04-100130al Way
City of
Applicant
Mechanical Permit #: 04 -100130 - 00 - ME
Comm+nity De
ity bevvelelopment Services
ELI HAGGINS
ELI HAGGINS
33536 1st Way S
4727 SW 317TH LN UNIT D
4727 SW 317TH LN UNIT D
Federal Way, WA 98003-6210
FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
Ph: 253.661.4000 Fax: 253.661.4129
Inspection request line: 253.835.3050
Project Name: HAGGINS %P
Project Address: 4727 SW 317TH � UnitD Parcel Number: 784300 0040
Project Description: Install gas line from attic furnace to fireplace and install fireplace gas insert
Owner
Applicant
Contractor
ELI HAGGINS
ELI HAGGINS
ELI HAGGINS
4727 SW 317TH LN UNIT D
4727 SW 317TH LN UNIT D
4727 SW 317TH LN UNIT D
FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
(253) 838-5557
Mechanical Valuation..........................................2900 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
Description Quanti Descri'` Eton Quanti' Description Quantity
Fireplace Inserts Gas Piping I f
PERMIT EXPIRES July 13, 2004.
Permit issued on January 15, 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. _
Owner or agent: Jl.� �\;� �—�_ Date:
J
A
CITY Of
Federal Way
For Office Use Only:
The following is
""—CEN EDum, DEVELOPMENT SERVICES
33530 FIRST WAY SOUTH PO BOA 9718
FEDERAL WAY, WA 98063-9718
PERMIT APPLICATION JAN X 5 Z004WW,�n�u ((eAle alroaumlm129
TD:
FW File Number: -0 - �� Q Q - OF FEDERAL VYAY
-an
will not be accepted. Please
SITE ADDRESS: �%:mr2 4 'SW 3 � n SUITE/APT #
ASSESSOR'S TAX/PARCEL #: _ _ _ _ _ _ - _ _ _ _ SQUARE FOOTAGE OF LOT:
LEGAL DESCRIPTION (eg: Acme Estates, Lot 1) C cw\_4 U (N\ ( V\ C U (LSA
(Attach separate page for lengthy if
TYPE OF PERMIT (This application): ❑ BUILDING o PLUMBING MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onluh.
or
IQ*103j0-10 az FA k5iDi
PROPERTY
OWNER
CONTRACTOR-
APPLICANT:
ONTRACTOR
Last
NAM, ^ PRIMARY PHONE:
MAILING ADDRESS (STREET ADDRESS CITY, STATE, ZIP
NAME COMPANY
OFFICE PHONE:
MAILIN ADDRESS ( REET ADDRESS;): TY, STATE, ZIP
CELL PHONE:
CI OF FEDERAL WAY SINESS L(CEN NUMBER: EXPIRATIO DATE:
FAXUMBER:
rONTRACTORS REGISTRATION NUMBER:
(copy of card required with each application) _
EX ON DATE:
APPLICANT:
NAME:
COMPANY
OFFICE PHONE:
MAILING ADDRESS (STREET ADDRESS):
CITY, STATE, ZIP
EVENING PHONE:
RELATIONSHIP TO PROJECT:
❑ Architect ❑ Tenant ❑ Other (Describer
FAX NUMBER:
( -
CONTACT PERSON FOR THIS PROJECT: ❑ Property Owner ❑ Contractor ❑ Applicant I E-MAILADDRESS:
EXISTING USE:
EXISTING ASSESSED/APPRAISED VALUE $_
SPRINKLERED BUILDING? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN
SEWER SERVICE PROVIDER: 0 LAKEHAVEN
PROPOSED USE:
ej
VALUE OF PROPOSED WORK: $
FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: ❑ YES ❑ NO
❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ HIGHLINE 0 PRIVATE (SEPTIC)
■ PROJECT FLOOR AREAS
AREA DESCRIPTION
EXISTING S . FT.
PROPOSED SQ. FT.
TOTAL _ _
BASEMENT
c ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
FIRST
BASIC PLAN? ❑ YES
❑ NO
SECOND
CHANGE OF USE? c YES
THIRD
N`EW ADDRESS REQUIRED? ❑
YES n NO
FOURTH
c NO
PLATTED LOT? c
YES r! NO
ADDITIONAL FLOORS (DESCRIBE)
DEMO PERMIT REQUIRED? YES
❑ NO
DECK(COVERED?)
GARAGE/ C ORT
MANY FLOORS?
TOTAL EXISTING
TOTAL PROPOSED
TOTAL -(STING AND PROPOSED
"NEW HOMES ONLY'" NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
Indicate number of each type of fixture that is to be installed
MECFIAIUICAL
Value of Mechanical Work $ R46D
AIR HANDLING UNITS
BBQS
BOILERS
_COMPRESSORS
DUCTS
PLUMBING
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINF,S
LAYS (Bathr Sok
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS PIPE OUTLETS
SHOWERS
SUMPS
URINA '
JACUUM BREAKERS
as part of this project. Do not include existing fixtures to remain.
GAS LOGS
HOODS
RANGES
GAS WATER HEATERS
WATER CLOSETS (T.ii�q
DRINKING FOUNTAINS
RAINWATER SYS
ELECTRIC W
REFRIG. SYSTEMS
WOODSTOVES
MISC (Describe)
MISC (Describe)
1 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 the city as a part of this application.
NAME/TITLE: DATE:
(Signature) (Title)
RELATIONSHIP TO PROJECT: ❑ Property O%vncr ❑ Applicant ❑ Contractor ❑ Architect ❑
FOR OFFICE USE ONLY:
❑ XEW ❑ ADDITION
c ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
BUILDING SHELL ONLY? (i YES c NO
BASIC PLAN? ❑ YES
❑ NO
ZONING DESIGNATION:
CHANGE OF USE? c YES
n NO
N`EW ADDRESS REQUIRED? ❑
YES n NO
UP/SEPA/SU? (:i YES
c NO
PLATTED LOT? c
YES r! NO
DEMO PERMIT REQUIRED? YES
❑ NO