01-102806 City of Federal Way Mechanical Permit #:01 - 102806 - 00 - ME
CotmnunityDevelopment 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: OLSON pJ9,
Project Address: 29637 21ST"S Parcel Number: 931510 0080
Project Description: MEC-Replace oil furnace with gas furnace and electric water tank with with gas hot water tank,
including gas piping.
Owner Applicant a Contractor
Robert E Olson PUGET SOUND FURNACE CO PUGET SOUND FURNACE CO
29637 21ST AVE S PO BOX 26331 PO BOX 26331
FEDERAL WAY WA FEDERAL WAY WA 98093 FEDERAL WAY WA 98093
98003-4245 (253)874-8014
Mechanical Valuation 3200 Over the Counter Permit Yes
Mechanical Fixtures
y c Description ,T'i IQu' ntity yin. L'Description JQuantity W,` ; — -'°bescription ' ° '`<IQuantity)
Furnaces 1 Gas Piping 1
PERMIT EXPIRES January 13,2002,IF NO WORK IS STARTED.
Permit issued on July 17,2001
I hereby certify that the above ' rmation is correct and that the construction on the above described property and
the occupancy and the use will e in accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
0
Owner or agent: Date: -2-1/ `"
Ae_....c-AA, I Ffil V‘. I 7 -- /5 - c) < c.....c..J
I
C,'o. G_ RECEIVEDEIKEIL_ CONSTRUCTION PERMIT APPLICATION
uvFIY
APPLICATION NUMBER: 0 C - I D Z 70 _In&
1 Mit 1 7 ?(1 i APPLICATION NUMBER: - -
APPLICATION NUMBER: - -
Cil yOFFL:---
BgD�� WAY
**The following info
rmation—Please print(in ink)ortype**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
/ • PPERTY INFORMATION -
SITE ADDRESS:O29 37 J/ '91/Q• SiJ ASSESSOR'S TAX/PARCEL #: i 3 I SL v - O 0 0
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROTECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING )I MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): C2/t. r Gyj ek)^'Vd /o- f1.4/,"1/.61 f1.4/,"1/.6p4- 6L 6-e t,& 70 6'0 Co...'vt /o.✓ /^.,1-71 frL A.--/ 9/ //f 1 .
PROJECT NAME: O LSO,J .
• PEOPLE INFORMATION
PROPERTY OWNER: NAME: PHONE:
Pi d!,f°n� (VVr ) zr/ -o ioj(/6
MAILING 71ADDRESS
3 7 REST ADDRESS;2 ,STATE,ZIP): mdfcY�L, • la 4)`‘
CONTRACTOR: NAME: DAYTIME PHONE:
fGi . e. .f�u�o fWili-e f c- ' ( 7j3 ) 7Y - fier-Vo
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: �/
1'a• .Pi!' oZ 6.3J/ / I- 4y 1..-1, )c7-1 (Zig ) erT)/- Fa/
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
- - ( c-)-9-a - p(tS7
CONTRACTOR'S REGISTRATION NUMBER: /� '` EXPIRATION DATE: 1
(copy of card required) ( w r. £ f 0 ' O z f, I� /G2 / °`
APPLICANT: NAME: ,.... DAYTIME PHONE:
.. cow- le, _14,1,.r&----1 -- iciar ,c,,, ..fiti4i..6 Ai. (101 ) 2 y� - V,54)
1 MAI G ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
Tt i Ai' v2 6E/ .9.L �A1 . x°9,3 ( Lo3 )F7f/-�1fL
RELATIONSHIP TO PROJECT: " FAX NUMBER:
i ❑ ARCHITECT ❑ TENANT J1 OTHER(DESCRIBE): a '7 ,/ IL • ( C„)L L 7
E-MAIL ADDRESS:
I
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ 12 GUS
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHUNE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER'SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
. ■ PROJECT FLOOR AREAS -
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
■<'FIXTURES . .. .
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.(
COMPRESSOR(S) I FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) I WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC CP GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(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,and
further,that I am authorized 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 Way as to any claim(including costs,expenses,and attorneys'fees incurred in the
investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the City of
Federal Way,but only where such claim arises out of the reliance of the city,including its officers and employees,upon the accuracy
of the information supplied to the city as a part of this application.
NAME/TITLE: ✓ 2c A' -o"" "9 DATE: -2'42
❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
FOR OFFICE USE ONLY:
Cl NEW El ADDITION Cl ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES Cl NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO
COMM!INITY BFVFLOPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718-253-661-4000•FAX.253-661-4129