03-104077City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Pb: 253.661.4000 Fax: 253.661.4129
Mechanical Permit #:03 -104077 - 00 - ME
Project Name: WILSON VOV
Project Address: 32027 5TH SW
Project Description: Remove and replace gas water heater.
Inspection request line: 253.835.3050
Parcel Number: 926490 0450
Owner
Applicant
Contractor
Tamara S Wilson
WASHINGTON ENERGY SERVICES CO
WASHINGTON ENERGY SERVICES CO
32027 5TH AVE SW
2800 THORNDYKE AVE W
2800 THORNDYKE AVE W
FEDERAL WAY WA
SEATTLE WA 98199
SEATTLE WA 98199
MgdMjF&JyaIuation ..........................................600
Over the Counter Permit.
..206)•282-4700••••••••Yes
PERMIT EXPIRES March 13, 2004.
Permit issued on September 15, 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: tAla CVPt Date:
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CONSTRUCTION PERMIT APPLICATION
CITY OF PPU ATION NUMBER:
Federal Way APPUCATION NUMBER: _ -
PPIICATION 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: 67 ASSESSOR'S TAX/ PARCEL #: 1- 7 l O - V q�
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application):
PROJECT DESCRIPTION (Provide
❑ BUILDINGLUMBING .
O ELECTRICALtoNGINEERING
description):
DEMOLITION
PROJECT NAME--TAITtar�
PEOPLE INFORMATION
PROPERTY OWNER: NAME:
D M
CONTRACTOR:
yl op
APPLICANT:
r -M
MAILING ADDRESS (S7
32 DZ7
K111SOtl
0
W 1: eder-z l WAY
AYTi E PHO
I (2-53)9711- 53?
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NAME:WP'J Cp J���V��
C W4 +YI' � / 6M#qy �V r
i -AIME PHONE:
1EEVEEM.G
MAILING ADDRESS (STREET ADDRESS; CTFY, STATE. ZIP):
I
PIONE- f
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
( )
CONTRACTORS REGISTRATION NUMBER: / ' , A f
WASH I Ej qQQ `—tj
(wPY of card required) — — — — — — —
EXPIRATION DATE:
Z /'(6
NAME:LOP—SCAD
DAYTIME PHONE: •� � i
MAILING ADDRESS ( E ADDRESS; C , SE, ZIP):
VA�
EVENING PHONE: s
RELATIONSHIP TO PRO%Cr: V FAX NUMBER: 1
O ARCHITECT O TENANT O OTHER ( DESCRIBE):
EMAIL ADDRESS: I
CONTACT PERSON FOR THIS PROJECT: O PROPERTY OWNER O APPLICANT CONTRACTOR
DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION 5
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? O YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: 0 YES 0 NO
WATER SERVICE PROVIDER: o LAKEHAVEN ❑ HIGHLINE ❑ TACOMA O PRIVATE (WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE 0 PRIVATE (SEPTIC)
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"NEW RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS:
e SW2-7 5y'0"-
"NEW
`t'0`
SELLING PRICE:
■ PROJECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
WOODSTOVE(S)
FIREPLACE INSERT(S)
RANGE(S)
FIRST
FURNACE(S)
,.t7?YES'r^�
SECOND
HEAT SOURCE:
O ELECTRIC GAS
PLUMBING
THIRD
LAVATORY(S)
URINAL(S)
FOURTH
RAIN WATER SYS.
VACUUM BREAKER(S)
`H'EATERS)
0 ELECTRIC GAS
OTHER FLOORS (DESCRIBE)
WASH MACHINE OUTLET
C
SINKS)
DECK
MISC. ( )
SUMP(S)
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING,UNIT(S)
BBQ(S)
BOILERS)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHERS)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
N FIXTURES
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S)
GAS LOGS)
REFRIG. SYSTEMS)
FAN(S)
HOOD(S)
WOODSTOVE(S)
FIREPLACE INSERT(S)
RANGE(S)
MISC. ( )
FURNACE(S)
,.t7?YES'r^�
GAS PIPE OUTLET(S)
HEAT SOURCE:
O ELECTRIC GAS
PLUMBING
LAVATORY(S)
URINAL(S)
I
[ WATER
RAIN WATER SYS.
VACUUM BREAKER(S)
`H'EATERS)
0 ELECTRIC GAS
SHOWER(S)
WASH MACHINE OUTLET
C
SINKS)
WATER CLOSET(S)
MISC. ( )
SUMP(S)
DISCLAIMER/SIGNATURE RLC
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 clalm (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 Its officers and employees, upon the accuracy
of the Informations pplied t e city as a part of this application.
NAME/TNAME/TITLE: UletX-4bDATE: 4?/2/a
0 PROPERTY OWNER o APPLICANT y CONTRACTORAY
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COMMUNTFY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253.661.4000 • FAX: 253-6614129
www.rltvoffederafway.00m
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