03-105440j I1
I
City 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: MCDONALD
Project Address: 30804 4TH 4t
Project Description: Install gas to gas water heater
Mechanical Permit #:03 - 105440 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 241330 0230
Owner
Applicant
Contractor
Kelly K McDonald
WASHINGTON ENERGY SERVICES CO
WASHINGTON ENERGY SERVICES CO
30804 4TH PL S
2800 THORNDYKE AVE W
2800 THORNDYKE AVE W
FEDERAL WAY WA
SEATTLE WA 98199
SEATTLE WA 98199
98003-4044
(206)282-4700
Mechanical Valuation..........................................600 Over the Counter Permit...................................... Yes
PERMIT EXPIRES June 15, 2004.
Permit -issued on December 18, 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 Wa /
Owner or agent: I/"d_1 Date: rte! C d
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s�� CONSTRUCTION PERMIT APP KATION
CITY OF PPLICATION NUMBER: - ' -
Federal Way APPLICATION NUMBER:
PPLICATION 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.
f PROPERTYO. •
SITE ADDRESS: D U 7771 ASSESSOR'S TAX/PARCEL
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROJECT•• •
TYPE OF PROJECT (This application): o BUILDING XPLUMBING .1NECHANICAL ❑ DEMOLITION
o ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
,ME r, , � ) _ _ � � �
DAYTIME PHONE:
I
MAILING ADDRESS (STREET ADDRESS; Cny. STATE �
r EVENING PHONE' _
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTORS REGISTRATION NUMBER:
(«ter of card r",Amd) • LS I i L S 7 I D
EXPIRATION
i DATE:,3
APPLICANT: NAME: �DAAYTIMME�PHONE:
W
1 +'SP) 20Z T //
70) i
�
❑ ARCHITECT O TENANT 'OTHER ( DESCRIBE):(LG�!/k'(� 1 ( -
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER ❑ APPLICANT VICONTRACTOR
DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED USE:
PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQ! IIRED: O YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN O HIGHLINE O TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE G PRIVATE (SEPTIC) '
S'd 62TbT99RS2T:01 :WO6A 8T:22 2108-t7T-390
k*NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS:
/4 Z 3v90 C( S
ESTIMATED SELLING PRICE:
■ PR03ECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED S . FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
indicate number of each type of fixture
MECHANICAL
AIR HANDLING LINIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) EFRIG. OV TEM
BOILERS) FIREPLACE INSERT(S) RANGE(S) WOODSMISC. ( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC VGAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) WATER CLOSET(S) misc.( )
INTERCEPTOR(S) SUMP(S)
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 attomeys' 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 Hs officers and employees, upon the accuracy
of the information sup 'ed to the
as a part of this ap cation.
NAME/TITLE: VY Lv C.- DATE: ��` (�✓�
❑ PROPERTY OWNER ❑ APPLICANT O CqO&ACTOR
�o ID 'I tic IUIi- ' rn 0 061
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 •253-661-4000 • FAX: 253.661-4129
www.Cbmffedera lway.eom
9°d G2Tt7T99ZS2T:01 :WOdd GT:22 2002-t7T-930