01-104502 City of Federal Way Mechanical Permit #:01 - 104502 - 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: JACKSON
Project Address: 610 SW 308TH Parcel Number: 178880 0350
Project Description: MEC-Replace gas furnace.
Owner Applicant Contractor
Ben H&Luana G Jackson ALL SEASONS INC.-CONST CONT ALL SEASONS INC.-CONST CONT
610 SW 308TH ST 5118 N HIGHLAND ST 5118 N HIGHLAND ST
FEDERAL WAY WA TACOMA WA 98407 TACOMA WA 98407
98023-3959 (253)879-9144
Mechanical Valuation 1800 Over the Counter Permit Yes
Mechanical Fixtures
Description -Quantity Description !Quantity Description ,Quantity
Furnaces 1
PERMIT EXPIRES May 25,2002,IF NO WORK IS STARTED.
Permit issued on November 26,2001
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the . 11 be in accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Wa, 9
Date: 1, -- Q
Owner or agent: l o
I�
.:: ECEIVED
aTY°I. _ CONSTRUCTION PERMIT APPLICATION
FSE PL-- NOV 2 6 2001 APPLICATION NUMBER: C�i - 16 Y-5 0Z_H8
�lv FEY APPLICATION NUMBER: _ _ - _ - - - -
./ bl I Y OF FEDERALEP AY APPLICATION NUMBER: - -
BUILDING DEPT.
fi1/‘ 1/41
**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.
■ PROPERTY INFORMATION
SITE ADDRESS: (PIC) (--1--) a)(2)- r- ASSESSOR'S TAX/PARCEL #: I -" 8 B 8 o O 3 S O
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): 0 BUILDING 0 PLUMBING 't ''"EHANICAL 0 DEEMOLIT ON
. 0 ELECTRICAL 0 ENGINEERING❑
PROJECT DESCRIPTION(Provide detailed description):
waR �Ace- OLD Fu Q N a cG- w t t i4 A CcG 1� Eau
GA.s
cc ( 5•CIA.f WI/
PROJECT NAME: ) 4C ICE -
■ PEOPLE INFORMATION
DAYTIME PHONE:
PROPERTY OWNER: NAME: �X53) 94(v - IS(v S
MAILING ADDRESS(STREET ADDRESS;CITY,
SSTAT )
(.91 O ()) 3Ua'kh STATE, u,..)Q c),)
P �€;V`Z
DAYTIME PHONE:
CONTRACTOR: NAME: (��) -q
i\-U- Asp1�`J /NC, (2E___________21 --'
PHONE.
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): )
FAX NUMBER:
Jit A 1 e0Hl-. /•-•0 ....47T�c 'u
c ,3. t_,:` g8403--
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: - F(EXPIRATION
j)8-4-c� - 914.
( — — — — — — — — EXPIRATION DATE:
CONTRACTOR'S REGISTRATION NUMBER: / / Q
.4 1, 1 c.. = i. 4 .3 Q 5 S 12_
DAYTIME PHONE:
APPLICANT: NAME: (Z53) E5 - /C/4'
LL 5L ISS o iU S /N L EVENING PHONE:
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
FAX NUMBER:
3)8
77 �2
RELATIONSHIP TO PROJECT: FAX
N 3) T -
❑ ARCHITECT 0 TENANT 0 OTHER(DESCRIBE): E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER 0 APPLICANT El/CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: p;4�� EXISTING BUILDING ASSESSED/APPRAISED VALUATION ¢
f,
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: ¢ I SOd
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES 0 NO
WATER SERVICE PROVIDER: 0 LAKEHAVEN 0
ACOMA 0(SEPTIC)
(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 FIIGHLINE 0PRIVATE
**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.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILERS) FIREPLACE INSERT(S) RANGES) MISC.( )
T— COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: 0 ELECTRIC 0 GAS
PLUMBING
BATHTUB(S)
LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) 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 and defense of such daim),which may be made by any person,induding tine undersigned,and filed against the City of
Federal Way,but only where such dai� tlu
out of the reliance of nduding its officers and employees,upon the accuracy
of the information su *n th rite a� a/n sa ke anniirafinn
�
NAME/TITLE: _
(DATE: _ II- 2_1-01_OI
❑ PROPERTY OWNER 0 AP &c NT di/CONTRACTOR
IROFFICEiUSE ONLY:
REPAIR ❑ TENANT IMPROVEMENT
��EtN T
�- ❑ADDIION ❑ ALTERATION �LOT.SI�E
NSUS CODE
ZONING DESIGNATION: BUILa NG SHELL ONLY? 0 YES D NO
C PLAN? ❑ Y'ES q,SIO
Q�IP�LAN`OESIGNATION - � � ��,
EC1ION TOWNSHIP RANGE NEW DDRE SREQUIRED?,.. ❑;YES ❑ NO'.
PLATTED LOT? ❑ YES fl NO CHANGE OF USE? ❑ YES 0 NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129