01-104390 City of Federal Way
Community Development Services Mechanical Permit #:01 - 104390 - 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: WYMAN FIty
Project Address: 29949 4TH'S Parcel Number: 692870 0010
Project Description: HVAC-Change out of a gas furnace
Owner Applicant Contractor
Victoria Wyman GATEWAY HEATING&AIR CONDITIO GATEWAY HEATING&AIR CONDITIO
29949 4TH AVE S GATEWAY HEATING&AIR CONDITIO GATEWAY HEATING&AIR CONDITIO
FEDERAL WAY WA 3802 AUBURN WAY N 3802 AUBURN WAY N
98003-3622 AUBURN WA 98002 (253)931-0610
Mechanical Valuation 2878 Over the Counter Permit Yes
•
Mechanical Fixtures
Descplp i ; A, mp",I. Qt'!iantity . Description ,;, Quantity :";ihi= Descriptor Quantity
Furnaces 1
A —
PERMIT EXPIRES May 14,2002,IF NO WORK IS STARTED.
Permit issued on November 15,2001
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 Feder C
Owner or agent: C3: /Date: ` I 4J 'O
(4, — o t 3 ; a (,>Vv1
,,,or RECEIVED N CONSTRUCTION PERMIT APPLICATION
> RY'- 1 5 2001 APPLICATION NUMBER: 6 _ - J U 4 31 Q - V
Nov APPLICATION NUMBER: - -
U" TAlt
APPLICATION NUMBER: - -
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**The following is required information—Please print(in ink)or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
�j ■ PROPERTY INFORMATION • / +
SITE ADDRESS: / q q ,41.1„, S, ASSESSOR'S TAX/PARCEL #: (c p
q z O-7--0- 0 0 1 0
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING 0 PLUMBING MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL 0 ENGINEERING FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description):
PROJjCT NAME:
■ PEOPLE INFORMATION
PROPERTY OWNER: NAME: ri p ) DAYTIME PHONE: /
V i ne i t:'� Yill '/l)�' ( 5352 - '7�si
0 Iqq OREq(STREET AgDRE55;CifY,STATE ZIP): P ie. o i
1-074-ti q cyc(z3
CONTRACTOR: NAME: DAYTIME PHONE:
_ -s'-j rk)CP i 11 (( ) - J ( •/0
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):u C r 4ti EVENING PHONE:
o LA f 13• Si)& Cr"-_1 1 3Q j qg ( ) - I
CITY OF FEDERAL AY BUSINESS LICENSE NUMBER: FAX NUMBER:
I q_-- a P-ice 7sE-,cam-a4- ( s3) )y -0 y6)
CONTRACTOR'S REGISTRATION NUMBER: //�� ,' 1 f,Q EXPIRATIONIODATE:/� /�/
(copy of card required) 6 f-_E to bug O_5 � O5 / Q /v
APPLICANT: N E: DAYTIME PHONE:
(b t-Ti / ffTl�C ( fr/cc s3 X 's/ -06 (O
MAILING ADDRESS(STREET ADDRESS;CITY,SjqE,ZIP): qErb� EVENING PHONE:
ot
- 8n� ��I�-���WAY/> .�U i�� 'kit g .�J O� ( ) -
RELATIONSHIP TO PROJECT: //��,,.,, FAX NUMBER:
IV
0 ARCHITECT 0 TENANT P�THER(DESCRIBE):, °'' CTO e?.._ (2 5)SOY -dj'af i.
EMAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER ❑ APPLICANT ONTRACTOR
■ DETAILED BUILDING INFORMATION//
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
¶JCs
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ t; V.
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE 0 TACOMA 0 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:
Indicate number of each type of fixture
MECHANICAL '
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTE�(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ 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 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 "ty as a part of this application. f
-----2/___G
NAME/TITLE: (VS rkia-- DATE: I (5-0/
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR 0 TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? 0 YES 0 NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES 0 NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES 0 NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES 0 NO
comp.,'inirTy nFVFI OPMENT SERVICES•33530 FIRST WAY SOUTH•P.O. BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000-FAX:753-661-4129