01-100156 City of Federal Way •
Community Development Services Mechanical Permit #:01 - 100156 - 00 - ME
3e5e0 1st Way S Inspection request line: 253.661.4140
Federal Way,WA 98003-6210 l� �l
Ph:253.661.4000 Fax:253.661.4129 (3:30pm cut-off for next day inspections)
Project Name: WILSON
Project Address: 1264 S 315TH Parcel Number: 787520 0250
Project Description: MEC-Replace existing gas furnace.
Owner Applicant Contractor
Lawrence J&Bemardita Wilson C&N REFRIGERATION C&N REFRIGERATION
1264 S 315TH ST 10905 25TH ST CT E 10905 25TH ST CT E
FEDERAL WAY WA EDGEWOOD WA 98372 EDGEWOOD WA 98372
98003-5357 (253)841-3134
Mechanical Valuation 2000 Over the Counter Permit Yes
Mechanical Fixtures
Description Quantity Description Quantity Description Quantity
Furnaces 1
Permit issued on
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 agent: Date: C.3( / l ‘ r0
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1
cn or ' CONSTRUCTION PERMIT APPLICATION
VV APPLICATION NUMBER: d / - l 0 Q /ST1 - /18
cAPPLICATION NUMBER:
�� ` APPLICATION NUMBER: - -
**The following is required information—Please print(in ink)or type**
i Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.'
- . - ■ PROPERTY INFORMATION
SITE ADDRESS: . Z ft;`( 5 31 5T3- .S l . ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
r` ■ PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING T. MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): Q c `A J C ,-5-1-- C)(�S ��r- -
PROJECT NAME:
■ PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
C-. ' ' -ice_ L— Ls:J i-%. (2-$3 ) ati4 - S`Y4-13
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
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CONTRACTOR: NAME: ) DAYTIME PHONE:
C ' (\\ 7--� .c,`q c-�a-��./..._ (2$ 84( -3 1341
MAILING'ADDRESS(STREET ADDRESS; ,STATE,ZIP): EVENING PHONE:
tis (c e(03 zs s-i-, c • A 9 e--t-v, L.,1. 19,i ( )sem -e__
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
- (2 53 ) yci$' -`7 6 4 5
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) 5 J/A) RCf1KX ^ _ _ I ` / G / G
(
APPLICANT: NAME: DAYTIME PHONE: •
( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER: •
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( ) - j
E-MAIL ADDRESS:
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: $ `,2_/ 0/.7D •
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
5) 4 Js.2
**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) 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 to the city as a part of this application.
NAME/TITLE: J C 5 �1��� DATE: \ ( 6 (f
0
❑ PROPERTY OWNER ❑ APPLICANT l`� CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION: BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO
rnMMi INm nFVFI OPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129