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03-101019 �`l CONSTRUCTION PERMIT APPLI • ON '\N, CITY OF �`.V Federal Way APPLICATION NUMBER: > 3_ 10 p01/- on APPLICATION NUMBER: kPPLICATION NUMBER: **Th• following is re. ired information-Please print(in ink)or type** Please note: Electrical, ire Preventidn S stems and Engineering permits may require a separate application. 1. - FA' PROPERTY INFORMATION SITE ADDRESS: S -6 5, I 1 okr(h p- th t t"ti y ASSESSOR'S TAX/PARCEL #: 5 5- e 0 05 LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): / FA PROJECT INFORMATION TYPE OF PROJECT(This application): o BUILDING 0 PLUMBING MECHANICAL o DEMOLITION ❑ ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description): - -'1V - r C f k-C-C t_ - - PROJECT NAME: S Pt C _ - 111 11 PEOPLE INFORMATION PROPERTY OWNER: NAME: ' DAYTIME PHONE yKa (0( / -- (2c3) 8: -7(677 MAILING 7 MAILING A SS gDRCITY, CONTRACTOR: NAME: DAYTIME PHONE: � C X200 282-1"7V MAILING ADDRESS(STREET AD ESS;CITY,STATE,ZIP): A I EVENING PHONE: OR g o 0 A.0 L., _ I ) ,�c� - CITY OF FEDERAL WAY BUSINESS U ENSEWDMBER: �� FAX NUMBER: - ( ) 1 CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE (copy of card required) W A-.3 4.-i- .5 3 3 O C t //DATE: o / D I APPLICANT: NAME: C DAYTIME PHONE MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE 1 RELATIONSHIP TO PROJECT: �� FAX NUMBER: 0 ARCHITECT o TENANT �QOTHER( DESCRIBE): 32 j ( ) - \ ;72i_ � E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER o APPLICANT ❑ CONTRACTOR ■ DETAILED BUILDING INFORMATION EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION , C S.S---L�C �� PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ SPRINKLERED BUILDING? 0 YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:o YES 0 NO WATER SERVICE PROVIDER: o LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC) **NEW RESIDENTIAL CONSTRUCTION ONLY** N BER OF BEDROOMS: ESTIMATED SELLING PRICE: $ ■ PROJECT FLOOR AREAS FLOOR at NG SQ,FT. PROPO • SQ.FT. j TOTAL BASEMENT FIRST SECOND THIRD FOURTH OTHER FLOORS(D RIBE) DECK IGA• • E MANY FLOORS? TOTAL: ■ FIXTURES 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) BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( ) COMPRESSOR(S) FURNACE(S) DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: 0 ELECTRIC o GAS PLUMBING BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S) DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( ) INTERCEPTOR(S) SUMP(S) L DISCLAIMER/SIGNATURE BLOCK I certify under penalty of perjury th t 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 daim(induding costs,expenses,and attorneys'fees incurred in the Investigation and defense of such daim),which may be made by any person,including the undersigned,and filed against the City of Federal Way,but only w e such daim arises out of the reliance of the dty,induding its officers and employees,upon the accuracy of the information ppli to the city At.,part of ication. NAME/TITLE: - DATE: S J �� ❑ PROPERTY OWNER o APPLICANT c. •NTRACTOR FOR.OFFICE.USE ONLY Y3,NEW,' ,t ❑ADDITION e.,,=.O ALTERATION'. ❑„REPAIR a a TENANT<IMPROVEMENT, ,. nx. CE •t ) 0-64% .w MI.` >LOT;SIZE: ' ta:`x.;t . r "; x i 4,„0 ZONINGDESIGNATION 4�'__ „_ .BUILDING SHELL ONLY?Va'YES ;o NO =COMP:PLANDESIGNATION :BASIC PLAN? 5'-;.❑'YES::!'2'••'.6'NO :1" SECTION, y ; TOWNSHIP. RANGE NEW ADDRESS REQUIRED? ;❑YES .r-•o NO PLATTED LOT?:' ❑YES ©NO '` _y CHANGE OF USE?, [i YES fl NO COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129 www,dtvoffederalway.com 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: SPICER Project Address: 823 S MARINE HILLS WAY Project Description: Install fireplace insert Mechanical Permit #:03 - 101019 - 00 - ME Inspection request line: 253.835.3050 Parcel Number: 515293 0050 Owner Applicant Contractor Donald T Spicer & Mary E Spicer WASHINGTON ENERGY SERVICES CO WASHINGTON ENERGY SERVICES CO 823 S MARINE HILLS WAY 2800 THORNDYKE AVE W 2800 THORNDYKE AVE W FEDERAL WAY WA SEATTLE WA 98199 SEATTLE WA 98199 98003-3183 1 1 (206) 282-4700 PERMIT EXPIRES September 13, 2003. Permit issued on March 17, 2003 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. L Owner or agent: Date: v