04-100801{
City of Federal Way
Community Development Services Mechanical Permit #: 04 - 100801 - 00 - ME
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050
Project Name: CHRIST'S CHURCH
Project Address: 941 S DASH POINT 9�
Project Description: Gas piping to hvac equipment
Parcel Number: 052104 9092
Owner
Applicant
Contractor
CHRISTS CHURCH AT FED WAY
PLUMBING TODAY, INC.
PLUMBING TODAY, INC.
941 S DASH POINT RD
PLUMBING TODAY, INC.
PLUMBING TODAY, INC.
FEDERAL WAY WA
17675 SR 536
17675 SR 536
98003-3795
MOUNT VERNON WA 98273
(360) 848-6685
Mechanical Valuation..........................................4800 Over the Counter Permit...................................... No
Mechanical Fixtures
Description Quantity Description Quanti Description Quanti
Number of Gas Outlets 7
PERMIT EXPIRES September 15, 2004.
Permit issued on March 19, 2004
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. '7
Owner or agent: c (,�2 Date: ! U
1�,t ID �- 5/3/6 V i� &4`1- A26�01Jo
RECEIVED
CRY OF
Federal wayA�7 20 04 PERMIT APPLICATION
/vte-( t(
OOMMUNrrY DEVELOPMENT sERV10Es
33530 P1Rsr WAY SOUTH • Po BOX 9718
FEDERAL WAY, WA 98063-9718
2536614115• FAX. -253-661-4129
L'rtow.citunRrderalwav mm
For Of6or Um Only i�Y — TD:
DUfLUING DEPT.—��—
The followinq is required information- an incomplete qkplication will not be accepted. Please print legibly (in in/c) or tope.
SITE ADDRESS: q71 S_ V -2 s% fo/4t Kot
-
ASSESSOR'S TAX/PARCEL #: S 1 D - �I Q SQUARE FOOTAGE OF LOT:
SUITE/APT #
LEGAL DESCRIPTION (e.g.: Acme Estates, Lot 1)
(Attach separate page for lengthy legal description)
TYPE OF PERMIT (This application):VAfiV4?G ❑ PLUMBING MECHANICAL ❑DEMOLITION
ELECTRICAL C1 ENGINEERING k❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlut
GPROJECT NAME (Name of Business/Owner Last Name): i 5 S C.- 1.i iC
CONTRACTOR:
LENDER:
(if Proposed Value > $5,0001
APPLICANT:
NAME
TOL f, I f
�lOFFICE
u�l6/,+v PANY T -
X 4I it NGS z
OFFICE/PANY^
0,6'0) f0'
- 66C7S�
MAILING ADDRESS (STREET ADDRESS;):
/767 .5W S36
RELATIONSHIP TO PROJECT:1
El Architect ❑ Tenant ❑ Other (Describer e0d raC /0/-
CITY, STAT , ZI
lk7ouAI7 IIfr�ati �/c, 9r.
CELL PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
z n -oa -1 Q J� ? Q:
EXPIRATION DATE:
is / 3 j /0y
FAX NUMBER:
6no) ?W
-�� w
X Q -- 45z -
CONTRACTOR'S REGISTRATION NUMBER:�)
(copy of cud required with each application)
/�L_
l/ ' " � 6 7_7
EXPIRATION DATE::
NAME: DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS;): CITY, STATE, ZIP
NA J o� ��y �S
�lOFFICE
u�l6/,+v PANY T -
PHONE,
(3%6) OK -affs
MAILING ADDRESS (STREET ADDRESS):
CITY, STATE, ZIP
EVENING PHONE:
(S60) W/ -zy3
RELATIONSHIP TO PROJECT:1
El Architect ❑ Tenant ❑ Other (Describer e0d raC /0/-
FAX NUMBER:
( mo ) 1? - 66 8'0
CONTACT PERSON FOR THIS PROJECT: ❑ Property Owner Contractor ❑ Applicant E-MAIL ADDRESS:
EXISTING USE: (, I( / (/T
EXISTING ASSESSED/APPRAISED VALUE $_
SPRINKLERED BUILDING? ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN
SEWER SERVICE PROVIDER 0 LAKEHAVEN
PROPOSED USE: L rl L41
VALUE OF PROPOSED WORK:
7
FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?:
❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ HIGHLINE 0 PRIVATE (SEPTIC)
(0
■ PROJECT FLOOR AREAS
AREA DESCRIPTION
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
o ALTERATION
o REPAIR ❑ TENANT IMPROVEMENT
FIRST
o YES o NO
BASIC PLAN? o YES
❑ NO
SECOND
CHANGE OF USE? o YES
o NO
THIRD
❑ YES o NO
UP/SEPA/SU? ❑ YES
o NO
FOURTH
o YES o NO
DEMO PERMIT REQUIRED? o YES
o NO
ADDITIONAL FLOORS (DESCRIBE)
DECK (COVERED?)
GARAGE/CARPORT
HOW MANY F ?
TOTAL EXISTING
TOTAL. PROPOSED
TOTAL EXISTING AND PROPOSED
**NEW MES ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
Indicate number of
that is to be Inst or relocated as part of this project. Do not include existing fixtures to remain.
AWCZfAATCAL
Value of Mecham Work $ y S DD: 0
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
PLUMBING
BATHTUBS (or T„b/Sho—rCombo)
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINES
LAVS (Bathroom sink
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
_ � GAS PIPE OUTLETS
SHOWERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
GAS LOGS
HOODS (comm cw)
RANGES
GAS WATER HEATERS
WATER CLOSETS (roikq
DRINKING FOUNTAINS
RAINWATER SYS
HOSE BIBBS
ELECTRIC WATER HEATERS
REFRIG. SYSTEMS
WOODSTOVES
MISC (Describe)
MISC (Describe)
I certify under penalty of perjury thai the information furnished by me is true and correct to the best of my
knowledge, and fierther, 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 th xccu5pq of the information supplied to the city as a part of this application.
v-
NAME/TITLE: GATE:
nature) (Title)
RELATIONSHIP TO PR JECT: ClProperty Owner ❑ Applicant Contractor ❑ Architect ❑
FOR OFFICENSE ONLY:
o NEW ❑ ADDITION
o ALTERATION
o REPAIR ❑ TENANT IMPROVEMENT
BILDING.SHELL ONLY?
o YES o NO
BASIC PLAN? o YES
❑ NO
ZONING DESIGNATION:
CHANGE OF USE? o YES
o NO
NEW ADDRESS REQUIRED?
❑ YES o NO
UP/SEPA/SU? ❑ YES
o NO
PLATTED LOT?
o YES o NO
DEMO PERMIT REQUIRED? o YES
o NO
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