner: ALAN H UPSAHL
Address: 127 S 297TH PL
FEDERAL WAY, WA 98003-3629
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 back of this card.
❑ Mechanical Rough-in(4165) 0 Gas Piping(4125) ❑ Final-Mechanical(4065)
Approved Appr%ved to release test Approved
By Date By G,iyDate? • Z 27" "-sy . � Date?AL2 O
b ,
44.1. RECEIVED
, JUL 2 0 2005 05- j 0 3 5- c( 1
Federal Way
PERMIT SF MFC E L PL DE EN
COMMUNITY DEVELOPMENT SERVIC
33325 D R LLA SWATH•63BOX bTY OF FEDPL LICATION O N
FEDERAL WAY,WA 98063-9718 B U I LID I Nd TD /
253-835-2607.FAX 253-835-2609
www.atuoffederalwau.com
The ollowin• is re• ired in ormation-an Inco •lete • ••lication will not be acce•ted. Please •rint le•ibi in ink or j
Z/
�j • PROPERTY INFORMATION�
SITE ADDRESS / S S. Z.9 /7 �/ "L/ 77,1/JC/J
1 4y 98 J SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 7 7 G 7 2 Q- 0 / a 0 LOT SIZE(sf) //J 2 5
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) / 2 SA-AIL E (//S/4- .13
(Attach separate page for lengthy legal desenphon)
MI PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING AKMECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PR�jj"CT���DESCRIPTION (Provide detailed description of work included on this permit onlu)
, ,,,, 6.4-5-�!3 .n A c.c. G..� Ne.-- -v ,5/tr. elis F.et/,frc./-
6 4-S ?i ri/i/6 712,-..e.
,i.,i rc e --,--r i IJ (2)
J -, ,e.-4c c-J
PROJECT NAME(Name of Business or Owner Last Name) t/pS 4 ei 1—
• PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER (25-r) D 2y JT
oyy?NG ADDRESS NP�/��
CITY,STATE,ZIP
/Z7 S, Z9 7 ? PL i--&—p/..e..47— '4 y / tv4 9 l'ocU
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
4. � /AVG/#f,s' = (24 )c ?z - Sbeta
MNG ADDRESS
/f.:1 Y,STATE,ZIP CELL PHONE
( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
— — — / / (. )7a2 7 3d'-3
B L
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
4 .4sAP s _gQ ! z-S9. / l
APPLICANT COMPANY NAME APPLICANT AME OFFICE PHONE
7--r/(4...„74,--„,..,„. /-/(z /6f-4, (4 )2�'T- - 9/7,
MAILADDRESS c Cr!'?,ST ZIP pp CELL PHONE
L1 1 /9GJ 5� � �, NIP( �AX NUMBER
LATIONSHIP TO PROJECT
0 Architect 0 Tenant Agent ❑ Other(Describe) (2l . )299 -_5 &"c)
CONTACT i� / / 2M�A�RY PHONE /'L! I. C 0,e/ �4AI.C
r/y !�/Ltj� (`^V ) �,�-- 717 S !�a`._7��
LENDER Per RCW 19.27.095: Lender information is NAME
required if project value exceeds$8,000 ✓•-(,/
MAILING ADDRESS CITY,STATE, P
• DETAILED BUILDING INFORMATION
EXI PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYST' ' - ••= 'D/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WEL
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
'
•
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL? eSt TOTAL PRWPOOD SS TOTALS/.
**NEW HOMES ONL'** 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 $ Y IJV
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commerc,ak( WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS / FURNACES GAS WATER HEATERS
DUCTS 3 GAS PIPE OUTLETS
PLUMBING
BATHTUBS(orTub/Shower combo) SHOWERS WATER CLOSETS(rode) 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
I 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 /ZJ/
(Signature) (Title)
RELATIONSHIP TO PROJECT o Owner iec'Agent 0 Contractor 0 Architect 0 Other
"R conics 171
a NEW o ADDITION o ALTERATION a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? n YES a NO BASIC PLAN? a YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/EWA/SU? a YES a NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? a YES a NO
R„llafi„
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