03-105292City of Federal Way
Commmllity Development Services
33530 1 st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129 (�
Project Name: MAIR V% J&
Project Address: 30121 31SIAW
Mechanical Permit #: 03 - 105292 - 00 - ME
Project Description: Install gas piping to existing free-standing fireplace
Inspection request line: 253.835.3050
Parcel Number: 416710 0175
Owner
Applicant
Contractor
Christopher W Muir & Pamela L Muir
WASHINGTON ENERGY SERVICES CO
WASHINGTON ENERGY SERVICES CO
301213 1 ST AVE SW
2800 THORNDYKE AVE W
2800 THORNDYKE AVE W
FEDERAL WAY WA
SEATTLE WA 98199
SEATTLE WA 98199
98023-2320
(206)282-4700
RECEIVED CONSTRUCTION PERMIT APPLICATION
CITY of APPLICATION NUMBER: Oii - L Q
Federal Way DEC 0 2 2003 APPLICATION NUMBER: - _
CITY OF FEDERAL WAY APPLICATION NUMBER:-
The follov 4_PQ P9PlfifOrmation— Please print (in ink) or type—
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY INFORMATION
SITE ADDRESS: "361Z) 3 1 �r AVE- E( -AJ ASSESSOR'S TAX/PARCEL #: L 4e 7z t u - Q ! ?�
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROJECT• •
TYPE OF PROJECT (This application): o BUILDING o PLUMBING XMECHANICAL o DEMOLITION
❑ ELECTRICAL O ENGINEERING O FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME:nom.
■ PEOPLE INFORMATION
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
NAME;n
Mat
r- ' 1 DAYTIME PHONE'
(�F / (-2-53),F7Z- - 6033
MAILING ADDRESS (STREET ADD CITY STATE, ZIP):
I
5617
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IDAYTIME PHONE: i
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MAILING ADDRESS (57MrREEqjF
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ADDRESS; CffY, STATE. ZIP.
k -E.
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CJ l7
EVENING PHONE'
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTORS REGISTRATION NUMBER:
Win
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S 1 .5` Z l O
I EXPIRATION DATE:
(copy of Card required)
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�DAYTIME
�OHONE:
MAILING ADDRESS (STREET ADDRESS; CM, STATE, P): EVENING PHONE:
-,S,til�-c_ ( i
RELATIONSHIP TO PROJECT: FAX NUMBER:
o ARCHITECT O TENANTkl'OTHER ( DESCRIBE):�G, ( -
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE:
SPRINKLERED BUILDING?
WATER SERVICE PROVIDER:
PROPOSED VALUATION FOR IMPROVEMENTS: $
❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES a NO
❑ LAKEHAVEN O HIGHLINE O TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN O HIGHLINE ❑ PRIVATE (SEPTIC)
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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:
FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOGS) REFRIG. SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILERS) FIREPLACE INSERT(S) RANGE(S) MISC. ( )
COMPRESSOR(S) FURNACE(S) XGAS DUCT(S) GAS PIPE OUTLETS) HEAT SOURCE: p ELECTRIC
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATERS)
DISHWASHERS) RAINWATER SYS. VACUUM BREAKER(S) o ELECTRIC o GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSETS)MISC. ( )
INTERCEPTOR(S) SUMP(S)
DISCLAIMER/SIGNATURE RLC
I certify under penalty of perjury that the information furntshed 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 informations plied tod�asa ofthis a lication.
NAME L�
/TITLE: DATE: Z
0 PROPERTY OWNER p APPLICANT ❑ C NTRACTOR
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COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 •2S3-661-4000 • FAX: 253-661-4129
b'd G2Tt7T992S2T:01 :WOa3 ZS:LO 2002-2-030