03-104190City 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: COLLINS
Project Address: 3209 SW 323RD
Project Description: Replace 80,000 btu gas furnace.
Mechanical Permit #:03 - 104190 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 873190 0940
Owner
Applicant
Contractor
Roger O Collins & Vickie K Collins
WASHINGTON ENERGY SERVICES CO
WASHINGTON ENERGY SERVICES CO
3209 SW 323RD ST
2800 THORNDYKE AVE W
2800 THORNDYKE AVE W
FEDERAL WAY WA
SEATTLE WA 98199
SEATTLE WA 98199
l 4gqJMtD0,Valuation..........................................3737
1Over the Counter Permit...
(206)-282-4700 • •• • • • •• Yes
Mechanical Fixtures
Descri tion Qiaanti, Description Quantity] Description Jquantity
Furnaces
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 Way.
Owner or agent: Date:
q111C �
CONSTRUCTION PERMIT APPLICATION
CITY of �..� PPLICAMON NUMBER: b 3- - _
Federal Way PPLICATION 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.
'��
PROPERTY INFORMATION
p t
SITE ADDRESS., y� J� r� U J ASSESSOR'S TAX/ PARCEL #; O f - 0 -
LEGAL
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PR03ECT INFORMATION
TYPE OF PROJECT (This application): O BUILDING O PLUMBING MECHANICAL O DEMOLITION
O ELECTRICAL O ENGINEERING O FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME: (folll ns
■ PEOPLE INFORMATION
PROPERTY OWNER:
CONTRACTOR:
P jC1
"MC: DAYTIME PHONE-
P,oger Co I I /n'r j(2g3)&7q - a741
MAILING
V ` lADDRESS
ADDRESS; 323 ' uAer TE, ZIP); $�Ctig_/ Q I u4C4 W / 1 E5 6 g 3
i I
NAME'
wilsk) n �'erl�l�n
DAYTIME PHONE:
c )Z82 47tb
MAILING ADDRESS (STREET ADDRESS: CRY, STA
_9M` amid e -fes w� 78 X99
EVENING PHONE-
HONE•_9
CRY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
1
CONTRACTORS REGISTRATION NUMBER:
d card required) —EY^-OB'
IXPIRATIO)N %ATE3: /(copy
APPLICANT: NAME: DAYTIME PMONE: '
wQ,s Co c ) 292 -
MAILING ADDRESS (STREET ADDRESS; CRY, STATE. ZIP): EVENING PHONE
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT O TENANT p -OTHER ( DESCRIBE):
i EMAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER O APPLICANT CONTRACTOR I
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/REQUIRED: ❑ YES O NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN O HIGHLINE O TACOMA O PRIVATE (WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE G PRIVATE (SEPTIC)
2'd 62TbT992S2T:01
:140aJ tS:ZO 2002-0T-d3S
**NEW RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS:
ESTIMATED SELLING PRICE:
■ PROJECT FLOOR AREAS
fw 323'
FLOOR
EXISTING SQ. FT.
PROPOSED S . FT.
TOTAL
BASEMENT
I]YES�� o X10 r i y�
❑ PROPERTY OWNER
O APPLICANT
FIRST
�Cli NGS=OF tfSE?.�- YE�'�;n NO ��4r'"�'��;�'�� ,.'
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
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)
BOILER(S) FIREPLACE INSERTS) RANGE(S) MISC. ( )
COMPRESSOR(S) FURNACE(S)
DUCTS) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC kGAS
PLUMBING
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINK(S)
SUMP(S)
URINAL(S)
VACUUM BREAKER(S)
WASH MACHINE OUTLET'
WATER CLOSET(S)
]ISCLAIMER/SIGNATLIRF RI[;
WATER HEATER(S)
❑ ELECTRIC O 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 wont 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 infornation supplied to the city as a part of this application
NAME/TITLE:
�i
A�)
DATE: _ q /` 6 L63
ONfNGbGN�ATIa
I]YES�� o X10 r i y�
❑ PROPERTY OWNER
O APPLICANT
CONTRACTOR
�Cli NGS=OF tfSE?.�- YE�'�;n NO ��4r'"�'��;�'�� ,.'
J
ob VA I t,-k_`hcv - 437 3-7 , D d
*F0R-Q.FFICE[: SE�.-O_NL°:
;NEW, I �lQPLTIQ'N �Ill;R1=RA ,: ON„
n _ cu,.a taunsiv:.r+aamr.ti
PREP/►) . - NANT MP,R0VIE ,
ICENSiJS"COO
ONfNGbGN�ATIa
I]YES�� o X10 r i y�
4S LIi�DI -c-H P
w..�N... i.£6N..
{g
y. 7�5�- YES
C U��C��. Row' � e�` ?t F �k •'
.?' ARM
MES _ �. Cf: N0
`!�i;LATTED�OT?C3:Y�S; ❑ NO,i .
�Cli NGS=OF tfSE?.�- YE�'�;n NO ��4r'"�'��;�'�� ,.'
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 •253-661-4000 • FAX: 253-661-4129
www.dtvofrederalway.com
t d 62TbT992S2T:01 :WOaJ t7S:za 2002-OT-d3S