03-105291City Federal Way
Community Development Services Mechanical Permit #: 03 - 105291 - 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: CRETTENDEN
Project Address: 29825 10TH aG Parcel Number: 195460 0131
Project Description: Install gas fireplace w/ gas piping
Owner
Applicant
Contractor
Paul Crittenden
WASHINGTON ENERGY SERVICES CO
WASHINGTON ENERGY SERVICES CO
29825 10TH AVE SW
2800 THORNDYKE AVE W
2800 THORNDYKE AVE W
FEDERAL WAY WA
SEATTLE WA 98199
SEATTLE WA 98199
98023-8206
(206) 2824700
Mechanical Valuation..........................................4143 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
m3 ,.l@SCI'Ij3lOE',,, y,. ,
Fireplace Inserts 1 Gas Piping 1
PERMIT EXPIRES June 1, 2004.
Permit issued on December 4, 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. /
Owner or gA Date: l��
ent: L
IIS %y YS pipIr rj alp r-Zf-
t
• � RECEIVED
fKe--
CONSTRUCTION PERMIT APPLICATION
CITY OF LICA -110N NUMBER: Q
Federal Way DEC ° zoo3 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.
SITE ADDRESS: L �/ ��y Ly �CJ "' ASSESSOR'S TAX/PARCEL #:`gy
6 a '61 I
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PR03ECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING o PLUMBING QXECHANICAL ❑ DEMOLITION
o ELECTRICAL o ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME: C_
1 -i 1 ` &
PEOPLE• •
PROPERTYOWNER: NAME: OAYi1MEPM0NEt
MAIUN DRESS (STREET ADDRESS; CITY, ATE, 21P
1 -?"19 ,S" Sw to Rc) Wa `i F46 2'
CONTRACTOR:
APPLICANT:
NAr}E _ Qgnll L Ces
DAYTIME ONc`: 2 _ 7
MAILING ADDRESS (STRjEqr ADDRESS; Cr7, STATE . -ZIP ` ��
�ENING PHONE• -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER�,D - V 3 1 62_'3 00 ��
_ —
F,q)(NUMBER: -
CONTRACTORS REGISTRATION NUMBER:
Lt�1�5 H 1 L= S q Z D91,0,316-5
EXPIRATION DATE:
(copy of card requlmd)
)Z9Z -Y70)
RELATIONSHIP TO PROJECT: FAX NUMBER'
In ARCHITECT o TENANT'OTHER ( DESCRIBE): v
-- -- -
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER
t•MALL AUUKtJ0;
I
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE:
PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? o YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: o YES o NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN O HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
S'd 62TbT99ZS2T:01 :WO2JA ZS:ZO 2002-2-930
C.r t ff, ArLO t -A -2-,70 a. 5- S -w /67`1
**NEW RESIDEN;IAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS:
ESTIMATED SELLING PRICE: I
■ PROJECT FLOOR AREAS
FLOOR
EXISTING S2. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNITS) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILERS) 7 FIREPLACE INSERT(S) RANGE(S) MISC. ( )
COM PRESSORS) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC o GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHERS) RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC o GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) WATER CLOSET(S) MISC.(
INTERCEPTORS) SUMP(S)
DISCLAIM ER/SIG NATURE 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 claim arises out of the reliance of the city, Including Its officers and employees, upon the accuracy
of the information s If --d too as a part of this application. `
NAMEITITLE•
DATE:
o PROPERTY OWNER ❑ APPLICANT o CONTRACTOR
J0 b Va tu�4 CA L41 C131
CDMMUNriY DEVELOPMENT SERVICES • 33330 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 980639718 •253-661-4000 • FAX: 253-661-4129
XMMU&5ffJW ralWaV,=
9'd 62TtrT992S2T:01 :WOad 2S:ZO 2002-2-930