03-105350City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: MARTIN -OLIVE
Project Address: 30232 20TH SAVL S
Project Description: Remove and replace gas furnace.
Mechanical Permit #:03 - 105350 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 042104 9203
Owner
Applicant
Contractor
Millicent Martin -Olive
WASHINGTON ENERGY SERVICES CO
WASHINGTON ENERGY SERVICES CO
30232 20TH AVE S
2800 THORNDYKE AVE W
2800 THORNDYKE AVE W
FEDERAL WAY WA
SEATTLE WA 98199
SEATTLE WA 98199
98003-4244
(206) 282-4700
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• RECEIVED
WtR-
h ` DEC 1 1 2003 CONSTRUCTION PERMIT APPLICATION
. CITY OF P�� APPLICATION NUMBER:
Federal Wad OF FEDERAL WAYAPPLICATION NUMBER:
BUILDING DEPT, — — — APPLICATION NUMBER: NUMBER: - -
s'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: `�/ �3 2, � / 1 `' S ASSESSOR'S TAX/ PARCEL 9:0
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROJECT•• •
TYPE OF PROJECT (This application): o BUILDING o PLUMBING MECHANICAL ❑ DEMOLITION
o ELECTRICAL ❑ ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME:
PEOPLE I• •
PROPERTY OWNER: E -C `I ^ A� / _ � � �( `( �� ; DME PHONE'
MAILING ADDRESS (STREET ADDRESS;CITY Sl' 7E, ZID): r�
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CONTRACTOR:
APPLICANT:
NA F,:
VI�I�C I EN
n 14 Leu
DAYTIME PHONE:
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MAILING/ADDRESS ( E ADDRESS; . STATE. ZIP .EVENING
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CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
Z6 - O 3 !U vZ3 �/ -00 /X
FAX NUMBER:
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CONTRACTORS REGISTRATION NUMBER:
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1 EXPIRATION DATE:
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(�, ofc3rd �w�)
NAME: DAYTIME PHONE:
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MAILING ADDRESS (STREETADDRESS; CTIY, STATE. #P): EVENING PHONE:
RELATION51-1IP TO PROJECT: FAX NUMBER:
❑ARCHITECT ❑TENANT'OTHER (DESCRIBE): -
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER O APPLICANT
EXISTING USE:
PROPOSED USE:
SPRINKLERED BUILDING?
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
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EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED VALUATION FOR IMPROVEMENTS: $
O YES O NO FIRE SUPPRESSION SYSTEM PROPOSED IREQUIRED: O YES ❑ NO
❑ LAKEHAVEN ❑ HIGHLINE 0 TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN O HIGHLINE ❑ PRIVATE (SEPTIC)
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**NEW RESIDENTIAL CONSTRUCTION ONLY"
• NUMBER OF BEDROOMS:
Z 2_0YL_%.
ESTIMATED SELLING PRICE:
■ PROJECT FLOOR AREAS M7
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) Z FURNACE(S)
DUCT(S) GAS PIPE OUTLETS) HEAT SOURCE: O ELECTRIC O(GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
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 CLOSET(S) MISC. ( )
INTERCEPTORS) SUMP(S)
DISCLAIMER/SIGNATURE Ri r
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 su plied to tike as a part of this application. /
NAME/TITLE:��A DATE: C
0 PROPERTY OWNER o APPLICANT 0 CO CTOR
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COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTii • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 .253-661-4000 • FAX: 253-661-4129
www.cbmfrederalway. com
t7 'd 62Tt7T99ZS2T:01 :WOdJ Sb:OT 2002-8-03C