03-102627City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
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Project Name: WHITLEY �C
Project Address: 30057 10TH SW
Mechanical Permit #:03 - 102627 - 00 - ME
Project Description: Gas to gas hot waterheater changeout.
Inspection request line: 253.835.3050
Parcel Number: 515320 0416
Owner
Applicant
Contractor
James M Whitley
WASHINGTON ENERGY SERVICES CO
WASHINGTON ENERGY SERVICES CO
30057 10TH AVE SW
2800 THORNDYKE AVE W
2800 THORNDYKE AVE W
FEDERAL WAY WA
SEATTLE WA 98199
SEATTLE WA 98199
98023-8207
(206)272-4700
Mechanical Valuation..........................................567
Over the Counter Permit ...................................... Yes
PERMIT EXPIRES December 28, 2003.
Permit issued on July 1, 2003
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:
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CITY OR CONSTRUCTION PERM PLICATION
Federal Way APPLICATION NUMBER:
APPLICATION NUMBER:
PPLIC'ATION NUMBER:
"The following is required information — Please print (in ink) or typ
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
SITE ADDRESS: 125 q l 1 7W v W S U—) ASSESSOR'S TAX/PARCEL 4: 1 'Z40 _
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): o BUILDING L) PLUMBING MECHANICAL 0 DEMOLITION
0 ELECTRICAL o ENGINEERING O FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME;
PROPERTYOWNER: NAMt: —
TL� , AynmiN E
r'
M61UNG ADDRESS (STREET ADORFSS- CITY, STATE, ZIP): '•• •• ...._
CONTRACTOR: NAME;
DAYTIME PHONE: �
(`za)4)) z e z..
MAtt}NG RF -SS (STRUT ADDRESS;
CITY, STATE, :
ZIP 7y ..—�
^^LL77•. 1GYY1 CP/'f7/l I Y/" �L � ).....�(Vfn1N<i vMUNE'
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER;
FAX NUMBER:
_ ` I
C54T-O -TORS REGI$?ION NUMBER;
1 EXPIRA7TON UAIE:
mdcard, ) tA—)>�
APPLICANT:
NAME:
Y`
MAILING ADDRESS (STREET AWRES5; C1if, STATE, ZIP): --
RELA770ny14IP 7.0 PROJECT: '"' -- -----
O ARCHITECT o TENANT —O OTHER ( DESCRIBE). _
CONTACT PERSON FOR THIS PROJECT: u PROPERTY OWNER
EXISTING USE:
PROPOSED USE:
SPRINKLERED BUILDING?
WATER SERVICE PROVIDER:
u APPLICANT o CONTRACTOR
(DAYTIME PHONE: — ..-
` � I
EVENING PHUWE:
FAX NUMSEA;
(
E)USTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED VALUATION FOR IMPROVEMENTS: i
O YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: O YES o NO
O LAKEHAVEN O HIGHLINE o TACOMA O PRIVATE (WELL)
SEWER SERVICE PROVIDER: O LAKEHAVEN 0 HIGHLINE
£0 "al LE3L£ tpzv SZb
O PRIVATE (SEPTIC)
ZZfIEI Wd t'Z: ZT £00Z-SZ-Nnr
**NEW RESIDENTIAL CONSTRUCTION ONLY"
OF BEDROOMS:
ESTIMATED SELLING PRICE:
M PROIECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED . FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAQE
HOW MANY FLOORS?
TOTAL.,
Indicate number of each type of fixture
12"')"3—'s
MECHANICAL ' uw,1(1 d..�-
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILIER(S) FIREPLACE INSERT($) RANGE(S) MISC. ( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC )<GAS
PLUMBING
BATHTUBS) LAVATORY(S) URINAL(S) WATER HEATER(S)
DIsHWASHER(S) RAINWATER SYS. VACUUM BREAKERS) n ELECTRIC n 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 BLC
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 Balm (including costs, expenses, and attorneys' fees Incurred in the
investigation and defense of such daim), 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 suppiled to the city as a part of this application.
NAME/TITLE: DATE: �P12 l d3
a PROPERTY OWNER a APPLICANT CONTRACTOR ''
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COMMUNri'Y DEVELOPMENT SERVIQ=S • 33530 FIRST WAY SOUTli • PO BOX 9718 • FP,DIiRAL WAY, WA 98063-9718. 2S3-661-4000 • FAX: 2S3-661-4129
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