04-101276i
Citfof Federal Way
Community Development Services
'33,110 1 st `Nay S
Federal Way, WA 95003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: CAMOZA A -X
Project Address: 31560 55TIlkW
Project Description: Install new Bryant heat pump.
Mechanical Permit #:04 -101276 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 321020 0315
Owner
Applicant
Contractor
Kelly S Camoza
WASHINGTON ENERGY SERVICES CO
WASHINGTON ENERGY SERVICES CO
31560 55TH PL SW
2800 THORNDYKE AVE W
2800 THORNDYKE AVE W
FEDERAL WAY WA
SEATTLE WA 98199
SEATTLE WA 98199
98023-2047
(206)282-4700
Mechanical Valuation..........................................11281 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
DescriptionDescription _jQuant Description Quantity
Air Handling Units �� 1
PERMIT EXPIRES October 5, 2004.
Permit issued on April 8, 2004
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:--- —
2 q10 Le' CLF c°°
5-2004 18:08 FROM:
•1'
f
RECEIVED
TO:12536614129 P.4
A p R 0 6 Z004
caWUNRY DEVELOPMM SERVICES
33530 FIRST WAY SOUTH • PO BOX 9716
PE ITFIO� ATION ��
FEDERAL WAY WA 98063-9718
253.6614715 -FAX, 253-567 1129
Ri uLDNG
EVENING PHONE:
( ) -
I
F �
Faorh x o.1y. I FW File Number: 09l - = ,V L 2„ 1. &_ - 0 0 1
The following Is ieouized information -an incomplete application will not be accepted. Please print legibly (!n Ink) or type.
SITE ADDRESS: (Y1 It> -/+V E-cv ell)
ASSESSOR'S TAX/PARCEL #: jZ,� O ZGt 0 3 L5__ SQUARE FOOTAGE OF LOT:
APT
LEGAL DESCRIPTION (e.g,: Acme Estates. Lot 1)
(Attach separate page for lengthy legal descriptlon
TYPE OF PERMIT (This application):? 1'. ? PLUMBIN ?DEMOLITION
ELECTRIC ENCINEERINC ? FIRE PREVENTION SYSTEM
PROJECT NAME (Name of Business/Owner Last Name): C �(/LI'y►ZWA_
PROPERTY
OWNER:
CONTRACTOR:
LENDER:
Ilr Pmpaed Value > 15.0001
APPLICANT:
NAME. PRIMA
NC ADDRESS
" �i l vl / V `� !/1� (�H ! E�/
IQ(SIREFr�9pp- CgLj5TATE. 7IP bj
NAME - J
COUP -ANY
COMPANY I
OFFICE PHONE:
MAI
EVENING PHONE:
( ) -
ST TE 7J p�
c
bvn
CITY OF
OFF FEDERAL. WAY BUSIN ' ' ''1�I)C E N
s•
BFR: - EXPIRATION DATE
64- 1
FAX NUMBS
CO WS CISLRA O NUMBER; 11 . �� �// !eSq /
(copy of card required with each applicatlon) W A L ` 1 b
EXPIR�47 ION 1) l 5 -
/ L- /
NAMEDAYTIME
MAILING ADDRESS (STREET ADDRESS:: CITY. SPATE. ZIP
NAME:�R j� Y `-
COUP -ANY
OFECEPHONE,
�• ^
LING ADD ( ADDRESS
C STATE.
lY
EVENING PHONE:
( ) -
KtIA 1 NSHIP TO OJECT:
FAX NUMBER:
? Architect ? Tenant ? Other (DescNbe):
CONTACT PERSON FOR THIS PROJECT: ? Property Owner ? Contractor ? Applicant .
EXISTING USE: PROPOSED USE:
EXISTING ASSESSED/APPRAISED VALUE S VALUE OF PROPOSED WORK: S
SPRINKLERED BUILDING? ? YES ? NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: ? YES ? NO
WATER SERVICE PROVIDER: ? LAKEHAVEN ? HIGHLINE ? 'TACOMA ? PRIVATE (WELL)
SEWER SERVICE PROVIDER: ? LAKBHAVEN ? HIGHLINE ? PRIVATE (SEPTIC)
APR -5-2004 18:09 FROM:
Ca w1 o -2�
TO:12536614129 P.6
155-1
AREA DESCRIPTION
EXISTING S . FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
DRINKING FOUNTAINS
AIR HANDLING UNI EVAPO TIVE COOLERS
GAS LOGS
FIRST
HOODS Ku-m—"D
BOILERS FIREPLACE INSERTS
RANGES
SECOND
GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
THIRD
? YES
? NO
NEW ADDRESS REQUIRED?
FOURTH
UP/SEPA/SU?
? YES
? NO
ADDITIONAL FLOORS (DE5CRIBE)
?YES ?NO
DEMO PERMPI' REQUIRED?
? YES
DECK (COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS?
iara_EXMMNG
tUgAL PSD
IMALrXlSN:GMDP"OISM
'"NEW HOMES ONLY— NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: S
Indicate number of each type of fixture that is to be Installed or relocated as part of this project. Do not Include existing fixtures to remain.
MECHANICAL
SHOWERS
Value of Mechanical Work S
DISHWASHERS
SINKS
DRINKING FOUNTAINS
AIR HANDLING UNI EVAPO TIVE COOLERS
GAS LOGS
BBQS FANS
HOODS Ku-m—"D
BOILERS FIREPLACE INSERTS
RANGES
COMPRESSORS FURNACES
GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
REFRIG. SYSTEMS
WOODSTOVES
MISC poscrlbu)
BATHTUBS 1eTub/srwe,C4q"
SHOWERS
WATER CLOSETS trdw MISC (Describe)
DISHWASHERS
SINKS
DRINKING FOUNTAINS
GAS PIPE OUTLETS
SUMPS
RAINWATER SYS
WASHING MACHINES
URINALS
HOSE BIBBS
IAVS lewuo,,,,&k
VACUUM BREAKERS
ELECTRIC WATER HEATERS
I certify under penalty of perjury that the Information furnished by me Is true and correct to the best of my knowledge,
and 11Lrther, 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 claw. which may be trade by any person, Including the undersiWied, and
Med 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 a accura the information i to the city as a part of this appliced
NAME/TfTLE ��f 1 � L� DATE:
RELATIONSHIP TO PROJECT: 7 Property Owner&0? Appllcanc 'Pa_tractor7:._P Architect 7
FOR OFFICE USE ONLY:
? NEW ? ADDITION
? ALTERATION
? REPAIR ? TENANT IMPROVFINENT
BUILDING SHELL ONLY?
?YES ?NO
BASIC PLAN?
? YES
? NO
ZONING DESIGNATION:
CHANGE OF USE?
? YES
? NO
NEW ADDRESS REQUIRED?
?YES ?NO
UP/SEPA/SU?
? YES
? NO
PLATTED LOT?
?YES ?NO
DEMO PERMPI' REQUIRED?
? YES
? NO
Bulletin 9100 -January 13, 2004 Page 2 of 4 kViandouts - RevisedlPermit Application A