02-104066City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Mechanical Permit #:02 - 104066 - 00 - ME
Project Name: NORTHSHORE CHEVRON GAS PIPE
Project Address: 34007 HOYT, SW
Project Description: MECH - Install gas pipe to stove top and deep fryer
Inspection request line: 253.835.3050
Parcel Number: 308900 0355
Owner
Applicant
Contractor
NORTHSHORE CHEVRON *RAY EBERT *
SUNSET AIR INC
SUNSET AIR INC
NORTHSHORE CHEVRON
5210 LACEY BLVD SE
5210 LACEY BLVD SE
34007 HOYT RD SW
LACEY WA 98503
LACEY WA 98503
FEDERAL WAY WA 98023
(360) 456-4956
Mechanical Valuation..........................................1769 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
SF )�€Serl�fl�Ofl ��L�_
Gas Piping 2
PERMIT EXPIRES March 19, 2003, IF NO WORK IS STARTED.
Permit issued on September 20, 2002
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 orda with a laws, rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: Date:
0 L �' - S = t7 -2,, G
kAG- 7Z .2 -S—� 0,:� 4f-- e'J
CfYOf CONSTRUCTION PERMIT APPLICATION
� - PPLICATION NUMBER
:
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APPLICATION NUMBER: - -
APPLICATION NUMBER: - -
**The following is required information - Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
j PROPERTYs •
SITE ADDRESS: �-TUQ-7 14c j 6 L ASSESSOR'S TAX/PARCEL #: _ _ _ _ _ _ -
LEGAL pESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESgRIPTION IF LENGTHY):
PROJECT• •
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME:
PROPERTY OWNER: I NAME:
CONTRACTOR:
APPLICANT:
DAYTIME PHONE:
(;25�) R3R -
MAILING ADDRESFI(STREET ADDRESS CITY, STATE, ZIP):
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NAME: ,p ,j/1�
DAYTIME PHONE:
�
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Ciqc
MAILING ADDRESS ( EET ADDRESS; CITY STATE, ZIP):
EVENING PHONE:
CITY OF FEDERAL WAY BUSINES9 LICENSE NUMBER
FAX NUMBER:
(36D) Lf -S5
CONTRACTOR'S REGISTRATION NUMBER:
EXPIRATION DATE:
(copy of card required)
NAME: ! �� DAYTIME PHONE:
(3&a) c -
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
&JACS Jib (3")
RELATIONSHIP TO PROJECT:,, // FAX NUM
1:1ARCHITECT ❑ TENANT ❑ OTHER ( DESCRIBE):�/kL4--K- C�+v ( -
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER 'APPLICANT ❑ CONTRACTOR
DE/:11LE•l-iT)1.•)1►[M1►17•1:I &ATI&C
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ �—
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE (SEPTIC)
'*NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS:
ESTIMATED SELLING PRICE:
■ PR03EU FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
FIRST
_
PLATTED LOT? ❑ YES ❑ NO
CHANGE OF USE? ❑ YES ❑ NO
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING UNITS)
BBQ(S)
BOILERS)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHERS)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
■ FIXTURES
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACE INSERT(S) RANGE(S) MISC. ( )
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINKS)
SUMP(S)
URINALS)
VACUUM BREAKER(S)
WASH MACHINE OUTLET
WATER CLOSET(S)
']TScTATMER/-gTGNATURE BLC
WATER HEATER(S)
❑ ELECTRIC ❑ GAS
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 cl im arises out of the reliance of the city, including its officers and employees, upon the accuracy
of the information s i d th a part of this application.
NAME/TITLE:DATE:
❑ PROPERTY OWNER APPLICANT ❑ CONTRACTOR
Fnp nFFTr'F I IGF nNl Y.
❑ NEW vv❑ ADDITION El ALTERATION
El REPAIR ENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO
CHANGE OF USE? ❑ YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • P.O. BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 253-661-4129