04-100005if C1tb of Federal Way
Community Development Services Mechanical Permit #: 04 - 100005 - 00 - ME
33530 1 st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050
Project Name: JONES
Project Address: 5119 SW 311TH PI
Project Description: Install gas furnace.
Parcel Number: 321020 0455
Owner
Applicant
Contractor
Grey H Jones & Joaquine K Jones
WASHINGTON ENERGY SERVICES CO
WASHINGTON ENERGY SERVICES CO
5119 SW 311TH PL
2800 THORNDYKE AVE W
2800 THORNDYKE AVE W
FEDERAL WAY WA
SEATTLE WA 98199
SEATTLE WA 98199
98023-2029
1 (206)282-4700
Mechanical Valuation..........................................3809 Over the Counter Permit...................................... Yes
Mechanical Fixtures
Description -Quantity description' Description Quantity;
� Furnaces
PERMIT EXPIRES July 6, 2004.
Permit issued on January 8, 2004
I hereby certify that the above information is correct and that the construction on the above described prop:,rty and
the occupancy and the use will be . accordance with the laws, rules and regulations of the State of Washington and
the City of Federal Wa .
Owner or agent: _ �'�"` C � G( Date:
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A e"L% - cD 14C- C- J
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CITY OF
Federal Way
Y A�
CONSTRUCTION PERMIT APPLICATION
PPUCATION NUMBER:
APPLICATION NUMBER:
APPLICATION 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.
/ p 2 L/ PROPERTY h ^
SITE ADDRESS: �I ( ( S U-) 7 ASSESSOR'S TAX/ PARCEL fit:
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROIECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING o PLUMBING MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECTr
■ PEOPLE INFORMATION
PROPERTY OWNER:
CONTRACTOR:
r �
MAILING ADDRESS
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ELCei10
DAYTIME PHONE:
) 2- 7
MAILING ADDRESS ( RE ADDRESS; ,STATE, ZIP .
-EVENING PHONE: -
CITY OF FEDERAL WAY BUSINESS UCENSE NUMBER;
ZO - O '�_
FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER: _
C` S �7
(copy M card rcqulred) _ — C`�
1 EXPIRATION DATE:
® fes'
APPLICANT: NAME
DAYTIME PHONE:e�}Y-rL'
ca�
MAILING ADDRESS (STREET ADDRESS; CITY, STATE,PIP):9'7)
EVENING PHONE:
RELATIONSHIP TO PROJECT:�(� i FAX NUMBER:
❑ ARCHITECT o TENANT °OTHER ( DESCRIBE)-,asY U ( )
EMAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑PROPERTY OWNER p APPLICANT VCONTPLACTOR �
DETAILED BUILDING INFORMATION
EXISTING USE:
PROPOSED USE:
EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED VALUATION FOR IMPROVEMENTS: S o
SPRINKLERED BUILDING? ❑ YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN o HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
L'd 62TbT992S2T:01
W06A 90:2T 2002-T2-330
*,*NEW fikESIDENTIALCONSTRUCTION ONLY"
NUMBER OF BEDROOMS:
ESTIMATED SELLING PRICE:
■ PR03ECT 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) EVAPORA LER(S) GAS LOGS) REFRIG. SYSTEM(S)
BBQ(S) FANS HOOD(S) WOODSTOVE(S)
BOILERS) FIREPLACE INSER (S) RANGES) MISC. ( )
COMPRESSORS) = FURNACE(S)
DUCTS) GAS PIPE OUTL HEAT SOURCE: 0 ELECTRIC AGAS
PLUMBING
BATHTUBS) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHERS) RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) WATER CLOSET(S) MISC. ( )
INTERCEPTOR(S) SUMP(S)
DISCLAIM ER/SIGNATU RE BLOCK
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 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 Bairn arises out of the reliance of the city, Including Its officers and employees, upon the accuracy
of the informationMupplied a city as a part of this application.NAME/TrrLE:rt ( "CJDATE
:
0 PROPERTY OWNER u APPLICANT ONTRACTOR
CDMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOK 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-9000 • FAX: 253-661-4129
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b'd G2TVT992S2I:01 :WOdd 90:2T 2002 -ZZ -330