03-104325City of Federal Way
Community Development Services
33530 1 st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Mechanical Permit #:03 - 104325 - 00 - ME
Inspection request line: 253.835.3050
Project Name: ENIGBOKAN
Project Address: 122 S 357TH Gjr Parcel Number: 114000 0060
Project Description: &as Fikrt4ace ejno,,�,ui- S
Owner
Applicant
Contractor
Evelyn M Mitchell
WASHINGTON ENERGY SERVICES CO
WASHINGTON ENERGY SERVICES CO
122 S 357TH ST
2800 THORNDYKE AVE W
2800 THORNDYKE AVE W
FEDERAL WAY WA
SEATTLE WA 98199
SEATTLE WA 98199
4i*Ayaluation..........................................4078
Over the Counter Permit..(.206).282.4700
........ Yes
Mechanical Fixtures
PERMIT EXPIRES March 20, 2004.
Permit issued on September 22, 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: Date:
lD%31�� 3
A%;:!!
CITY OF
Federal Way
"The foil
Please note: Electrical, Fire
CONSTRUCTION P MITP LI TION
RECEIVED PPLICATFON NUMBER: _ _ - _ _ _ _ �'r)[
PPLICATION NUMBER:
SEP 1 9 2003 PPLICKMN NUMBER:
is required information - Please print (in ink) or type'"
WMjKTeering permits may require a separate application.
SITE ADDRESS: Z '55 77''k SfASSESSOR'S TAX/PARCEL #: j Ll 606 - 0069(D
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROIECT 1141FORMATION
TYPE OF PROJECT (This application): o BUILDING O PLUMBING MECHANICAL ❑ DEMOLITION
O ELECTRICAL O ENGINEERING O FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT•
■ PEOPLE INFORMATION
PROPERTY OWNER: NAME*A-YQ V m ` loO L 'a - 1
MAWNG ADDRESS (STREET ADDRESS: CITY,TE, ZIP
122, S- 35- r`t- S� e
CONTRACTOR:
MAIUNG
LOW
(COPV or card reauh-ea)
APPLICANT: NAME:
MAIUNG ADDRESS (STREET
w14y C.0A-
)RESS; CITY, STATE. ZIP),.
S LICENSE NUMBER:
NUMBER: W/ 1 ^ JL4
(E7S ? - Q13
O ARCHITECT O TENANT ❑ OTHER ( DESCRIBE):
3
DAYTIME PHONE:
EVENING PHONE -
FAX NUMBER:
I
DATE:
/ '-�, / 0S—
:
EVENING PHONE'
l %
FAX NUMBER.
\ ' i E MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT `CONTRACTOR I !
DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION ; f
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $_TI
SPRINKLERED BUILDING? a YES O NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES o NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN O HIGHLINE
Z'd 62TtbT99ZS2T:0i
O TACOMA rJ PRIVATE (WELL)
❑ PRIVATE (SEPTIC)
Wada SS:60 2002-GT-d3S
1-2,-2- s 3 s -??`Y' J �-
"+NEW RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: ;
■ PROJECT FLOOR AREAS
FLOOR
EX[STING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (OF -SCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL
0 FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANOLING UNIT(S) EVAPORATWE S) GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S) ' FAN(S) HOOD(S) WOOT)STOVE(S)
BOILERS) FIREPLACE MERT(S) ML -
Jr -COMPRESSOR( FURNACE(S)
DUCTS) GAS PIPE OUTLET(S) HEAT SOURCF-- p ELECTRIC GAS
BATHTUBS) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAINWATER SYS. VACUTJM BREAKER(S) Ei ELECTRIC D GAS
DRINKING FOUNTAINS) SHOWER($) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) WATER CLOSEt(S) Misc.(
INTERCEPTORS) SUMP(S)
7)I5ZCLATMFR/STr.NATt1RF Al r
certify under penalty of perjury that the Information furnished by me Is true and Correct to the Crest of my knowledge, and
(uctther, that i am authorized by the owner of the above premises to perform the work far which the perhnit 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 dalm arises out of the reliance of the city, including Its officers and employees, upon the accuracy
of the information capped Lo city as a part of this application. //9/
NAMEJTITLE• 4 VrllbDATE: q" ` LL 03
o PROPERTY OWNER o APPLICANT n CO RACTOR
job Vatt"n,- -d YO -78, 616
COMMMU Y BeYELOr•MEW SERVICES • 330D FIRST WAY SOUTH - PO 9OX 9718 - FWWAL WAY, WA 9W"718 . 25]-661-4000 • FAX: 253651-4129
8'd 66TbT99ZS6T:01 :WO&d 9S:60 2002-6T-d3S