02-100004City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Pli:253.661.4000 Fax: 253.661.4129
Project Name:
Project Address:
BOLLAERT
306 SW 293RD
Plumbing Permit #:02 - 100004 - 00 - PL
Project Description: PL - Change out gas to gas water heater.
Inspection request line: 253.835.3050
Parcel Number: 119600 0665
Owner
Applicant
Contractor
Brian B & Rebecca R Bollaert
WASHINGTON ENERGY SERVICES
WASHINGTON ENERGY SERVICES
2800 THORNDYKE AVE W
2800 THORNDYKE AVE W
SEATTLE, WA
SEATTLE, WA
98199
(206)282-4700
�escrlpkicn�I��� Quanti
ater Heaters
6
Plumbing Fixtures
PERMIT EXPIRES July 2, 2002, IF NO WORK IS STARTED.
Permit issued on January 3, 2ft2
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 'th the laws, rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agen : Date:
1 uw\\:)
,
JAN -02-02 11:35 FROM-NORTHWEST-CASSIMAR 206-374-0834 T-051 P.03/07 F-445 P�
97E3E"tF=L— APPUCAMON NUMBER: a-- La
�? FNA.PptlCATION NUMBER:
APPLICATION NUMBER:
**The following is required Information — Please print (in ink) or type"
Please note: Electrical, Fre Prevention Systems and Engineering permits may require a separate apPlicaUon.
SITE ADDRESS: 10 6 S' !,-) el `i 3 v +- ASSESSOR'S TAX/PARCEL #: 1 5 S C7 0- 0 6 6 S
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): ❑ BUILDING W PLUMBING Q MECHANICAL ❑ DEMOI-ITION
❑ ELECTRICAL O ENGINEERING❑ FIRE PREVENTION SYSTEM
PR03ECf DESCRIPTION (Provide detailed description):
A
'PRO3ECT NAME: 6b '1r- , 0 11 a e✓ t
PROPERTY OWNER:
CONTRACTOR.
APPLICANT:
FMA
'4 @Q / y (ALt3) 9z - Ib6Z
LUNG ADDRESS (STREET ADDRESS, GiY, SPATE, 2lP)t
Tato !r --j '193 V 4 _ .
- ` 9oc
��
CONTACT PEERSON FOR THIS PR03ECT: ❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR L -
10 DETAILEDGUiLDINGIN17ORMATION
EXISTING USE, 5- ExisTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRYMKLEREU BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED- ❑ YES ❑ N4
WATER SERVICE PROVIDER: 1] LAKEHAVEN ❑ t1IGHLTNE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATC (SEPTIC)
:*NEW RESIDENTIAL CONSTRUCTION ONLY** ' •
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
AIR HANDLING UNIT(S)
FIRST
GAS LOG(S)
REFRIG. SYSTEM(S)
BBQ(S)
SECOND
HOOD(S)
WOODSTOVE(S)
BOILERS)
THIRD
RANGE(S)
MISC. ( )
COMPRESSOR(S)
FOURTH
DUCT(S)
OTHER FLOORS (DESCRIBE)
HEAT SOURCE:
❑ ELECTRIC ❑ GAS
DECK
BATHTUB(S)
GARAGE
HOW MANY FLOORS?
URINAL(S)
WATER HEATER(S)
DISHWASHER(S)
TOTAL:
VACUUM BREAKER(S)
❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S)
I certify under penalty of perjury th ft 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 a' o f the reliance of the city, including its officers and employees, upon the accuracy
of the information supplied to the city as � this A*lication.
DATE: [ �)(��
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES - 33530 FIRST WAY SOUTH - PO BOX 9718 - FEDERAL WAY, WA 98063-9718 - 253-661-4000 - FAX: 253-661-4129
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:
❑ ELECTRIC ❑ 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)
SINKS)
WATER CLOSET(S)
MISC. ( )
INTERCEPTOR(S)
SUMP(S)
I certify under penalty of perjury th ft 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 a' o f the reliance of the city, including its officers and employees, upon the accuracy
of the information supplied to the city as � this A*lication.
DATE: [ �)(��
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES - 33530 FIRST WAY SOUTH - PO BOX 9718 - FEDERAL WAY, WA 98063-9718 - 253-661-4000 - FAX: 253-661-4129