03-104467City 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: HANCOCK
Project Address: 3815 SW 321ST St
Project Description: Gas wather heater changeout
Mechanical Permit #:03 -104467 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 873190 2450
Owner
Applicant
Contractor
Douglas F Hancock
WASHINGTON ENERGY SERVICES CO
WASHINGTON ENERGY SERVICES CO
3815 SW 321ST ST
2800 THORNDYKE AVE W
2800 THORNDYKE AVE W
FEDERAL WAY WA
SEATTLE WA 98199
SEATTLE WA 98199
NgOMM, Valuation..........................................600
Over the Counter Permit..
(246)•272-4700• • • • • •• • Yes
PERMIT EXPIRES April 3, 2004.
Permit issued on October 6, 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
l
Owner or agent: Date: Pb Q
f i
PrCtq
CONSTRUCTION PERMIT APPLICATION
CITY OF �...� PPLICATION NUMBER: 1 -L Q Ty to I -
Federal Way APPLICATION NUMBER:
APPLICATION 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.
SITE ADDRESS: 6 J �� 7� 21,) 72-1 sf �� ASSESSOR'S TAX/PARCEL tl: r� [ 3 � Q
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROJECT• •
TYPE OF PROJECT (This application): D BUILDING PLUMBING o MECHANICAL ❑ DEMOLITION
o ELECTRICAL o ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME:
PEOPLE.• •
PROPERTYOWNFR! NAME:
CONTRACTOR:
APPLICANT:
�^ M DAYTIME PHONE:
MAILING ADDRESS (STRUT ADDRESS; CITY, STATE, ZIP):
rYLAedi-rad T.A o23
IEI/jrl J I, A 9
W'�J�-482---LOM
DAYTIME PHONE:
MAtIIMG ADDRESS ( E ADDRESS; ,STATE _ `
k.6 AAO
EVENING PHONE. -
QTY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER:^
5 1 L S
EXPIRATION DATE: ,
(coLryofcaro ��) _77-100-1
fD3/ DS�
Z82 - i�7�1
RELATIONSHIP TO PROJECT: FAX NUMBER;
O ARCHITECT ❑ TENANT 'OTHER ( DESCRIBE);
i
C�'Wll AVUKC�.I: �
CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER ❑ APPLICANT �ACONTRACTOR ( I
• • •INFORMATION /�
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED USE:
PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? o YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: o YES o NO
WATER SERVICE PROVIDER: o LAKEHAVEN O HIGHLINE O TACOMA 0 PRIVATE (WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN O HIGHLINE ❑ PRIVATE (SEPTIC)
�'d 62Ti7T992S2T:01 :14083 22:80 €002-62-d3S
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*"NOW IGEMDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE:
■ PROJECT FLOOR AREAS
BASEMENT FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
FIRST
FAN(S)
FIREPLACE INSERT(S)
HOODS)
RANGE(S)
WOODSTOVE(S)
SECOND
FURNACE(S)
__ MISC. ( )
THIRD
GAS PIPE OUTLETS)
HEAT SOURCE:
❑ ELECTRIC O GAS
FOURTH
PLUMBING
OTHER FLOORS (DESCRIBE)
LAVATORY(S)
RAIN WATER SYS.
URINAL(S)
VACUUM BREAKER(S)
`� WATER HEATER(5)
p ELECTRIC
DECK
SHOWER(S)
WASH MACHINE OUTLET
GAS
GARAGE
HOW MANY FLOORS?
SINKS)
SUMPS)
WATER CLOSET(S)
MISC. (
TOTAL:
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S)
BBQ(S)
EVAPORATIVE COOLER(S)
GAS LOG(S)
REFRIG. SYSTEM(S)
BOILERS)
FAN(S)
FIREPLACE INSERT(S)
HOODS)
RANGE(S)
WOODSTOVE(S)
COMPRESSOR(S)
FURNACE(S)
__ MISC. ( )
DUCT(S)
GAS PIPE OUTLETS)
HEAT SOURCE:
❑ ELECTRIC O GAS
PLUMBING
BATNTUB(S)
DISHWASHERS)
LAVATORY(S)
RAIN WATER SYS.
URINAL(S)
VACUUM BREAKER(S)
`� WATER HEATER(5)
p ELECTRIC
DRINKING FOUNTAINS)
SHOWER(S)
WASH MACHINE OUTLET
GAS
GAS PIPE OUTLET(S)
INTERCEPTORS)
SINKS)
SUMPS)
WATER CLOSET(S)
MISC. (
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 supplied to th �Itys a part of this application.
NAME/TITLE: DATE:
'7��C 63
❑ PROPERTY OWNER D APPLICANT a C NTRACTOR
ID �� �U _A r)4 �6
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 •253-661-4000 • FAX: 253-661.4129
t;'d 62TbT992S2T:01 :WOZId 22:80 2002-62-d3S