02-100306I
City of Federal Way
Commmiity Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: HAGEYELU �J J
Project Address: 34701 5TH SW
Project Description: MEC - Install gas water heater
Mechanical Permit #:02 -100306 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 132172 0150
Owner
Applicant
Contractor
Kari A & R George Hagerhjelm
NORTHWEST PERMIT
ABC WATER HEATERS & PLUMBING
34701 5TH AVE SW
2320 1ST AVE SUITE 250
1824 S 126TH ST SUITE A
FEDERAL WAY WA
SEATTLE WA 98121
EVERETT WA 98204
98023-8357
(425)348-2884
Mechanical Valuation..........................................500 Over the Counter Permit ...................................... Yes
PERMIT EXPIRES July 24, 2002, IF NO WORK IS STARTED.
Permit issued on January 25, 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.
Owner or agent Dater �)C
CONSTRUCTION PERMIT APPLICATION
1*+r;x- f�EI — _
PPLICATTON NUMBER: —
PPLICATION NUMBER: -
PPLICATION NUMBER: _
**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.
PROPERTYO.
f.4
SITE ADDRESS: _ 3 N 4 U I S ✓ live S 1^J ASSESSOR'S TAX/PARCEL #: /
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): - ❑ BUILDING
❑ ELECTRICAL ❑ ENG
PROJECT DESCRIPTION (Provide detailed description): i S�
MECHANI DEMOLITION
fflIt'PREVENTION SYSTEM
t'J UE1--e-' `I 4111,` l �Gvyl /44
PRO3ECTNAME:—
PEOPLE INFORMATION
PROPERTY OWNER:NAME: f DAYTIME PHONE:
Ge°fjT 4c,yey-0/,,, I (dy)) 9S2 - 9-fY—I"
CONTRACTOR:
APPLICANT:
MAIunb AUUKtSS LS 1 Ktt 1 AUUKU5b y n, s I Al t, LIP):
3'� }0l - S &e SQ
NAME:
DAYTIME PHONE:
CL
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP -0
57 LJ
EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTORS REGISTRATION NUMBER: � � � � � � � � � � � �
EXPIRATION DATE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT:, FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER ( DESCRIBE): ( )
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ) CONTRACTOR
EXISTING USE: S (L EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ -rO 0
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: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
5510
' ncYlf RFSIOENTIAL CONSTRUCTION ONLY"
INUMBER OF BEDROOMS:
ESTIMATED SELLING PRICE:
FLOOR i EXISTING SQ. FT.
BASEMENT
PROPOSED S . FT.
TOTAL
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
�GA:R�AGE�FLOO RS7
TOTAL:
AIR HANDLING UNIT(S)
_ BBQ(S)
BOILERS)
COMPRESSORS)
DUCT(S)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACE INSERTS) RANGE(S) MISC. L 1
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ELECTRIC ❑GAS
PLUMBING
BATHTUB(S) LAVATORY(S)
DISHWASHER(S) RAIN WATER SYS.
DRINKING FOUNTAIN(S) SHOWER(S)
GAS PIPE OUTLET(S) SINK(S)
INTERCEPTORS) SUMP(S)
URINAL(S) WATER TER(S)
VACUUM BREAKERS) eIWELECTE AS
WASH MACHINE OUTLET
WATER CLOSET(S) MISC.
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 Clty 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
13 PROPEAOWNER
❑ APPLICANT CONTRACTOR
DATE:
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUM • P.O. BOX 9718 • FEDERAL. WAY, WA 98063.9718.253-661-4000 • FAX, 253.661-4129