03-102889i
City Federal Way
Community Development Services Mechanical Permit #: 03 - 102889 - 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: JONES
Project Address: 2936 SW 323RD
Project Description: New gas fireplace insert
Parcel Number: 873190 0490
Owner
Applicant
Contractor
Richard L Jones & Wanda L Jones
SUNDANCE ENERGY SERVICES, INC.
SUNDANCE ENERGY SERVICES, INC.
2936 SW 323RD ST
SUNDANCE ENERGY SERVICES, INC.
SUNDANCE ENERGY SERVICES, INC.
FEDERAL WAY WA
10228 MAIN ST
10228 MAIN ST
98023-2523
BOTHELL WA 98011
(425) 481-9660
Mechanical Valuation..........................................4000 Over the Counter Permit...................................... Yes
Mechanical Fixtures
G '
Fireplace Inserts
PERMIT EXPIRES January 11, 2004.
Permit issued on July 15, 2003
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
See Application
Owner or agent: Date:
CITY OF
CONSTRUCTION PERMIT APPLICATION
PPLICATION NUMBER: 0 -3 - -
Federal Way PPLICATION NUMBER:
PPLICATIDN NUMBER: OMMUA1tCYDEV€IQF(, UT MENT
**The following is required information — Please print (in ink) or type** J U L 14 2003
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
SITE ADDRESS: 07934 5ij STS Al. Lo.9 9,d ASSESSOR'S TAX/ PARCEL #: _ _ _ _ _ _
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application):
❑ BUILDING A66BING "ECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
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PROPERTY OWNER:
L4TG f" -T l
APPLICANT:
NAME* ,-r DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
NAME:
S ujt.'-PAOCX 4"by Sfi'ul �s c
DAYTIME PHONE:
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MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
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EVENING PHONE:
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CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER:
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EXPIRATION DATE:
9 jl
9 ,yy
(copy of card required) �7 M N d/
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MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
DAYTIME PHONE:
( )
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER ( DESCRIBE):
// E-MAIL ADDR SS
CONTACT PERSON FOR THIS PROJECT: *00ROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR IaATO &�'►�'`R'i 'w
EXISTING USE: I AP,4 VMf- EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: $ PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES 0-k0 FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES "0
t
WATER SERVICE PROVIDER: KEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: P CAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
r
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
BUILDING SHELL ONLY? ❑ YES' ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
FIRST
NEW ADDRESS REQUIRED? ❑ YES D NO
PLATTED LOT? ❑ YES ❑ NO
CHANGE OF USE?' ❑ YES ❑ NO
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEMS)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILERS) FIREPLACEINSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
BATHTUB(S)
DISHWASHERS)
DRINKING FOUNTAINS)
GAS PIPE OUTLET(S)
INTERCEPTORS)
PLUMBING
LAVATORY(S) URINAL(S)
RAIN WATER SYS. VACUUM BREAKER(S)
SHOWER(S) WASH MACHINE OUTLET
SINKS) WATER CLOSET(S)
SUMP(S)
WATER HEATER(S)
❑ ELECTRIC ❑ GAS
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 claim arises out of the reliance of the city, including its officers and employees, upon the accuracy
of the information suppli the city as a pa,�rtl -this application.
NAME/TITLE: 5 DATE:
®'PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION
4 REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
BUILDING SHELL ONLY? ❑ YES' ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE'
NEW ADDRESS REQUIRED? ❑ YES D NO
PLATTED LOT? ❑ YES ❑ NO
CHANGE OF USE?' ❑ YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 253-661-4129
www. cityaffederalway.:com