05-100338 City if FedetakWay Mechanical Permit #: 05 - 100338 - 00 - ME
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: BURGESS eV
Project Address: 31953 36THISW Parcel Number: 873198 3320
Project Description: Gas to gas water heater ehangeout
Owner Applicant Contractor
Elvin A Burgess Jr. WASHINGTON ENERGY SERVICES CO WASHINGTON ENERGY SERVICES CO
31953 36TH AVE SW 2800 THORNDYKE AVE W 2800 THORNDYKE AVE W
FEDERAL WAY WA SEATTLE WA 98199 SEATTLE WA 98199
98023-2138 (206)282-4700
Mechanical Valuation 600 Over the Counter Permit Yes
PERMIT EXPIRES July 25,2005.
Permit issued on January 26,2005
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 i! ,
Owner or agent:` / Date: 1 /��7/
THIS CARD IS TO REMAIN ON-SITE
CITY OF 11.11 Community Development Inspectionaecord
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-100338-00-ME
Owner: ELVIN A 13URGESS JR.
Address: 31953 36TH AVE SW
FEDERAL WAY, WA 98023-2138
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 Mechanical Rough-in(4165) ❑ Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By fL f Date Z. -16— itr
JAN-26-2005 09:40 FROM: TO:12538352609 ' P.5
, �f •
D5 _ - 0403
a PERMIT SF MF CO EL PL DE EN FP
Federal Way ^ —" `�
oanwvevrr DEYELOPMENT saavtcas
33325 t"'AVENUE SOUTH•PO BOX""
FEDERAL ver, A P P L I CAT I O N
TO
:53435.2407•FAX 212•535-2609 / /
IDADEAnafkakEIERIEt
The allow( • is re•wired information—an incomplete a••Mutton will not be acce•ted. Please •Tint leibi in i or
• PROPERTY INFORMATION
•
SITE ADDRESS 31 615- 2 3 ✓ e v SUITE/UNIT#
ASSESSOR'S TAX/PARCEL Y LJ 33__L �
V 2 _ _ LOT SIZE(sn
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
Ma.*+crr+u pope for*troths/Wel dsao(vd.N
• PROJECT INFORMATION •
TYPE OF PERMIT 0 BUILDING O PLUMBING MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit gray)
4,.f 712) • 9`(,.J £ JJ t1..2eL C �.
9 'ye_
PROJECT NAME(Name of Business or Owner Last Name) 13 Li rc el
` . . • NI PEOPLE INFORMATION
PROPERTY NAME " PRIMARY PHONE p
OWNER £IUih Par8e- r (2J)(131 - 4QTtl��Q
MAILING ADDRESS Cm,STATE,ZIP
tc(53 3Ce` ' ,1-Itc JL) -f- ) ciTa Clic WO 23?
CONTRACTOR COMPANY NAME APPLICANT NAMEOFFICE PHONE •
*
Wh` 45¢��.v-�a-'>• 4 ' (� Li l�tf& (da,).-2,"2...1 - '1e°
MAIUNG DD � ICC C � �t/•W �/ CELL PHONE
D "
-
CITY OAF FEDERAL WAY BUSINESS UC SE NUMB EXPIRATION DATE FAX NUMBER
CONTRACTOR'S REGISTRATION NUMBER(copy or card required with tach appUcaUon) PIRATION DATE
LIA-5f-tfzJ•97ice y / Z /et -
APPLICANT COMPANY NAME APP9CANr NAME OFFICE PHONE
L�II/(I[/SIL ( ) -
MAILING ADDRESS CITY.STATE,ZIP CELL PHONE
(+(2 774° - 32.0/r
RELATIONSHIP TO PROJECT • FAX NUMBER
O Architect 0 Tenant 0 Agent 0 Other(Describe) ( ) -
CONTACT NAME
Li ri ac._ ((�IyI NONg7 '3_ ^ E-MAIL ADDRESS
LENDER V;� -acw, Li``..:i eti.mailae. NAME <
MAILING ADDRESS CITY,STATE,ZIP
' •• ■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? o YES O NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 BIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN o HIOHLINE 0 PRIVATE(SEPTIC)
JAN-26-2005 09:40 FROM: TO:12538352609 P.6
';;:1'.1:1,::.,•,--t
•,;: ,�j:e: •• PROJECT FLOOR AREAS .
_
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
_FIRST • .
SECOND
•THIRD •
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
TOTAL mama TOTAL TROMSO) TOTAL OM MO►IOWiW
'"HOW MANY FLOORS?
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $..
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
I C&A.NICAL � (�i �—
Value of Mechanical Work $ Cp
EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
NR HANDLING UNITS HOODS(c.a,mercW) WOODSTOVES
BBQS FANS MISC(Describe)
BOILERS FIREPLACE INSERTS RANGES
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS OAS PIPE OUTLETS .
PLUbiBINCi SHOWERS WATER CLOSETS R.wu MISC(Describe(
• BATHTUBS(.r Tu►/st»YvC.ol») DRINKING FOUNTAINS
DISHWASHERS SINKS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES • URINALS HOSE BIBBS
LkVS(e:uv..ir Sinks)
VACUUM BREAKERS ELECTRIC WATER HEATERS
-. ` _ - _ _ _ , .ADISCLAtMER/SIGNATURE ILOCK _ . .- • - . .. • _ - -
er,
I certify under penalty of perjury that the information furnished by me is true and correct o theest of tton is my knowleade. l further agreand
to hotI
am authorized by the owner of the above premises to perform the work for which the permitapplicationin the
harmless the City of Federal Way as to any claim(including costs, expenses and
n fees
incurred
uf investigation Federal Way,but only where such claim
and defense of
such claim), which may be made by any person,including the undersigned, filed against the City
arises out of the reliance of the city, eluding its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application. / / // /c?
p.-6
NAME/TITLE IA C ' da• filli
DATE ` J
1
V (Signature) ! (Title)
i RELATIONSHIP TO PROJECT D Owner gent O Contractor O Architect D Other
Is
}moi Y,i. F:h v}JIN1���'+�4��•
FOIZ,LOFFCE'USE O,1JhTA,s.,
• a NEW a ADDITION o ALTERATION o REPAIR o'TENANT IMPROVEMENT
l
` _BUILDING SHELL ONLY? a YES o NO BASIC PLAN? o YES o NO
�
ZONING DESIGNATION. CHANGE OF US,E? . a YES o NO
t NEW ADDRESS REQUIRED? o YES o NO
UP/SEPA/SU? o YES o NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? a YES o NO
(- Z v gi ii 3Irc3 36'7?,
Bulletin 11100-March 30.2004 '" • Page 2 of 4 1\[{andouls-Reviscd\}crmit Application