01-103676 City of Federal Way Mechanical Permit #:01 - 103676 - 00 - ME
Community Development Services
3S
Federal3530 Way WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: CURTIS
Project Address: 33936 28TH SW Parcel Number: 010920 0550
Project Description: MEC-Replace 80,000 btu gas furnace.
Owner Applicant Contractor
Frank Alan Curtis NORTHWEST PERMIT WASHINGTON ENERGY SERVICES CO
33936 28TH PL SW 2320 1ST AVE SUITE 250 2800 THORNDYKE AVE W
FEDERAL WAY WA SEATTLE WA 98121 SEATTLE WA 98199
98023-7716 (206)282-4700
Mechanical Valuation 2900 Over the Counter Permit Yes
Mechanical Fixtures
Description ,�, 'Quantity Description '. .IQuantity Description �Quantityl
Furnaces 1
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 propertyand
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: 6& Q 2 Date:icth
f) e G • F, -,/ci O G / v - / v 0 I G c,./
SEP;19-01 17:39 FROM-NORTHWEST-CASS I MAR 206-374-0834 T-247 P.03/08 F-137
�:7E.r<Fit— APPLICATION NUMBER: al - .L p_ 5.63.40? 1t
f� APPLICATION NUMBER: — ,r+,; ';, 4 —
• /..-tcycA
APPLICATION NUMBER' _ — _. ..-r '" _ d,
■*The following is required Information—Please print(in ink)or types
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
Q f�
N PROPERTY INFORMATION
SITE ADDRESS: 3-2 3 /3 b Or 04 £I J "} ASSESSOR'S TAX/PARCEL ft: Q 1 Q 1 2 D- Q S S L)
• LEGAL DESCRIPTION OF SIJB]ECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): '
N PROJECT INFORMATION .
TYPE OF PROJECT(This application): 0 BUILDING 0 PLUMBING 1MECHANICAL O DEMOLITION
• 0 ELECTRICAL 0 ENGINEERING❑ FIRE PREVENTION SYSTEM� 9e4..c. ,arvietco,.PROYECT DESCHIPT/ON(Provide detailed desc ipption):__ VR ( e ..A8�l^J
. ___._._.___.______________
____ ,
��,,,�,���/' 1(A V •C ...
.. •-__PROJECT,NAME;,._ YJ 6"�J� �
• PEOPLE INFORMATION •
PROPERTY OWNER: KAHB: DAYnMEPRONE:
AV1 Aar (a ?) J W - ?JFS
• MAILING ... . . -(ntt1' ATE, �o4 W / 7(fG Z- 7
?3 , 2c? w
CONTRACTOR: IlAin Comm MOM -
174124 ADORE ► =" ADDRESS;CITY,STATE,LP): LIMING PHONE:
a'$"QO 1 A , /A i / i ' et IL..' d l ( ) --
OTT OF FEDERAL WA =I •- NJI1 ER: Foix II UtIeet.
~ G EXPIRATION DATC;
OOIHRACfaR'SRFR .IARrIOHNIlMBER s q 0 c to o1 / 16 / 61,
APPLICANT: ' ,�j� . d►mME PHONE:
( )
w
MAILING ADD �DREbSC Q1,SAF, % ENE(aNG PHONE;
REIATIONSHIP TO PROJECT: FAX NUI18
CI ARCHITECT 0 TENANT 0 OTHER(DESCRIBE):_ ( )
EMAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER 0 APPLICANT fiCONTRACrOR
• DETAILED BUILDING INFORMATION
EXISTING USE: 1) fi / EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ p,n'
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $, v l v V •
SPRINICLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:CI Yis, ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN .0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
SErtil9-01 ,, 17:40 FROM-NORTHWEST-CASSIMAR 206-374-0834 T-247 P.04/08 F-137
` Tin t•ESIDENTIAL wi vvi swvs wv..v.....
NUMBER 06 BEDROOMS: , ESTIMATED SELLING PRICE: $ '
IIIMIIMIII ■ PROJECT FLOOR AREAS
Fi001t EXISTING .FT. PROPOSEv ,FT. TOTAL _
BASEMENT
FIRST •
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
• 'DECK
GARAGE
HOW MANY FLOORS7__,� _ --
TOTAL: -
•
E - ■ FIXTURES
P. Indicate number of each type of fixture
MECHANICAL
l'. AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEMS]
BBQ(S) ., FAN(S) HOODS) WOODSTOVE(S)
COMPRESSOR(S)
INSERT(S) RANGE(S) MISC.(
BOM PESRES50 KCS)ER(S) �_ (� FURNACES)
� _ J
DUCT(s) GAS PIPE OUTLET(S) HEAT SOURCE: Q ELECTRIC .OGAS
PLUMBING
BA B(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC LI GAS
DRINKING FOUNTAIN(S) _ SHOWER(S) WASH MACHINE OUTLET MISC.��_
GAS PIPE OUTLET(S) , SINK(S) WATER CLOSET(S)
. INTERCEPTOR(S) SUMP(S)
■ DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of peaiury that the information furnished by me is true and correct to the best of my knowledge,an
further,that i am authorized ized by the owner of the above premises to perform the work for wihids the permit application is made. I
further agree to hold harmless the Qty of Federal Way as to any claim(including costs,expenses,and attorneys'fees Incurred In tb
Investigation and defense of such daim),whirls may be made by any person,Including the undersigned,and filed against the aty a
Federal Way,but only where such claim arises out of the reliance of the dty,including its officers and employees,upon the acwrac
of the information supplied to the dty as a part of this application.
NAMEMTLE: �` — _ DATE: ANY r
❑ PRO OWNER ()APPLICANT ❑ CONTRACTOR
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GOHftIJHf Y OEYELOFf ff SEnvicES•33530 FIRST WAY SOUTH•P.O.80X 9718•MOW_WAY,WA 9(0639718.253-661-4000•FAX:2S3 ,61.4t29