03-104024of Federal Way
Community Development Services Mechanical Permit #:03 -104024 - 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: LLEWELLYN
Project Address: 27804 20TH & PIS Parcel Number: 757562 0330
Project Description: Remove and replace gas water heater
Owner
Applicant
Contractor
JEFF LLEWELLYN
WASHINGTON CORROSION SRVC INC
WASHINGTON CORROSION SRVC INC
27804 20TH PL S
1425 BLAINE AVE NE
1425 BLAINE AVE NE
FEDERAL WAY WA 98003
RENTON WA 98056-2774
RENTON WA 98056-2774
(425) 228-1393
Mechanical Valuation..........................................600
Over the Counter Permit......................................Yes
PERMIT EXPIRES February 24, 2004.
Permit issued on August 28, 2003
I hereby certify that the above information is correct and that the construetio€t on the above described property and
the occupancy and the u will Jr� inCordancgth the laws, rules and regulations of the State of Washington and
the City of Federa a .
Owner or
ia/9 /05-�
Yom`'
Date: 0, ��rU
RECEIVED
CONSTRUCTION PERMIT APPLICATION 111
< CITY OF O'"—'�.��
PPLICATION NUMBER: - y
Federal Way
AUG 2 g 2003 APPLICARON NUMBER: _ _ -
APPLICATION NUMBER:
**The WTy*SkW fbYmation
— Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
f�j �
PROPERTY • •
SITE ADDRESS: /� ! A9, / Po (/Q iC 5, ASSESSOR'S TAXIPARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PR03ECT INFORMATION
TYPE OF PROJECT (This application): o BUILDINGMBING MECHANICAL o DEMOLITION
o ELECTRICALOFMCGINEERINGI0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): 11e ee Cz�i4 A Com' 1 Jill e�
126-c� r��
PROJECT NAME:
••LE INFORMATION
PROPERTY OWNER: NAME:
DAYTIME PHONE'
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
X7 86 A-� l Soo
CONTRACTOR: NAME: I DAYTIME PHONE:
'► 7a -, �' rr`,ea s i o v� c ! ( ¢ZS) 22t
MAILING ADDRESS (STREEIr ADDRESS; CITY, STATE, ZI : EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER:
I EXPIRATION DATE:
(copy of card required)
APPLICANT: NAME: DAYTIME PHONE:
MAILING ADDRESS (STREET AD SS; CITY, STATE, ZIP): EVENING PHONE: i
RELATIONSHIP TO PROJECT: FAX NUMBER:
o ARCHITECT ❑ TENANT o OTHER ( DESCRIBE):
I
j E-MAIL ADDRESS: —�
I
CONTACT PERSON FOR THIS PROJECT: ❑PROPERTY OWNER o APPLICANT ❑CONTRACTOR L
DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES o NO
WATER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE o TACOMA o PRIVATE (WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN ❑ HIGHLINE 0 PRIVATE (SEPTIC)
"NEW RESIDENTIAL CONSTRUCTION ONLY"
r
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PR03ECT FLOOR AREAS I
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILERS) FIREPLACE INSERT(S) RANGE(S) MISC. ( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: o ELECTRIC o GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) / WATER HEATER(S)
DISHWASHERS) RAIN WATER SYS. VACUUM BREAKER(S) o ELECTRIC GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET /
GAS PIPE OUTLET(S) SINKS) WATER CLOSET(S) MISC. ( )
INTERCEPTOR(S) SUMP(S)
BLOCK
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 sunolied-to the dtv as a-nart of this anolication.
NAME/TITL
o PROPERT
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718. 253-661-4000 • FAX: 253-661-4129
www.dwoffederalway.00m
REGISTERED AS•PROVIDED BY LAWt
CONST CONT SPECIALTY;
REGI ST . #,: -EXP - DAT$ "=
--CLBGAF WASHICS055KC 05/04/2004
'P,EFFECTIVE DATE 05/03 1995;,
WAS1i!MGTQN CORROSION ,SRVCGZNf—
.1425 BLAINE VE NE
kENTON WA f 956-_27-74
�v;�,iarure _
.sued l l;k?f tt7;vlENT_OF LABQr, ANI) IN DIl� C y1.