01-104299 •
•
City of Federal Way Mechanical Permit #:01 - 104299 - 00 - ME
Community Development 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: NOMIYAMAe1
Project Address: 32020 40TH'SW Parcel Number: 873190 2630
Project Description: MECH-Changeout gas furnace for existing residence.
Owner Applicant Contractor
Frank K&Betty Y Nomiyama WASHINGTON ENERGY SERVICES CO WASHINGTON ENERGY SERVICES CO
32020 40TH PL SW 2800 THORNDYKE AVE W 2800 THORNDYKE AVE W
FEDERAL WAY WA 98023-2447 SEATTLE WA 98199 SEATTLE WA 98199
(206)282-4700
Mechanical Valuation 4000 Over the Counter Permit Yes
- Mechanical Fixtures
ir ,,De cription. JQuantityl Descr ption K . uantity Description Quantity
Ful laces 1
PERMIT EXPIRES May 6,2002,IF NO WORK IS STARTED.
Permit issued on November 7,2001
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: C asa.s Date: chic /
NOV-05-01 21:17 FROM-NORTHWEST-CASSIMAR 206-374-0834 T-629 P.01 F-706
^•- ``� Nta !IwoAPPLICATION NUMBER: -
APPLICATION NUMBER: ...,.::: ,-
f �www�
- APPLICATION NUMO
**The following!s required information-Please print an Ink)or types*
�7' r l• ii Fire Prevention Systems and Engineering permits may require a separate application. •
•
a PROPERTY INFORMATION
SITE ADDRESS: 3P-OD-O �L S(/t) ASSESSOR'S TAX/PARCEL #: r --/ 3 .1. c.) — a D Q
- LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): .
• ■ PROJECT INFORMATIONN -
TYPE OF PROJECT(This appli cation): 0 BUILDING ❑ PLUMBING CHANICAL 0 DEMOLITION
• 0 ELECTRICAL 0 ENGINEERINGFIRE PREVENTION SYSTEM
M
<< •PROJECT DESCRIPTION(Provide detailed description): I - d-1.-4 • r . `s. 1 A , `
•
r
4.=S. i,
■ PEOPLE INFORMATION
PROPERTY OWNER: NAME: p, wDAYTIME NOW
(.. 15 we r�; case gag -
MAIuNG,1DORESs . ADDRESS;amY,STATE,ZIP):
- • -.A....& 1,10x3
CONTRACTOR: „I • oAr m€PRONE: -
J(�M,� ,r CIA-' t ' (' );E 'l7 o p
MAILXI$G,WORM '•,•i •• .wti CITY,STA �rr'I
EVENING MORE:
QTY OF FEDERAL WAY LICENSE NUMBER - FAX NUMBER
COBRA roRS R6Q5111ATION NURSER '`,•- --"l" - - -
i' t
VAS 1'T I ES °/- GW DfPG1Ai7oN DAIS:
APPLICANT: NAME: -
DAYTIME Pf1014E;
CU MA4,4141-1=2-w
r�ADDR ;c v STA,,IIP) - EVENING PRONE:
L • •
RELATION 910 PROJECT: r FAX NUMB: ••
0 AR«irTEGT 0 TENANT OTHER(DESCRIBE): ( ) _
•
E44-------78,LADORFSS:
•
CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER 0 APPLICANT "NTRACTOR
X DETAILED BUILDING INFORMATION
EXISTING USE: - EXISTING BUILDING ASSESSED/APPRAISED VALUATION ¢
PROPOSED USE: .— PROPOSED VALUATION FOR IMPROVEMENTS: $ "e"(D0 D. cab
SPRINKLERED BUILDING? ❑ YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES 0 NO
WATER SERVICE PROVIDER: Q LAKEHAVEN •❑ HIGHLINE 0 TACOMA 13 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN Q HIGHLINE 0 PRIVATE(SEPTIC)
NOV-05-01 21:17 FROM-NORTHWEST-CASSIMAR 206-374-0834 T-629 P.02/12 F-706
11 =�{W/y�R OF BBDItOOMS: ESTIMATED SELLING PRICE: f •
■ PROJECT FLOOR AREAS
•
FLOOR EX/STING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST •
SECOND•
THIRD •
•
FOURTH
OTHER FLOORS(DIiSCRIBE) --
DECK
•
GARAGE -- -
HOW MANY FLOORS?
TOTAL: , _
r FIXTURES
•F�
{Q Indicate number of each type of fixture tib,? /~/' I MECHANICAL
•
•
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILERS) FIREPLACE INSERT(S) RANGE(S) MISC.
..`�, COMPRESSOR((;) F FURNACE(S)
DtiCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: 0 ELECTRIC -.AS
PLUMBING
BATHTUB(S), LAVATORY(S) URINAL(s) WATER HEATER(S)
DISHWASHER() RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC 0 GAS
DRINKING POUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(s) SINK(S) WATER cLosEr(s) Misc.r
_,,, INTERCEPTOR(S) SUMP(5) •
•
■ 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 au hortced 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 Wa as to any claim(including costs,expenses,and attorneys'fees Incurred in the
B+vestlgathon and defe e.of dr claim),whid',ardy • ade by any person,including the undersigned,and filed against the City of
Federal Way,but 9nly where su. claim arses out o + c reliance of the city,including its officers and employees,upon the accuracy
of the informau supplied to the . part • i is application.
NAME DATE: > /c/C)
CI PROPERTY 0 • APPLICANT 07% CONTRACTOR
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COMMUNNYGEVIOPt93'LT=vices•33530 FIRST WAY SOuili•P.O.90XC9716•NERAL WAY,WA 98063.9718.253-661-4000•FAX:253 6614129