01-103672 City of Federal Way
Community Development Services Mechanical Permit #:01 - 103672 - 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: HINSON e\
Project Address: 30110 26THIS Parcel Number: 798500 0280
Project Description: MEC-Replace 100,000 btu gas furnace.
Owner Applicant Contractor
William P Hinson NORTHWEST PERMIT UNITED AIR COMFORT INC
30110 26TH PL S 2320 1ST AVE SUITE 250 5819 ANDREWS WAY N
FEDERAL WAY WA SEATTLE WA 98121 FT LAUDERDALE FL 33309
98003-4209 (206)575-9128
.�SS / a/ k/
Mechanical Valuation 3000 Over the Counter Permit Yes
Mechanical Fixtures
Description ' Quantity "Description Quantity ,Description Quantity
Furnaces
PERMIT EXPIRES March 24,2002,IF NO WORK IS STARTED.
Permit issued on September 25,2001
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: (is) .— 1 Lam, Date:91 0 (
.
. w*49-01 17:38 FROM-NORTHWEST-CASSIMAR 206-374-0834 T-246 P.01/02 F-136
=• CATION NUMBER: S - • : • _ •- ` _
FAY
CATION NUMBER: —.
.PLICATION NU .BR: •
**The following is required information—Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
■ PROPERTY INFORMATION
SrTE ADDRESS: Co 1,1() 26 N P I S ASSESSOR'S TAX/PARCEL#: .Gi f .Q Q - Q,_ Q
LEGAL DESCRIPTION OF SUB3ECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): •
_-
■ PROSECT INFORMATION •
TYPE OF PROJECT(This application): ❑ BUILDING 0 PLUMBING I I1ECHANICAL 0 DEMOLITION
. 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): . ...i ► • • f. •
A t.t.LLA, sI
PROSECT NAME: w t I /I
r PEOPLE INFORMATION ,
PROPERTY OWNER: NAru:: „ aAYTI�E ntONt;
( ), ) Wit t/UT (aS3)S7 9 Tit
MAILING ADORES: ADO ;aT(,STA ):
• — 3011 n • 1' P 1 S / c:&/ fcl L>3
CONTRACTOR: NAME; f�� DAYTIME PHONE:
lilt d :4 1 r çoAYt
' �MAU ,• �ti(STREET • - CITYS'TE.ZIP) � PHaNt;
s,�► t �HA�Yews' w • Fit L ..Qy i�. 3�C 1"�`"G
an OF FEDERAL WAY R, LICENSE NUMBER: FAX NUMBER ».
CON MOORS RE ISIRATION NUMBER .^ ^ ^ «• w •, — pMARION
DATE:
�...
11 .LV. $ 4 s? .1 3c .. so02_
APPLICANT: +e • wroNr
tA"AIN ( ).
MAILING moans(STREET ADDRESS;QTY,STATE,ZIP): EVENING FHONe
) -
RELATIONSHtP TO PROTECT: FAX RUMOR:
❑ ARCHITECT 0 TENANT 0 OTHER(DESCRIBE):, _ ( )
E-MAIL ADDRESs:
CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER 0 APPLICANT j'CONTRACTOR
• DETAILED BUILDING INFORMATION
EXISTING USE: VII-- EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ •'PROPOSED USE: - _ PROPOSED VALUATION FOR IMPROVEMENTS: $ 700 U T
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES 0 NO
WATER SERVICE PROVE ER: ❑ LAKEHAVEN n HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER.: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
•
„. • S+a')*-•t9-01 17:38 FROIA-NORTHWEST-CASSIMAR 206-374-0834 T-246 P.02/02 F-136
I
1... '~. NUMBEROE SEI)ROONS: ESTIMATED SELLING PRICE: $____ .----_
-
. 1111111111111111 ■ PROSECT FLOOR AREAS
FLOOR - DCISTiNG sq FT. PROPOSED SQ.FT. TOTAL ,
BASE$ENY
FIRST •
SECOND
THIRD -
”–FOURTH •
—
OTHER FLOORS(DESCRIBE) - -
DECK
GARAGE
• HOW MANY FLOORS? _ _ - ,
TOTAL:
's
■ FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLIIIIG UNIT(S) EVAPORATIVE COOLEER(S) GAS LOG(S) REFRIG.SYSTEMS;
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILERS) •
FIREPLACE INSF.RT(S) RINGE(S) MISC.(
COMPRE.SSOR(S) FURNACE(S)
DUCT(S) , GAS PIPE OUTLET(S) HEAT SOURCE: 0 ELECTRIC liGAS
• PLUMBING
BATHTUB(S) IAVATORY(S) URINAL(S) _ WATER HEATERS;
.DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC 0 GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE Otrrt.ET(S) SINKS) — WATER CLOSET(S) MISC.11.-----,
. INTERCEPTOR(S) SUMP(S)
1111111.111111 -
■ 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,an
further,that I am authorized by the owner of the above premises to perform the work for whidt the permit application is made. I
further agree to hold harmless the City of Federal Way as to any claim(inducing costs,expanses,and attorneys'fees Incurred In th
Investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the City c
Federal Way,but only where such Balm arises out of the reliance of the city,inducting its officers and employees,upon the accurst
of the information supplied to the city as f this application. q
NAME f TICLE w'"'/f► DATE: // r G
0 PROP OWNER 133 APPLICANT 0 CONTRACTOR
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