01-104310 •
City of Federal Way
Community Development Services Mechanical Permit #:01 - 104310 - 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: LINDSTROM�Je1
Project Address: 31925 36THSW Parcel Number: 873198 3270
Project Description: MEC,-Change out gas furnace
Owner Applicant Contractor
JAY LINDSTROM NORTHWEST PERMIT WASHINGTON ENERGY SERVICES CO
31925 36TH AVE SW 2320 1ST AVE SUITE 250 2800 THORNDYKE AVE W
FEDERAL WAY WA 98023 SEATTLE WA 98121 SEATTLE WA 98199
(206)282-4700
Mechanical Valuation 3000 Over the Counter Permit Yes
PERMIT EXPIRES May 8,2002,IF NO WORK IS STARTED.
Permit issued on November 9,2001
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 vat: G` Date: N c,./
yl uJ
I 2-
9
N-07 11 17:24 FROM-NORTHWEST-CASSIMAR 206-374-0834 T-654 P.01/05 F-746
CA.ar��s-a`. `=. N 4,/lls( APPLICATION NUMBER: O - • .' .
�.. .ro.. . / rte
(APPLICATION `
Nov 0 8 2001 APPLICATION : = ;" •. ti .
• 'The following is ter ��{on—Mease print(In Ink)or types*
Gi►Y OF F� ���►Y•
Pete Ei: trial,Fire Prevettl 4ittirtaiiirt4 Engineering permits may require a separate application. •
In PROPERTY INFORMATION
SITE ADDRESS: 1 q•�S •3 6 A'M S W ASSESSOR'S TAX/PARCEL#: 3 1 9 8 - 3 2' '3 n
• LEGAI.DESCRIPTION OF SU B)ECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): •
■ PROJECT INFORMATION
TYPE OF PRO]ECT(This application): ❑ BUILDING ❑ PLUMBING MECHANICAL 0 DEMOLITION
• 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
•PROJECT DESCRIPTION(Provide detailed desalption): — G 019 4 o cx 4 e.°./ 00 cJ 6 Tvl_ S 4-o yds
x YvI CA
•
!• wl. • .
,tPRO.TECTNAME: 1G\I L 11CI l'CA^1 •
* PEOPLE INFORMATION
PROPEEITYOWNER: NAME: t °A
Li S bavn 0J-3 ) - pL3y
I
HARM G ADOPESS ZSTREETADORM CITY.STATE.ZIP):
• '3 I i. S 36 v Ove S
CONI'RACBOR: MSC;
DAYr .
C,.! CSC0
(206 ) d'd• - (-19'00'
HMSO ADORE SADORGM QTY,STATE,MP): MONS MONO .
'OO l n v✓I lC #.J1 Sia Q ��I S�/ ) -
OTT OFMUM WAYemotes -- -' NUMBER FAX Y"`-
)
conn outs aEaSI7A110N NUIILER: ONIN AON we .
•
lb ,• c S 9 5 c w az / Y / oZ
APPLICANT: ' NAM DAYTATE moat
• )•
NAW ti MOSS MEET MOMS:QTY,STATE,ZIP} MONO PISMO
( )
P ..ATI WW1 TO PROMC%: FOX IARp
• ❑Altai/mar ❑TENANT ❑OTHER(DESCRIBE): _ ( ) •
M R=
CONTACT PERSON FOR.TttIS PROJECT: 0 PROPERTY OWNER 0 APPLICANT ONTRACrOR
r DETAILED BUILDING INFORMATION
EXISTING USE: S r P EXISTING BUILDING ASSESSED/APPRA SED VALUATION $ 3 COO 14
PROPOSED USE: -- PROPOSED VAWATION FOR IMPROVEMENTS:
• SPRINIIERED BUILDING? L]YES CI NO FIRE SUPPRESSION SYSTEM PRDPOSEO/REQUIRED:0 YES. Cl NO
WATER SERVICE PROVIDER, 0 LAKEHAVEN O HIGHUNE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDEI I 0 L•AKEHAVEN 0 HXGHWIE 0 PRIVATE(SEPTIC)
0 N 07- 1 17:24 FROM-NORTHWEST-CASS I MAR 206-374-0834 T-654 P.02/05 F-746
CON STRUGisun uni.s--
-VWAVER OF BEDROOMS: _ ESTIMATE?SELLING PRICE: $ • —_, -_..
%
■ PROJECT FLOOR AREAS
'J111 .
PROPOSED - •.FL. TOTA. FLOOR limIL.
EXISTING SQ.FT.
SECOND
• THIRD
FOURTH liJillir.1.111ra
OTHER FLOORS(f►ESCRIBE)
DECK
GARAGE
HOW MANY FLOORS? --
TOTAL:
1111111111.1
• Indicate nuneber of each type of fixture
1 MECHANICAL
EVAPORATIVE COOLERS) GAS LOGS) EFRIG.WOODSysru4(5,
AIROVE(S)
HANDLING UNITS) FAN(S) HOODS) MISS IL—..--
...)r...,_ Q(S)
FIREPLACE INSERT(S) RANGE(S)
— 5011-ER(S) IR(S) FURNACE(S) GASDUCTS) GAS PIPE OUTLET1:3S) HEAT SOURCE: ELECTRIC
� . • P W MBXNG
— BATHTUB(S) IAVATORY(S) URINAL(S) WATER HEATERS
DISHWASHERS) _ RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC 0 GAS
DRINKING FOUNTAINS) SHOWERS) WASH MACHINE OUTLET,GAS PIPE MLSC.( _
^� INY >IG�(S) • SINluS) WATER GLOStT(S)
SUMPS)
■ DISCLAIMMER/SIGNATURE BLOCK
I cmWy under penalty of perjury that the Information furnished by me Is true and coned to the best of my latowledBOv ie
further,that I am authorized by the owner of the above premises to perform the work for which th��T M
t application is made. I
further agree to hold 1>tanatess the City of Federal Way as to any daim(lnduding costae expenses► and filed tornere ees k%netthe►
Investigation and defuse of such claim),which may be made by any person,Including the undersigned,
City
naiad y,but only where
to we dry as arises
paout of rt this reliance
f f the dry,Including its offices*and employe,upon the aura
theof Information
NAME/><1TLE: • DATE: /1/at/ — 7-_c11
•0 PRO OWNEIt 0 APPLICANT An CONTRACTOR
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COMMUNITY XV Bir seances-3300 FWST WAY SOUTH•P.O.BOX 5715•MOM.WAY,WA 550634715•n3461-1000•FARC 25744614129