04-101805IN
M �
City of its Development Services of �iay
Community DeMechanical Permit #: 04 - 101805 - 00 - ME
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-7000 Fax: (253) 835-2609 Inspection request line: (253) 835-3050
Project Name: WEISZ
Project Address: 33720 7THSWParcel Number: 729804 0340 0— "
Project Description: Install gas furnace and heat pump. **11/4/04 -Include gas hot water tank**
Owner
Applicant
Contractor
RANDY WEISZ
WASHINGTON ENERGY SERVICES CO
WASHINGTON ENERGY SERVICES CO
33720 7TH PL SW
2800 THORNDYKE AVE W
2800 THORNDYKE AVE W
FEDERAL WAY WA 98023
SEATTLE WA 98199
SEATTLE WA 98199
(206) 282-4700
Mechanical Valuation..........................................12581 Over the Counter Permit...................................... Yes
Mechanical Fixtures
Description Quantity Description Quantity Description Quanti
Air Handling Units Furnaces 1
I hereby certify that the aboveinformation is
the occupancy and the use will be in accord
the City of Federal Way.
Owner or agent:'`
PERMIT EXPIRES November 9, 2004.
Permit issued on May 13, 2004
orrect and that the construction on the above described property and
:e with the laws, rules and regulations of the State of Washington and
Date: ` ` ct�0..
The following is required information -an incomplete application urill not be accepted. Please print legibly /in ink) or type.
SITE ADDRESS: 72-0 SUITE/APT N
ASSESSOR'S TAX/PARCEL M: 7ZfJ>0 - �_VOSQUARE FOOTAGE OF LOT:
LEGAL DESCRIPTION (e -g.: Acrne Estotes, Lot 1)
(Attach separate page for lengthy legal description)
TYPE OF PERMIT (This application): ❑ BUILDING ❑ PLUMBING XMECII.ANICAL ❑ DEMOLITION
AELECTRICAL O ENGINEERING O FIRE PREVENTION SYSTEM
PROD T D CRIPTION (Provide d •fed description of work included on this nerrnit onl
PROJECT NAME (Name of Business/Owner Last Name): (XPi/ J
mopm wpoRmmw
PROPERTY
OWNER
CONTRACTOR
LENDER
pr r...r vim.. , u,000l
APPLICANT:
NAME PRIMARY PHONE:
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-3-32
� 1�
MAILING ADDRESS (STREET ADDRESS;I: CITY, STATE, ZIP
NA ����
COMPANY
OFFICE PHONE,
( E 76- jr /'per
MAILING STEE
H[ 'Y-11=.1-2_004 1.5:10
FPOM:
TO. 125:36614129
P. 121f:z1_r__
1`
NAME:
wmn+vnn f ut vrlOPFlEKT SERVICES
cm os'
CITY, STATE- Zip
37S70 FIRST WAY SOM • PO BOX 9718.
Federal WayPERMIT
MAILING' ADDRESS ISrREET ADDRESSr CITY, STATE. ZIP
APPLICATION
FEDERAL WAY, WA 98067-9718
75Jb611115 FAZ 75.1 61-•i?9
FAX NUMBER:
( ) -
�n n<m1
Por 06« Um aVY
FW Fife Number: tf- 1
-
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TD.
1 �
The following is required information -an incomplete application urill not be accepted. Please print legibly /in ink) or type.
SITE ADDRESS: 72-0 SUITE/APT N
ASSESSOR'S TAX/PARCEL M: 7ZfJ>0 - �_VOSQUARE FOOTAGE OF LOT:
LEGAL DESCRIPTION (e -g.: Acrne Estotes, Lot 1)
(Attach separate page for lengthy legal description)
TYPE OF PERMIT (This application): ❑ BUILDING ❑ PLUMBING XMECII.ANICAL ❑ DEMOLITION
AELECTRICAL O ENGINEERING O FIRE PREVENTION SYSTEM
PROD T D CRIPTION (Provide d •fed description of work included on this nerrnit onl
PROJECT NAME (Name of Business/Owner Last Name): (XPi/ J
mopm wpoRmmw
PROPERTY
OWNER
CONTRACTOR
LENDER
pr r...r vim.. , u,000l
APPLICANT:
NAME PRIMARY PHONE:
end V 6-el.Tz. tZS�) - /,,F-
-3-32
� 1�
MAILING ADDRESS (STREET ADDRESS;I: CITY, STATE, ZIP
NA ����
COMPANY
OFFICE PHONE,
( E 76- jr /'per
MAILING STEE
ELL PHONE: -
CITY OF FEDE�L W� BUSINESS E� NUMBER: EXPIRATION Dq�� �
Z-E2 - D 6_ Z
!AX NUMBER: --
CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE.
(copy of eud rcgntred with each application)%LV LO / Z / d
NAME:
/DAYTIME PHONE:
l )
MAILING ADDRESS (STREET ADDRESS:),
CITY, STATE- Zip
NAME: �^ + ' COMPANY
OFFICE PHONE: -
MAILING' ADDRESS ISrREET ADDRESSr CITY, STATE. ZIP
EVENING PHONE:
RELATIONSHIP TO PROJECT:
❑ Architect ❑ Tenant O Other (Descnbej.
FAX NUMBER:
( ) -
CONTACT PERSON FOR THIS PROJECT: ❑ Property Owner Contractor ❑ Applicant E-MAIL ADDRESS:
DEiAMED BUMIDING INFORMATION
EXISTING USE: PROPOSED USE:
EXISTING ASSESSED/APPRAISED VALUE S VALUE OF PROPOSED WORK: $
SPRINKLERED BUILDING? O YES O NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED?: ❑ YES O NO
WATER SERVICE PROVIDER O LAKEHAVEN ❑ HIGHLINE O TACOMA O PRIVATE (WELL)
SEWER SERVICE PROVIDER O LAKEHAVEN ❑ HIGIFLINE O PRIVATE (SEPTIC)
MAY -10-2004 15:11 FROM:
3 ?ce-,v Gze lJ Z
TO:12536614129 P.14
AREA DESCRIPTION
E3USTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
GAS tAmS
REFWG. SYSTe)<S
__L__ •
BBQS
FIRST
HOODS K ---d4
__ WOODSTOVES
BOILERS
SECOND
RANGES
MISC (Desmbe)
_-cObtPRES.SORS
THIRD
GAS WATER HEATERS
DEMO PERMIT REQUIRED? o TES
DUCTS
FOURTH
PLUMM IN G
ADDITIONAL FLOORS (DESCRIBE)
BATHTUBS p,n,s/se..ec. by
DECK(COVFRED->)
WATER CLOSETS meed
MISC (Ih.cribe)
DISHWASHERS
GARAGE/CARPORT
DRINKING FOUNTAINS
OAS PIPE OUTLETS
HOW MANY FLOORS?
1O1"`�'A1O
1OR""iOPDMM
rorty tx a Axoraa.MED
ONLY'• NLIMH£R 4F 6EDRQOMS ES'ITIMATED SELLING PRICE: $
NI:Iv laoi�s
number of each type of fixture that is to be installed or relocated as part of this project. Do not include cxiating fixtures to remain-
AMCUAWCAL
Value of Mechanical Work
-NR HANOUNO UNITS
EVAPORAnVE COOLERS
GAS tAmS
REFWG. SYSTe)<S
__L__ •
BBQS
FANS
HOODS K ---d4
__ WOODSTOVES
BOILERS
FIREPLACE INSERTS
RANGES
MISC (Desmbe)
_-cObtPRES.SORS
FURNACES
GAS WATER HEATERS
DEMO PERMIT REQUIRED? o TES
DUCTS
OAS PIPLr OUTLE"17S
PLUMM IN G
BATHTUBS p,n,s/se..ec. by
SHOWERS
WATER CLOSETS meed
MISC (Ih.cribe)
DISHWASHERS
SINKS
DRINKING FOUNTAINS
OAS PIPE OUTLETS
3UMP3
RAINWATER SYS
WASHING MACHINES
URINAIS
HOSE SIBBS
MVS
VACUUM BREAKERS
BLEC WC WATER HEATERS
.)ISCLAIMPRISIGNATURE BLC
I certify under penalty of perjury that the ti —radon jUs-nished by rte is true and cormet to the best of my
irnewtedge, and further, that l a n aut"r cd by the owner of the ab,,_ psi _I_s to perform the work for which the permit
applicatfon is made. 1 further agree to hold hmatless the City of Federat Way as to any claim (Enctuding costs, expenses, and
attarnays' faes incurred in the investigation and defense of such claim), which may be made by anal person, bwbiding the
undersigned, and filed against thea Federal Way t only where such claim
arises out of the reliance of the city,
including its officers and employ s, n the accuracy aj mformation supplied to the city a a part of this application.
NAME/TI'CI.E DATE
a
R£LATIONSIIIP TO PROJECT`. O Property
14
O Applicant a Contractor 6 Architect. • ❑
(12'r -,?-26 32"pr
,FOIL 0FFjCEl3SE
a�ItFW�s'• •� ' = P ADDMON
BIIIS.'I61ING SBELL ONLY?
o ALTERATION
o IES a NO
o REPAIR o TENANT IMPRDVEL4�dIT
BASIC PLAN? o YES
o Ito
2b?t 7G DESIGNATION:
CHANGE OF USE? a YES
n NO
KLM ADDRESS REQUITM13?
YES ONO
UP/SEPA/SII? o YES
a NO
PLATTED LOT?
_0
DYES O NO
DEMO PERMIT REQUIRED? o TES
a NO
t3ullcL•n 410"1 _ ,I.are�.�, 1. stA( 4
Page 2
DEPARTMENT OF LABOR AND INDUSTRIES
REGISTERED AS PROVIDED BY LAW AS
CONST CONT GENERAL
REGIST.' # EXP.: DATE
CC01 WASHIES990CW 02/16/2005
EFFECTIVE DATE 02/16/2001
WA.SHINGTON ENERGY SERVICES CO
2800 THORNDYKE AVE W
SEATTLE WA 98199-2997
Detach .and D!,e!ae Cerut,cate
State of Washington
County of Snohomish
i
I certify that this is a true and correct copy of said document as of this date
Date:
o
Title
My Appointment Expires on 10/9/63
0
0