01-104185 City of Federal Way Mechanical Permit #:01 - 104185 - 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: CIOTTA
Project Address: 1439 SW 296TH 5t Parcel Number: 062104 9003
Project Description: MECHANICAL-Gas furnace changeout and(2)gas outlets in existing residence.
Owner Applicant Contractor
Matthew R&Julie A Ciotta CITY SHEET METAL CITY SHEET METAL
1439 SW 296TH ST 4202 AUBURN WAY N #8 4202 AUBURN WAY N #8
FEDERAL WAY WA AUBURN WA 98002 AUBURN WA 98002
98023-3411 (000)852-2174
Mechanical Valuation 1500 Over the Counter Permit Yes
Mechanical Fixtures
° M...°..'r,`x[ escription Quantity 1escrption ;` Quantity .Description :,44:P2 Quantity
Furnaces 1 Number of Gas Outlets 2
PERMIT EXPIRES April 29,2002,IF NO WORK IS STARTED.
Permit issued on October 31,2001
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy an. - . - will be in accordance with the laws,rules and regulations of the State of Washington and
the City of Fe,-ral Way.
Owner or age t: /u/ (,(.!i[/ Date: /b-3/- ZD 0 /
AJi —I -c7 ( `')
/
JjU1fE17..F1L.
G RECEIVED CONSTRUCTION PERMIT APPLICATION
ffiziErZFAPPLICATION NUMBER: LL - Z( 1cJ�00 ,4i
OCT 3 1 ?001 APPLICATION NUMBER: - - _ _
APPLICATION NUMBER`: -
(ji I Y Oh i LDLeiAL WAY — — — — — — — — — —
**The folloQVIe information-Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
5 �.W\ 07.9\(.6441 • PROPERTY INFORMATION
SITE ADDRESS: 1 o< O ,S ., ASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PRO]ECT INFORMATIO
TYPE OF PROJECT(This application): ❑ BUILDING I=1PLUMBING L7 MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): (P -L /Y C C,((",S 4 /{' 6U i
PROJECT NAME: �� art-A.
. - I. PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
\INO. U3 °- C)+} L (ao(0 ) 12-8 -1- 9-J
MAILING ADDRESS(STREET ADDRESS;QTY,STATE,ZIP):
t LF3C S W -3\a -C-`LV
CONTRACTOR: NAME DAYTIME PHONE:
C Shy 1'Y�A---4 ( Z>3) ,Rs-z.. - 2_n t
MAILING ADD (STREET ADDRESS;QTY,STATE,ZIP):" EVENING PHONE:
a.0 INL � U.lL k)0 ( ) saw
QTY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
- - (26-3 ) 3S2-- 2.-i Z
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) 0--- 1 1 _ _E111 �. 3 ,:1--i _ I / a l / 2-co z
APPLICANT: NAME: DAYTIME PHONE:
I 't CSM X 11 4,,,,_ ( 5) � Z - 21 �-
MAILING ADDRESS(STREET ADDRESS; TATE,ZIP): EVENING PHONE:
( )
I RELATIONSHIP TO PROJECT: � � FAX NUMBER:
❑ ARCHITECT ❑ TENANT IJL'5THER(DESCRIBE): CCTV i--e.) ✓ ( ) -
�/ E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ID PROPERTY OWNER El APPLICANT E1 CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ l -5737)
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: El LAKEHAVEN El HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY** ,
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
•
■ PRO3ECT 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.( e )
COMPRESSOR(S) I FURNACE(S)
DUCT(S) '-?\ _ GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC I 'GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ 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 daim(induding costs,expenses,and attorneys'fees incurred in the
investigation andd_efense of such daim),which may be made by any person,induding the undersigned,and filed against the City of
Federal Wa •ut only ere such claim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
of the inf. ation sup r lied to the dty a a part of this application.
NAME/TITL.: I'WI A/VV1/1}-'1/1 �/ DATE: 1 0 -d I-Cyv
❑ PROPERTY OWNER EE1 APPLI NT U✓ CONTRACTOR
`.FOROFFICE:USE:ONLY
SCDNEW:? g_ ADDITION ❑ALTERATION :REPAIR+- TENANT IMPROVEMENT
CENSUS',.CODE: LOT-SIZE
ZONING DESIGNATION: •BUILDING SHELL ONLY? :.❑ YES ❑ NO
COMP.PLAN DESIGNATION BASIC PLAN? ❑ S(ES` "❑ NO'
SECTION, _ TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? "❑ YES ❑ NO CHANGE OF USE?. ❑YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129