05-104604 •
City af'Federal Way Mechanical Permit #: 05 - 104604 - 00 - ME
Community Development Services
P.O lox 9718
• Federal Way,WA 98063-9718
Ph-(253)835-7000 Fax (253)835-2609 Inspection request line: (253) 835-3050
Project Name: KANE
Project Address: 30405 3RD fi pNeS Parcel Number: 232970 0040
Project Description: Installation of gas furnace.
Owner Applicant Contractor
Alton M Kane GATEWAY HEATING&AIR CONDITION GATEWAY HEATING&AIR CONDITION
30405 3RD AVE S 3802 AUBURN WAY N 3802 AUBURN WAY N
FEDERAL WAY WA AUBURN WA 98002 AUBURN WA 98002
98003-4004 (253)931-0610
Mechanical Valuation 1500 Over the Counter Permit Yes
Mechanical Fixtures
Description _Quantity Description Quantity Description Quantity
Furnaces 1
PERMIT EXPIRES March 8,2006.
Permit issued on September 9,2005
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.
r �,,� -
Owner or agent: '' / ( Date: q/q �
Ivf fns 4as kApcce. 441k.c9x_.
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\\ es
ar THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-104604-00-ME
Owner: ALTON M KANE
Address: 30405 3RD AVE S
FEDERAL WAY, WA 98003-4004
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) ❑ Gas Piping(4125) a Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date Byo j Datel V.21_03—
RECEIVE
.V.'A 12 - i c� Y o
�
../ deral Way
'( cOMMM7Y DEVELOPMENT SERVICES P E R M I Ts E P 0 9 2005 SF MF CO EL PL DE EN FP
33325 D AVENUE.WA77f•PO BOX 9718 A p p L I C A' I
FEDERAL WAV,FAX
953.835.2 180 O DERAL W /
253-835.2607•FAX 253435.2609 A Y
www.cituotTederalway.cora L I G DEPT
The ollowi • is re• fired in ormation-an inco 'tete • ••lication will not be acce•ted. Please •rint ie• •I in or
. IN PROPERTY INFORMATION
SITE ADDRESS 3 Oy 0 S 3 rot ' e_ S-• SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 3 C Q 70 - 0 Q 0 LOT SIZE(s)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Att.th•epararePrgcfa,lengthif legal da cdPtior)
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING MECHANICAL
• 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
PROJECT NAME(Name of Business or Owner Last Name)
• PEOPLE INFORMATION
PROPERTY NAME
OWNER �,., J PRIMARY PHONE
MAILINGADDRESS 1 \ - 1 Cl- Com► STATE,ZIP (2.5 ) 3C 4110
ZSOLk OS 34 A-, S • e_d i sp (\9A_ki (,-)Pt LiTDD� _
CONTRACTOR C(PANY NAME APPLICANT NAME OFFICE PHONE
r1 Pr1.- V\ x:171 rim; +-A V RESS C1T'(12it� "All( (aS3 ) CN -DL t t�
3J QZMAILING ,ZIP( n A/ NTE
J - 4 O( `STAf /(9 q2 (ELL PHONE)
H ONE
CtTY OF FEDE
ERRAL WAY BUSIN LICENSE NUMBER EXPIRATION DATE - FAX NUMBER "��
1 Cl-=1�-I C .5 -2 B L iZ/ 1\ / C5C ( 3 /S)014ozild)
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
APPLICANT PANT NAME APPLICANT NAME OFFICE PHO
C -e , � (&c3 ) 3( - 0640
MAILING MISimsn _ `N _I,01 CI SlattTATE,ZIP n f 2 ELL PHONE
RELATIONSHIP TO PROJECT �AX NUMBER �p �
a Architect ❑Tenant ❑Agent .V6t er(Describe)MARY PHARE ( ) -()`1'40-0
CONTACT N��`� (Ptca-s)"i3L 010010 X
O/4i��4! 1•Will.
LENDER 1.- ;1.,, • )- n•�:1 ,•,,,.r:; ori,-,.,-,,.::
•
J ' - 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 Toru '-atePROroacosry A6}rrx+
ir
"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 $ \50151:)----
•
AIR
S0t'-
AIR HANDUNG UNITS EVAPORATIVE COOLERS GAS LOGS
REFRIG.SYSTEMS
BBQS FANS HOODS IG...rc++q WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS I FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(.r'nEb/Showercombp SHOWERS WATER CLOSETS(Tales MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(s.tmo.msed," 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
c /_this application.
NAME/TITLE4iiti DATE q9'
/// (Signature) (Title) /
RELATIONSHIP TO PROJECT 0 Owner 0 Agent 0 Contractor ❑ Architect ❑ Other
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Bulletin#100—January 7,2005 Page 2 of 4
k\Handouts\Permit Application