03-105258L City 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: STARK If'. A
Project Address: 31527 42ND SW
Mechanical Permit #: 03 -105258 - 00 - ME
Project Description: Plumbing gas line to install gas fireplace logs
a � Inspection request line: 253.835.3050
Parcel Number: 873198 2890
Owner
Applicant
Contractor
James A Starr
GODFREY'S PLUMBING
GODFREY'S PLUMBING
31527 42ND AVE SW
15015 88TH ST E
15015 88TH ST E
FEDERAL WAY WA
PUYALLUP WA 98372
PUYALLUP WA 98372
98023-4018
Mechanical Valuation..........................................500 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
Description Quanti Description lQuantityl F --Description I Quantity
Gas Piping � 1
Owner or agent: Date: % �;I'/ O / /.& 3
k'/1 et""f 0'e /.?-//X/o3 7c -r -'-C
ci
=%� CONSTRUCTION PERMIT APPLICATION
CITY OF �..� RECEIVED PPLICATION NUMBER: - -
FederalWayPPLICATIONNUMBER:
DEC 0 1 2003 PPLIC --RoN NUMBER: - -
**The fQ'WiMWEUE�AtiKA7abon — Please print (in ink) or type**
BUILIYIN( �� pr HYY
Please note: Electrical, Fire Preven Ion 9 s and Engineering permits may require a separate application.
c '�e�PROPERTY• •
SITE ADDRESS: 3 S•��' "—//N®Ay ' �- U3 - ASSESSOR'S TAXI PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PR03ECT INFORMATION
TYPE OF PROJECT (This application): o BUILDING PLUMBING ❑ MECHANICAL o DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
&h 5 Y`zf-'PL-4 'c e Lo C'
PROJECT NAME: 5Tfig�
PLU m,8,',.c is &R-5 1 ;Pj I Ta i/(,67 l`CL
PROPERTY OWNER: NAME: DAYTIME PHONE-
5T-h/ze ; (a s3) q27
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
CONTRACTOR:
APPLICANT:
NAME:
DAYTIME PHONE:
i MAILING ADDRESS (STREET ADDRESS; CITY, STATE. ZIP):
i 2-08 JOS
EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
6 e V L)E /
Lz)14 _ _ - _ _ _
( ) -
CONTRACTORS REGISTRATION NUMBER:`
(coN a card required)
0 0 F !Z P* e
I EXPIRATION DATE:
S S Q o; ! 1
NAME: DAYTIME PHONE:
9.2 -7--D58
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): 4 EVENING PHONE:
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECTTENANT ❑ OTHER ( DESCRIBE): -
y E-MAIL ADDRESS: I
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER APPLICANT ❑ CONTRACTOR
DETAILED 13UILDING INFORMATION
EXISTING USE: SI .i a LE F/1MILY EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ �-1 1 I 0 0 0
PROPOSED USE: .S,+/nE
PROPOSED VALUATION FOR IMPROVEMENTS: $ fT V
SPRINKLERED BUILDING? ❑ YES >(NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES o NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE j(TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: ) LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
"NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING UNIT(S)
BBQ(S)
BOILERS)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S)
FAN(S)
FIREPLACE INSERTS)
FURNACE(S)
GAS PIPE OUTLET(S)
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINK(S)
SUMP(S)
Value of Mechanical Work: $.
GAS LOG(S) REFRIG. SYSTEM(S)
HOOD(S) WOODSTOVE(S)
RANGE(S) MISC. ( )
HEAT SOURCE: ❑ ELECTRIC ❑ GAS
URINAL(S) WATER HEATER(S)
VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
WASH MACHINE OUTLET
WATER CLOSET(S) MISC. ( )
DTSCLATMFR/STC,NATIJRF SLC
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 suppli to the clty as a part of this application.
NAME/TITLE: DATE:
PROPERTY OWNER APPLICANT ❑ CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 335M FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 253-661-4129
www.dtwffederalway.com