04-103922 X
City 67edariti WayMechanical Permit #: 04 - 103922 - 00 - MI
Community Developmenpmen t Services
P.O Box 9718
Federal Way,WA 98063-9718 Inspection request line: (253) 835-305C
Ph:(253)835-7000 Fax:(253)835-2609 P 9
Project Name: LEE
Project Address: 33722 4T SW Parcel Number: 729805 0240
Project Description: Gas to gas furnace changeout
Owner Applicant Contractor
Jerry Lee WASHINGTON ENERGY SERVICES CO WASHINGTON ENERGY SERVICES CO
33722 4TH AVE SW 2800 THORNDYKE AVE W 2800 THORNDYKE AVE W
FEDERAL WAY WA SEATTLE WA 98199 SEATTLE WA 98199
98023-8304 (206)282-4700 f
Mechanical Valuation 1875 Over the Counter Permit Yes
Mechanical Fixtures
Description !Quantity Description _Quantity. Description Quantity
Furnaces '
PERMIT EXPIRES March 29,2005.
Permit issued on September 30,2004
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 W61(4/111
q/3670-y
' Date:
Owner o agen
THIS CARD IS TO REMAIN ON-SITE f
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-103922-00-ME
Owner: JERRY LEE
Address: 33722 4TH AVE SW
FEDERAL WAY, WA 98023-8304
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD.
Inspections are listed as close to sequential order as possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not
be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections
are logged on the back of this card.
0 Me:hanical Rough-in(4165) 0 Gas Piping(4125) ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By Date 10111. 0.1_,
SEP-2;1r,2004 10:19 FROM: TO:12538352609 P.3
4A . . -
ederat Way -- 1--
PERMIT SF MF COEL PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES
3332EAVENUE, ITH•rOBOX971f APPLICATION
FEDERAL WAY,WA 9f064-9711 � D _r /
2S3-83S-4607•FAX 253-835-2609
unwnat uo/Tsderalwa u.cont
The ollowi • is re•wired i orntation-an incom•late ap•lication wit/not be acre•ted. Please •rint legibl in ink)or type.
II PROPERTY INFORMATION
3 2 ! ZZ L-;
SITE ADDRESS ✓ ' ,-" V & S Lci SUITE/UNIT I
7
ASSESSOR'S TAX/PARCEL Y ! 2 47( e d 2 y e LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
Mew**vomit pve prIengthyMpalQ UI
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING ❑ PLUMBING MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this vermit only)
9 As Qf ` YY\ice_. chr-c vt,y,
k,(6-
�-r ? + 3 I.a Ail 36,-mcl
PROJECT NAME(Name of Business or Owner Last Name) C.
• ' I. PEOPLE INFORMATION
PROPERTY Nme.freLee , PRIMARY PHONE
OWNER ILIN ADDRESS C TATE,ZIP `� 9C.000I-72-74a
MA
33"7 22 4 t itUt E ccs -0-e.) (4),1-71 C ti A- 07...7
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
W kfirl(wj .1SL?Ci ti Ce.V L4"4) exd - -gr7cro
MAILING ADD
Z.35714,ZJP ea CELL PHONE
�`TYY OF FEDERAL WAY BUSINESS UC NUMB rte EXPIRATIONDATE 1 FAX NUMBER/
2Q-03-J DI?1 - B L I / /ay— ( ) -
CONTRAgTORIS 1--(_/
REGISTRATION�NUMIIER��� er�galyd with oink application) EXPIRATION DATE
%ice F / Z icy-
APPLICANT COMPANY NAME t APPLICANT NAME OFFICE PHONE
�� ( ) -
MAILING ADDRESS CITY.STATE.ZIP CELL PHONE
( ) -
REIATIONSHIPTO PROJECT • FAX NUMBER
a Architect ❑Tenant O Agent o Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
( ) -
LENDER ,`ter RCW 19:27.095:'*Leridgr biformation ii" , NAME
itiquir*O.41:prolgct valtii_ezce.e s;5,000
MAILING ADDRESS CITY,STATE.ZIP '
■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
• EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
' SPRINKLERED BUILDING? O YES O NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? O YES O NO
. WATER SERVICE PROVIDER 0 LAKEHAVEN O BIGIILINE a TACOMA O PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 IIIGHLINE 0 PRIVATE(SEPTIC) a
SEP-22.2004 10:19 FROM: T0:12538352609 P.4
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.F1. PROPOSED SQ.rr. TOTAL
BASEMENT
F11ZS'T �■�
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT M,,elm►c.ow►.Rao.s.
TOTAL COSMIC TOTAL PRorosIC
HOW MANY FLOORS?
"NEW HOMES ONLY NUMBER OF BEDROOMS. ESTIMATED SELLING PRICE $
. FIXTURES , .._ ,- • ..
Indicate number of each type of fixture to be installed or relocated as part of this project.
Do not include existing fuMtnes to remain.
alluue of Mechanical Work S 16 7NICAL I
Va
GAS LOOS REFRIG.SYSTEMS
NR HANU UNITS EVAPORATIVE COOLERS HOODS
LO WOODSTOVES
SIMS FANS RANOES MISC IDescrtbCI
BOILERS FIREPLACE INSERTScAs WATER BEATERS
-! COMPRESSORS FURNACES
DUCTS OAS PIPE OUTLETS
PwareIA+G SHOWE
BATHTUBS WR CLOSETS tr.ak0 MISC(� ��
I.,n.►is1w�.src.�W.I RS ATE
DRINKINGAlECFOUNTNNS
DISHWASHERS SINKS �'— RAINWA ER SYST
OAS PIPE OUTLETS - SUMPS
URINALS HOSE MOBS
WASHI110 MACHINEt7 ,F,tT�C WATER HEATERS
LAVS nuo..+..ewst VACUUM BREAKERS
. •.. -..7,
,': 1:: _ l •,.•. . 4
-- ' - - - - D1SCLAINIER/SIGNATURE BLOCK - - -- - _
. knowledge,and further,that!
I,certify under penalty of perjury that the trljrnnaa.n furnished by me is true and correct application
best of!mals. 7� r myth , held
ant authorised by the owner of the above premises I.perform the mark for which the permit«sppil atiorred to the tn. ifuetee and defenseoh ld
of
harmless the City of Federal Way as to any claim(inelading eosts, expenses,and attorneys'f
such claim),which may be made by any person,including the undersigned.and filed against the City of Federal Way,tut rutty where such claim
arises out of the rattans of the citg,including Its.fjtoers and.mph trees,upon the accuracy of the Information supplied to the city as a part of
tits application. 1 ' ,
r�O
I ����
NAME/TITLE IIlitd <dLjr..1 �lv� MktMkt(Sipnoturel
,(4
RELATIONSHIP TO PROJECT O Owner ant o Contractor 0 Architect o OtherDOCS -
FOR OFFICE USE ONLY 1 e-
o NEW o ADDITION o ALTERATION a REPAIR o TENANT IMPROVEMENT
BASIC PLAN? o YES o NO
BUILDING SHELL ONLY? o YES o NO u'YES a NO
ZONING DESIGNATION CHANGE OF USE?
TIP/SEPA/SU? �— a YES o NO
NEW ADDRESS REQUIRED? o YES a NO DEMO PERMIT REQUIRED? o YES a NO
PLATTED LOT? o VES o NO
."-Pac. - ?37 z (--1 ,'/-UE ICJ
Bulletin NM-Match 30.2004
Page 2 of Meadows-Reviled Permit Application
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