02-105519WW
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City, Conununity Development Services of Federal Way Mechanical Permit #: 02 -105519 - 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: FOREST COVE
Project Address: 30921 16TH1SQW Aptd Parcel Number: 122103 9006
Project Description: MECH - Instal fan and venting
Owner
Applicant
Contractor
Forest Cove -388 LIc
A-1 ELECTRIC & PLUMBING INC
A-1 ELECTRIC & PLUMBING INC
1703 SW 309TH ST
PO BOX 66965
PO BOX 66965
FEDERAL WAY WA 98023-4389
SEATTLE WA 98166
SEATTLE WA 98166
(206) 431-1991
Mechanical Valuation..........................................115 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
PERMIT EXPIRES June 8, 2003, IF NO WORK IS STARTED.
Permit issued on December 10, 2002
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.
See .Application
Owner or agent: Date:
C
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0 �• CONSTRUCTION PERMIT APPLICATION
-- RECEIVE �YpFpPRTM PUCATION NUM13ER• Pa - -
Comm UMTY DEV D.1O 200 MCA170NNUMOM
CATION NUMBER:
DEC -
**The following is required information - Please print (in ink) or type**
Please note: Electrical, FlCe Pr fventlowSystems and Engineering permits may require a separate application. .
SITE ADDRESS: IDUCI c� ` 1 t �1 ' ASSESSOR'S TAX/PARCEL
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application)- ❑ BUILDING ❑ PLUMBING Z MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide de sled description):
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0 C,iI%CPA ,V P "(-) I is A
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
■ PEOPLE INFORMATION
NAME:
A -t c 1
DAYTWE PHONE:
(.10(0) t - 199 r
MAILING ADDRESS (SiREEi ADOREM CITY, STATE, ZIP): j
EVENING PHONE:
-
aW OF FEDERAL WAY BUSINESS UCENSE
FAX NUMBER:
006 ) 071A, -0007
CONTRACTORS REMSTR I" NIN40
ExPIRATTON DATE:
(awofCWreams P 1!
� / (7 /
In A f ( ) -
MU ING ADORES$ (STREET AOORE'SS; CITY, STATE, ZIP): WENING PHONE:
RELATIONSHIP TO
PROJECT -ARCHITECT ❑ TENANT ❑ OTHER ( DESCRIBE): ( ) -
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT LYCONTRACTOR
INFORMATIONDETAILED BUILDING
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: /
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVFN r'i wvcw TNF n 9101UAT= Icc•.rwn%
s NEW RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROTECT 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 UNITS) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S) T FAN(S) HOOD(S) WOODSTOVE(S)
BOILERS) FIREPLACE INSERTS) RANGE(S) MX:SC. ( )
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) RAINWATER SYS. VACUUM BREAKERS) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) misc.( )
INTERCEPTOR(S) SUMP(S)
ITCCLAtMt`R/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 wont 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 dty; including its officers and employees, upon the accuracy
of the information supplied to the city as a part of this application. ^
NAME/TTTLE: � � 7t ✓ DATE: —
❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
FOR orCE USE ONLY
_ HADD .Ofi. �❑iAITERATi N:�-, � _ .: �' a ,.;,d�TENAQI.T Ni�LO�/,FMENtT�-;�;
tCENSUS ebb � R . -.. Of XO S3ZE. z =F 4
DESIGNATION,,,;. r .. t' BUI .ING.!SHEt"(ONLY?, -❑'yES NO
OESYC;KA''tION'. _.
*BAST.'=LAN? =f 17 dfES ❑ NO h
SECTION,;; �..T'oWN$HIP RANGE NEW ADDRESS. UIRED? ❑YES '. .❑ NO'
PLATTEb: LOT7 ❑ 'YES ❑ NO CHANGE OF t1SE? . ❑YES ❑ NO71
COMMUNITY DWELOPMENT SERVICES - 33530 FIRST WAY SOUTH - PO BOK 9718 - FEDERAL. WAY, WA 9806349718 - 253.661-4000 - FAX: 253-661-4129
www.ckwffederalway.com-