03-102261City of Federal Way
Conumnity Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: KORSMO
Project Address: 30504 16THISW
Project Description: 16 foot gas piping for range
Mechanical Permit #:03 -102261 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 514930 0450
Owner
Applicant
Contractor
R A Korsmo & D A Korsmo
WASHINGTON ENERGY SERVICES CO (Gen
WASHINGTON ENERGY SERVICES CO (Gen
30504 16TH AVE SW
2800 THORNDYKE AVE W
2800 THORNDYKE AVE W
FEDERAL WAY WA
SEATTLE WA 98199
SEATTLE WA 98199
98023-3429
1(206)
282-4700
Mechanical Valuation..........................................543
Over the Counter Permit......................................Yes
Mechanical Fixtures
Gas Piping
PERMIT EXPIRES November 30, 2003.
Permit issued on June 3, 2003
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the u will be in accordance with the laws, rules and regulations of the State of Washington and
the City of Feder 1 W
Owner or agent: Date: �� V3
+ RECEIVED CONSTRUC-90N PERMIT APPLICATION
PPLICATION NUMBER: Z
city or ��
Federal Way .. O 3 2003 pPLICATION NUMBER: y
CITY �PPLICATION NUMBER:
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"*The 11111 woba glfi!'eG�nformation - Please print (in ink) or type' `
Please note. Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
;ITE ADDRESS:
SOR'S TAX/PARCEL #: j5Ltt
.EGAL DESCRIPTION OF SUBaECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
o PLUMBING ECIIANICAL ❑DEMOLITION
TYPE OF PROTECT (This application): o BUILDING
❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
cRn]EcT DESCRIPTION (Provide detailed description).
PROJECT NAME:
PROPERTY OWNER!
CONTRACTOR:
APPLICANT:
CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER 0 APPLICANT
XCONTRACTOR
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EVENING 6v10N£
FAX ^,tea,
EMAIL. ADDRESS _- - -- -- -
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EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION
E
XISTINGd USE. PROPOSED VALUATION FOR IMPROVEMENTS: S
PROPOSE
SPRINKLER[0 BUILDING?❑YES a No
FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: o YES NO
d tAKEHAVEN ° N1ATE (WELL)
WATER SERVICE PROVIDERI O PRIVATE (SEPTIC)
SEWER SERVICE PROVIDER: o LAKEHAVEN ❑ HIGHLINE
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