01-103675 P.' I
City DevelopmenteAmMechanical Permit #:01 - 103675 - 00 - ME
Communityay
Services
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: HAGBERG el rr f • _ t i, r %(�y
Project Address: 3311 SW 319TH'Unit26a �1,:- t4 1/?M (,j <13 l, u ' Parcel Number: 698000 0260
Project Description: MEC-Replace 60,000 btu gas furnace; install fireplace insert with gas piping.
Owner Applicant Contractor
Arthur M&Emelie H Hagberg NORTHWEST PERMIT WASHINGTON ENERGY SERVICES CO
3311 SW 319TH PL#26-C 2320 1ST AVE SUITE 250 2800 THORNDYKE AVE W
FEDERAL WAY WA SEATTLE WA 98121 SEATTLE WA 98199
98023-2244 (206)282-4700
7 ler-2/ dk kta / /%%i 55
Mechanical Valuation 5200 Over the Counter Permit Yes
Mechanical Fixtures
1 ADescription ' ti Quantity ...,. Description; . " Quantity ° ;,,,t, Description-;:,--„,-. 40 Quantity
Lireplace Inserts 1 Furnaces 1
4//// —/d//2% (
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.
n �j
Owner or agent: a �✓-\,C/� Date: 1
14(D k ,
/ ✓,
n,� 1
.
V 1
' SEP-19-01 17:39 FROM-NORTHWEST-CASSIMAR 206-374-0834 T-247 P.01/08 F-137
averIECI
NUMBE: Q 1 tQ 4. 25'-
\TIo FIV APPLICATION NUMB _ ..:.... .4, `' J
APPLICATION NUMBER: _.� _ "2.Z:• " -,...
**The following is required information—Please print(in ink)or type**
Please note: EIi:ctxical,Are Prevention Systems and Engineering permits may require a separate application.
111111.111.1111 ■ PROPERTY INFORMATION C �y /�
SITE ADDRESS: e3 3 1 \, 5 ) ?7I '1r,. P 1 �`1 6�OR'S TAX/PARCEL#: .6 /!Q .Q� /' c).6 11
• LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): ,
• - . " ■ PROJECT INFORMATION .
TYPE OF PROJECT(This application): r (7 BUILDING 0 LUMNGVMLCHAICALEML TON
Q ELECTRICAL ❑PBITION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): ( C4104 .a n Ui O • Q r's
` rrii 4t.ldo
N—I M - I f CL ' Ae J PIO
•
,.' PROJECT NAME: fl + I A �e V
11111111.1111111111 - ■ PEOPLE INFORMATION _ '
DAYi7ME PHONE:
PROPERTY OWNER: ! S d�� �'I .S
A , ,A ' 2 ;
cONTRActOR: i7----"'-----
is [AIMS PHONE:
• WCSc.O _(0/o6) as" 4 0.
Han u G M]OP. ss ADDRESS•arc.srAW.ZIP): ��r 9� EVEIRNC'NOM
. • 800 "t di L _ ,Q 1L,
-
CM of I D RAL WAY eUSYNess NclMBER: FAR MJM _
- (
CON TRACTORS REGISTRATION NUMBER; EXPIRATION DATE:
� !� � .�.� � i.. C w oak _!_a0:1_.
,___ W--.�
APPLICANT: NAME: DAYCIME PHONE: -
r
HAILING��srR.EET�ooRFSs:arc.bl'A7F,r,PJ: EYENiNG Pl10H� -
(
RDRDAn of iu PROJECT: FAX NUNa~
0 ARCHITECT 0 TENANT 0 OTHER(DESCRIBE): ( -
" NON.ADDRESS:
CONTACT PERSON FOR THIS PROJECT: Li PROPERTY OWNER 0 APPLICANT CONTRACTOR
a DETAILED BUILDING INFORMATION
EX/STlNd USE: S r1 ...- EXISTING BUILDING ASSESSED/APPRAISED VALUATION S. ,
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: ; eel _Sq ?%)O
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES. ❑NO
WATER SERVICE PROVIDER: 0 LAKEHAVEN •❑ HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
SEP-19-01 17:39 FR01A-NORTHWEST-CASSIMAR 206-374-0834 T-247 P.02/08 F-137
' fI RESIDENTIALOONSTRUCTWWNun-z--
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ —_
1111011.111111 ■ PROTECT FLOOR AREAS
•
FLOOD, EXISTING SO.Fr. PROPOSED SQ FT• �� TDOTAL ,,
ISASEMENT
FIRST
SECOND
• I-THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOC RS?
TOTALS
—
■ FIXTURES
Indicate number of each type of fixture
MECHANICAL
a _ AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) , GAS LOG(S) REFRIG.SYSTEMS)
• _ BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
t FIREPLACE INSERT(S) � _ RANGE(S) MISC.(_
COMPRF.SSOR(S) _____IL
" FURNACE(S) HEAT SOURCE: 0 ELECTRIC ❑GAS
DUCT(S) ^I GAS PIPE OUTLET(S)
PLUMBING
BATHTUBS) LAVATORY(S) URINAL(S) WATER HEATERS)
•
DISHWASHER(S) - RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC 0 GAS
DRINKING FOUNTAIN(S) SHOWER(S) ^ WASH MACHINE OUT1ET
GAS PIPE OUrl.ET(S) SINK(S) WATER CLOSET(S) MISC.( ,
INTERCEPTOR(S) SUMP(S)
■ 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!am authorized by the owner of the above premises to perform the worts for which the permit application is made. I
further agree to hold Charmless the City of Federal Way as to any daim(including costs,expenses,and attorneys'fees incurred In th
Investigation and defense of such claim),width may be made by any person,Including the undersigned,and filed against the Cithe ta
Federal Way,but only where such claim arises out of the reliance of the city,including its officers and employees,upon
of the information supplied to the aty as rt of this application.
/'Q
iVAMt:/7ITiEa /a - .._ DATE: '2-1 ;''.11" < / r�/. ...
(3 PROPERTYOWNEFt la APPLICANT ❑ CONTRACTOR
l._.t_��i].J.rr.!1 .�i. 5 ! ����,Y::.1 yy_ ` /• L � �y. r y 7 �� �.-- �,
En ;t...:,, ' .ieJ.931's ffi'kf� r,,f_ rLti,3,l�rr3���}. -77. "-1.;..�Y�r�181 T^y v\11 , lrtx ,/xT NiiliC• i,i
� 1^• ! Z'51, �r '':r{ :'' rL� . "+ ,_� hh�'In r�N . 7 7 _ ,,,,,.r,
, ' ' r .iNltru ,oC 4ti' r Lb.t) oh'L • h' f -..1 L l':.("6-.",;'i".; .
rr::•6-'!"1:1;C.?.' 11... tr�)�J'St1w�'^lY i1, ; 1 lir�S ?-„�(N.r���...n7��.��� � A � l
75�?� 'LI'I IJ S ` '.4-•:-.
I I
�`6;5 r 1 � frli I'. 1..y11.'t(t 'h \;Or Jr r• 11 Ir,.I .) .'' II.
� rlrk�^, �f�•4�-�-(�ll�ptD.L'4f.�J�y�ly ti�5.rrr[,i+ � {'`
'.i ,( { 3 ',y,'rd�"r�i_f'y�T :Hi.i, irk 1ek1y 3-t�-i' ),;ili10 Y r 1 i ( 1 0) hi
�. marl(ii � +lyl :.'� (•�4.��`alE ri� ,.ci��,.x,l.�:�u.�.;b ( .1. .r. r.._�.1� ?fie '
Firr.Y�l,:ilib 'F f.-; '',',HI ii);cii: illy lg. s4!ItJi�? E I.�) 1Z. r� r�� ..
,r.
tXXIM lNnY DEVELOPMENT SERVIC S•33530 FIRST WAY SCUM-P.O.Box 9715•FU H AL WAY,WA 900634715.253461-4000•PAX:25361-4129