03-104812City Federal Way
Community Development Services Mechanical Permit #:03 -104812 - 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: PEARSON
Project Address: 2215 S 304TH 5t Parcel Number: 053700 0110
Project Description: Remove oil furnace and replace with gas; install gas fireplace insert; install associated gas piping.
Owner
Applicant
Contractor
John A Pearson & Susan Pearson
WASHINGTON ENERGY SERVICES CO
WASHINGTON ENERGY SERVICES CO
2215 S 304TH ST
2800 THORNDYKE AVE W
2800 THORNDYKE AVE W
FEDERAL WAY WA
SEATTLE WA 98199
SEATTLE WA 98199
NgqUgii*j✓aluation..........................................6500
Over the Counter Permit..(.206)•282.4700........
Yes
Mechanical Fixtures
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 Wa
C°131�a
Owner or agent: o'e'�Date:
�na
• ` RECEIVED mF_
CONSTRUCTION PERMIT APPLICATION
CITY OF �� OCT2 2 20 0 PPLICATION NUMBER:
Federal Way PPLICATION NUMBER:
CITY OF FEDERAL WAY PPLICATION NUMBER: - -
BUILDING DEPT, — — — — —
"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.
PROPERTY INFORMATION
SITE ADDRESS: ' ✓A AS TAX/PARCEL #:Q 5:3 / d- 1
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROJECTO• •
TYPE OF PROJECT (This application): ❑ BUILDING �*LUMBING ECHANICAL o DEMOLITION
O ELECTRICAL O ENGINEERING oFIRE PREVENTION SYSTEM
PROJECT D
(Provide detailed description):
PROJECT NAME:
PEOPLE• •
PROPERTY OWNER: NAME: DAYTIME PHONE:
CONTRACTOR:
0
APPLICANT:
MAILIN ADDRESS (STREET ADDRESS, CnY, STATE, ZIP):
TNE')
AW �eTuC
DAYTIME PHONE;
046r,0) ? 7 I
MAILING ( E ADORE55; ,STATE _ ` Q
EVENING PHONE' -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
REGISTRATION NUMBER:
fQ S K S q7 /
EXPIRATION TE:
Cud Lr�
(OW Of quww)
/ -5�
NAME DAYTIME PHONE: i
47
MAILING ADDRESS (STREET ADDRESS; STATE, Pj: EVENING PHONE:
RELATIONSHIP TO PROJECT. I FAX NUMBER:
O ARCHITECT O TENANTOTHER ( DESCRIBE)-4�
j E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER O APPLICANT
EXISTING USE:
PROPOSED USE:
NTRACTOR
EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? CI YES O NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: O YES D NO
WATER SERVICE PROVIDER: O LAKEHAVEN a HIGHLINE ❑ TACOMA O PRIVATE (WELL)
SEWER SERVICE PROVIDER: O LAKEHAVEN O HIGHLINE O PRIVATE (SEPTIC)
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Tai -e- Z fir" Zz i r -s f 3at/A
**NEh% RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: S
FLOOR
BASEMENT
EXISTING SQ. FT.
PROPOSED SQ. FT.
—
TOTAL
FIRST
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) IHOODM
REFRIG. SYSTEM(S)
BO
LERS) FIREPLACE INSERT(S) RANGE(S) MI ODSTOVE(S) ]
COMPRESSOR(S) FURNACE(S)
DUCTS) _Zi GAS PIPE OUTLET(S) HEAT SOURCE: o ELECTRIC 'GAS
PLUMBING
BATHTUBS)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
LAVATORY(S)
RAINWATER SYS.
SHOWER(S)
SINK(S)
SUMP(S)
URINAL(S)
VACUUM BREAKER(S)
WASH MACHINE OUTLET
WATER CLOSET(S)
WATER HEATER(S)
0 ELECTRIC o GAS
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 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 daim 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: La DATE:
0 PROPERTY OWNER o APPLICANT CONTRACTOR
So
b 'I%Lt,r��-(. �Y` 5a0
COMMUNITY DEVELOPMENT SERVICES . 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FM 253-661.4129
2'd G2TbT992S0T-01 :WONA 02:L0 2000-22-1o0