07-10585610- 22 -'07 10:24 FROM- T -720 P002/010 F -534
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Federal W� 2 zoo? PERMIT
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DEPT.
Cm. STATE. MP
>v,aLudUValr�d<.�If„mcretli lNG
2800 Thorndyke Ave W
The oltow nq is aired i ortination an incom lete a lication wilt not be acce ted• Please rant !e ib (in in1� or
•
CITY OF FUDERAL WAY BUSINEW LICENSE NUMBER
SITE ADDREss 2353 $W 339TH ST
SUITE /UNIT it
ASSESSOR'S TAX /PARCEL S 3306200235 _ ' _ - _
LOT SIZE (qn
LEGAL DESCRIPTION (e,g, Acme Esda s. Lot 1)
CONTRACTORS REGISTRATION NUMBS (COPY of Oa=d requtr" with Wb APPlimdOzd
waacn VOpO � P400Jp• a P$ft kDO1 dMg MWO
W A S H I E S 9 7 1
0 B
TYPE OF PERMIT 0 BUILDING ❑ PLUMBING
�(=CHANICAL
❑ DEMOLITION ❑ ELECTRICAL
❑ ENGINEERINC. ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION /Provide detailed description of work included on this perMit on(u)
Replacing as to gas 50 gallon water heater
p 9 a 9
PROJECT NAME (Name of Business or Owner Last Name) MICHAEL DAHL
N PEOPLE INFORMATION
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
PRIMARY PHONE
NAME MICHAEL DAHL (263 ) 874-656!a LINO ADDRESS CITY. STATIC. 2IP
2353 SW 339TH ST Federal Wa , WA 98023
MPANY NAME
APPLCANT NAMk
OPPICE PHONE
WESCO
Naida Khan
(206 ) 378 - 6649
MAILING ADDRESS
Cm. STATE. MP
OEM PHONE
2800 Thorndyke Ave W
Seattle WA 98199
( ? -
CITY OF FUDERAL WAY BUSINEW LICENSE NUMBER
EXPIRATION DATE
PAX NUMBER
2 Q -4 3 - 1 -0 4 Z .3 -4 -B
12. / 31 /07
(
CONTRACTORS REGISTRATION NUMBS (COPY of Oa=d requtr" with Wb APPlimdOzd
EXPIRATION DA
W A S H I E S 9 7 1
0 B
09 /02 /09
COMPANY NAMYI
APPLICANT
0 OZ PHONE
Northwest Permit Inc
Naida Khan
( 369 ) 945 -2787
MAILINO ADDRESS
CrIY, STATE. A
CU• PHONE
1345 Gulf Road
Point Roberts, WA 98281
( -
RELATIONSHTP TO PROJECT
FAX NUMBER
❑ ATchitoct ❑ Tenant 44gent ❑ Othcr (Describe)
( )
EXISTING USE SFR
NAME PRIMARY PHONE IAU ADD
Naida Khan /Northwest Permit Inc. 360 ) 945 - 2781 fd1Md(WP•anr 0=0rga•10 miiLwa,
b . -
EXISTING ASSESSED /APPRAISED VALUE
PROPOSED USE
VALUE OF PROPOSED WORK
SPRINKLERED BUILDING? ❑ YES o NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER O LAKEHAVE1N ❑ MGMJNE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER 5XRVICE PROVIDER ❑ LAKEHAVEN ❑ BIGELINE ❑ PRIVATE (SEPTIC)
10- 22 -'07 10 :24 FROM- T -720 P003 /010 F -534
PROJECT FLOOR AREAS
AMA DESCRIPTION
EXISTING
PROPOtBED
S , FT.
TOTAL
B . FT.
BASEMENT
FIRST
SWOND
THIRD
FOURTH
As)I:) iTOAIAL FLOORS (DESCRIBE)
DECK (GO'tIPPED ?)
GARAGE ❑ CARPORT ❑
wa+aro rxoroam gprar. ,`� , •,� ��1 n ;
NU1VI13EItOFFIAOI2S '1�)l 6. iarae?11ai�S:�','•5 3.d "�,..." I __1.� 15A�r.W�'~:: "'YY�1
"NEWHOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
number of each type gfJiuture to be installed or relocated as part of this project. Do not
of r-UANICAL 9550.00
value of Mgchankal fork $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOOS REFRIG, SYSTEMS
Bugs FANS HOODS (Nmmnrcisl+ WOODSTOVE5
BOILERS feiMPL&CE INSERTS RANGES MISC (Desoribe)
COMPRE$SOP.S FURNACES 1 GAs WATER HEATERS
DUCT'S GAS PIPE OU•CLrM
BATITM153 (arrawshmromw) SHOWERS WATER CLOSETS Mu.0 MISC (Deseribe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE SIBBS
LAVS (auh.onm &t*s) VACUUM BREAKERS ELRCTRLC WATER HEATERS
I certify under penalty of perjury that the irtibrmation furnished by me is true and correct to the best of my knowledge, and further, that I
am authorlaed 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 Wag as to any claim (Including costs, expenses, and attorntys' fear incurred in the investigation and defense of
such claim), which may be made by any person, including the undersigned, andjiled against the City of Fsdtrat way, but only where such claim
arises out of the reliance of the city, including its officers and emptoyees, upon the accuracy of the irifonnatlon supplied to the city " a part of
this application.
NAMIr /T1TLE DATE " t
I61tAatur4 U
RELATIONSRW TO PROJECT a Owner LZent o Contractor 0 Architect a Other
Bulletin #100 — January 1, 2006 Page 2 of 4 k \H'andouts\Permit Application