03-105295City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Mechanical Permit #: 03 -105295 - 00 - ME
e
Inspection request line: 253.835.3050
Project Name: ANDERSON
Project Address: 30242 2ND *Ave S Parcel Number: 339180 0280
Project Description: Install 2 fireplace inserts, both with gas piping
Owner
Applicant
Contractor
P Anderson
WASHINGTON ENERGY SERVICES CO
WASHINGTON ENERGY SERVICES CO
30242 2ND AVE S
2800 THORNDYKE AVE W
2800 THORNDYKE AVE W
FEDERAL WAY WA
SEATTLE WA 98199
SEATTLE WA 98199
98003-4041
(206) 282-4700
Mechanical Valuation..........................................5525 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
s.,
Fireplace Inserts 2
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.
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Owner orgent Date:
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CONSTRUCTION PERMIT APPLICATION
clTv OF �� UL" APPLICATION NUMBER. - 1 - _
Federal Way CITY OF FEDERAL WAY APPUCATION NUMBER:
$UILDINQ DEPT PPLICAT1ON NUMBER: - -
"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: 3 D Z L Z O rlo c -S ASSESSOR'S TAX/ PARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PR03ECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING O PLUMBING MECHANICAL O DEMOLITION
❑ ELECTRICAL o ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
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PROJECT NAME:
PEOPLE• •
PROPERTY OWNER: NAME1 DAYTIME PHONE:
I
MAILING ADDRESS (STREET AQDR S; Cmf, ATE, Z��
CONTRACTOR:
APPLICANT.
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I DAYTIME PHONE: i
-
MAILING ADDRESS ( E ADDRESS; CITY.
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EVENING PHONE: _
CITY OF FEDERAL WAY BUSINESS LICENSE
NUMBER:
FAX NUMBER:
CONTRACTORS REGISTRATION NUMBER:c
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, EXPIRATION DATE: /
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(oovy of Lara muued)
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RELATIONSHIP TO PROJECT: I FAX NUMBER:
❑ ARCHITECT ❑ TENANT `OTHER ( DESCRIBE):a,�� i
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CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER o APPLICANT CONTRACTOR I
DETAILED BUILDING•• •
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE:
PROPOSED VALUATION FOR IMPROVEMENTS: $
1.
SPRINKLERED BUILDING? O YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA a PRIVATE (WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
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"NEW RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE:
■ PROJECT 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 UNITS) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILERS) FIREPLACE INSERTS) RANGE(S) MISC. ( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) r�I— GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC X GAS
BATHTUB(S)
DISHWASHERS)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
PLUMBING
LAVATORY(S)
RAINWATER SYS.
SHOWER(S)
SINK(S)
SUMP(S)
URINAL(S)
VACUUM BREAKER(S)
WASH MACHINE OUTLET
WATER CLOSET(S)
3ISCLAIMER/SIGNATURE 6t_❑
WATER HEATER(S)
0 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 arses out of the reliance of the city, Including its officers and employees, upon the accuracy
of the Information supplied to a clty as a part of i/fiQis pp cation.
NAME/TITLE:�l(� �1 l Zi D
DATE:
o PROPERTY OWNER 0 APPLICANT ❑ CONTRACTOR
fob 1/Arn SSzS. --
COMMUNITY DEVELOPMENT SERVICES • 33S30 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 •253-661-4000 • FAX: 253-661-4129
www.cnxomwmtway.com
8'd G2TbT992S2T:01 :WOJJ 2T:La 2002-2-33C