05-103008 .w f
City of Federal Way Mechanical Permit #: 05 103008 - 00 - ME
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
ti
Project Name: GULBRAA
Project Address: 33357 20TH S.f%Vt S Parcel Number: 797820 0101
Project Description: Remove and replace gas furnace and install A/C unit
Owner Applicant Contractor
A R Gulbraa A R Gulbraa GENESEE FUEL&HTNG CO INC
33357 20TH AVE S 33357 20TH AVE S PO BOX 18206
FEDERAL WAY WA FEDERAL WAY WA SEATTLE WA 98118
98003-6838 98003-6838 (206)722-1545
Mechanical Valuation 6000 Over the Counter Permit Yes
Mechanical Fixtures
Description Quantity]! Description Quantity Description [Quant
Air Handling Units I !I Furnaces 1
L
PERMIT EXPIRES December 20,2005.
Permit issued on June 23,2005
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.
J
Owner ora nt: . �'�---
' --- Date: �0/.43 ��
THIS CARD IS TO REMAIN ON-SITE
CITY OFCommunity Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-103008-00-ME
Owner: A R GULBRAA
Address: 33357 20TH AVE S
FEDERAL WAY, WA 98003-6838
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.
0 Mechanical Rough-in(4165) ❑ Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By C.:-- Date g ``'I'DS'
RECEIVED CONSTRUCTION PERMIT APPLICATIO
APPLICATION NUMBER:Q to3 Oa r
JUN 2 3 2005 APPLICATION NUMBER: -
APPLICATION NUMBER: -
r, ED_ERAL WAY
41Q 4-14 red information—Please print(in ink)or types*
Please note: Electrical,Fire Prevention Systems and Engineering perm may require a separate application.
• PROPERTY INFORMATION
SITE ADDRESS: 33357 20TH AVE S ASSESSOR'S TAX/PARCEL#: 7978200101
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
IN PROJECT INFORMATION
TYPE OF PROJECT(This applkation): o BUILDING 0 PLUMBING 41ECHANICAL o DEMOLITION
o ELECTRICAL o ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): RFPLACF 58 000 BTU GAS FURNACF ANI')INSTAI I NFW 2 TON
AC UNIT
PROJECT NAME: G Ukc�11�
III PEOPLE INFORMATION
PROPERTY OWNER: NAME:DICK GULBRAA DAYTIME PHONE:
(253 )838 9569
MAIUNG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
33357 20TH AVE S
CONTRACTOR: NAME: GENESEE DAYTIME PHONE:
(206 )722 - 1545
MAILING ADDRESS(STREET ADDRESS;CRY,STATE,ZIP): EVENING PHONE:
3616 S GENESEE ST, SEATTLE WA 98188 ( )
CRY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
( )
CONTRACTORS REGSTRATION NUMBER: EXPIRATION DATE:
(copy��muted) ENESFH 3 7 00 6 02 / 16 /06
APPLICANT: NAME:DICK GULBRAA DAYTIME PHONE:
(253 )838 9569
MAIUNG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
33357 20TH AVE S ( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
0 ARCHITECT o TENANT o OTHER(DESCRIBE): ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑PROPERTY OWNER )(APPLICANT A PLICANT ❑CONTRACTOR
11 DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR : $ 6000.00
SPRINIU.ERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑YES ❑NO
WATER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE o TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑LAICEHAVEN ❑HIGHL.INE ❑PRIVATE(SEPTIC)
A
4'*NEW RESIDENTIAL CONSTRUCTION ONLY**
- T NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL
• FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEMS)
BBQ(S) FAN(S)5; HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLETS) HEAT SOURCE: o ELECTRIC 0 GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC 0 GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
• DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of pada . . . Information furnished by me Is true and correct to the best of my knowledge,and
further,that I am authorized by the , r of the br to perform the work for which thepermit
further agree to hold harmless • • application M made. I
investigation and defense of claim),ofhh Federal�" '' �dakn(kndudkW coats,e>yenses,axd attorneys'fees Mcurnd Kn do
-by y person,Mduding the undersigned,and fled against the City of
Federal Way,but only where - claim a -. eliance of the city,including its officers and employees,upon the accuracy
of the Information supplied ,, the city as a ; rt of .. a. , kation.
NAME/TITLE: DATE: 6/22/05
❑PROPERTY OWNER )PPLI ❑ ' • • • ' S S 1 C� C uY Y S
FOR OFFICE USE • :
❑NEW ❑ADDMON o ALTERATION ❑REPAIR o TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION: BUILDING SHELL ONLY? 0 YES ❑NO
COMP PLAN DESIGNATION BASIC PLAN? ❑YES o NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑YES 0 NO
PLATTED LOT? o YES o NO CHANGE OF USE? ❑YES ❑NO
COMMUNITY DEVELOPMENT SERVICES•33530 RRST WAY SOUTH•PO BOO(9718•FEDERAL WAY,WA 98063-9718.253.661.4000•FAX:253-661-4129
www.citvoffederalway.com