04-103218 w
v
City of)rederal Way
Communi[y�llevelopment Services Mechanical Permit #:04 - 103218 - OQ - ME
31530 5st Way S
Federal.Way,WA 98003-6210
Ph:253.661 4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: WAGONER cJv
Project Address: 31805 54TH1SW Parcel Number: 189850 0040
Project Description: Remove and replace gas water heater
Owner Applicant Contractor
)oris A Wagoner WASHINGTON ENERGY SERVICES CO WASHINGTON ENERGY SERVICES CO
31805 54TH AVE SW 2800 THORNDYKE AVE W 2800 THORNDYKE AVE W
FEDERAL WAY WA SEATTLE WA 98199 SEATTLE WA 98199
98023-2016 (206)282-4700
Mechanical Valuation 600 Over the Counter Permit Yes
PERMIT EXPIRES February 15,2005.
Permit issued on August 19,2004
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 Way.
Owner or agent: /4,4-64._ Date: (41///,-1/
5I 0
v
THIS CARD IS TO REMAIN ON-SITE
CITY OF44A
Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04-103218-00-ME
Owner: JORIS A WAGONER
Address: 31805 54TH AVE SW
FEDERAL WAY, WA 98023-2016
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) 0 Gas Piping(4125) ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By f.../lJ Date ..►(Q,. Ga
1
04- (o 3Z)Y
AUG-12-2004 07:08 FROM: TO:12536614129 F.97 '"1§ E
_ mMMUNnY DEVELOPMENT SERVICES
33 30 WAY
SW1An f•PPO 97111.
FEDERAL
Fpeteral Way . PERMIT APPLICATION ?53661411n.FAX:v, i,1n 129
For Of&cc Uwe Only: )_ 0 3 a L jJ�"^/- C) 0 TO.
FW File Number: ® - 4 j( / /
i
The ollowin• is •uired in ormation-an ineo .late a- •Uication wilt riot be acce•ted Please •rint le•ibl (in inks)or j, -.
• PROPERTY INFORMATION
SITE ADDRESS: '3 ! g:0. '5 ...Mt-) SUITE/APT!t
I
ql 2'
ASSESSOR'S TAX/PARCEL it: 0 co cQ SQUARE FOOTAGE OF LOT:
LEGAL DESCRIPTION(e.g.:Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
U PROJECT INFORMATION
TYPE OF PERMIT(This application): 0 BUILDING 0 PLUMBING XRECHANICAL 0 DEMOLITION
0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM '
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only):
912-.5 -TCI ''a s Lat4e4- /t -Irlia-itcraz-c6
PROJECT NAME(Name of Business/Owner Last Name): WI,.•`(-e r"'
• PEOPLE INFORMATION
PROPERTY NAME: ' '` PRIMARY PHONE: Q
OWNER: jOri s w49o`► e - (z5-3) 1.3! J7°3
MAILING ADDRESS(STREET ADDRESS;(: CITY STATE.ZIP
3 I in,5" SIA^ /1-7/e SY-4J �� LL1r4
j tic 9.6r671-3
CONTRACTOR N, tdtch 1 Acii � COMPANY OFFICE PHONE:
MAILING ADDRE ST' ET D S;): .STAT ` 1 l a- e()
✓J7,A-CI
�¢/t'S, F�, cV 1� `SI 7�, ` ' / ly,•G L ELL PHONE: _
' OF
FEDE-05-L6_w .z iciAY BUSINESS LI sr NUMBER:a . ' KI'P/EXPIRATION
r (AX NUM)ER: -
CONTRACTORS REGISTRATION NUMBER EXPIRATION DATE:
(oen d card r.yalyd.rtt>.each.pptto.tfoal WP'iJh I -57 LO . - - 9 / �jG� V i or
LENDER: NAME: G i�
DAYTIME PHONE:
Oft..t...4 Valli.>{5.000j r
)
MAILING ADDRESS(STREET ADDRESS;(: CITY,STATE.ZIP `
APPLICANT: NAME: ' '"W COMPANY OFFICE PHONE: _
MAILING ADDRESS(STREET ADDRESS': CITY.STATE.ZIP EVENING PHONE.
RELATIONSHIP TO PROJECT: FAX NUMBER:
O Architect 0 Tenant 0 Other(Describe). ( ) -
CONTACT PERSON FOR THIS PROJECT: 0 Property Owner ? Contractor 0 Applicant E-MAIL ADDRESS:
■ DETAILED BUILDING` ` INFORMATION •
EXISTING USE: PROPOSED USE:
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK: $
,
SPRINKLERED BUILDING? D YES O NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: 0 YES 0 NO
WATER SERVICE PROVIDER: O LAKERAVEN ❑ HIGHLINE 0 TACOMA O PRIVATE(WELL) •
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 IIIGHLINE 0 PRIVATE(SEPTIC)
AUG-12-2004 07:08 FROM: TO:12536614129 P.6
3!-n 3'' 5-47\ ,
. 1111 PROJECT FLOOR AREAS
-
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ,FT. TOTAL
• BASEMENT
FIRST
SECOND
THIRD
FOURTH ,
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? Toru oasrtt+o • TOTAL.PROPOSED Tarty.COSTING AND ntornaEa -
"NEW HOMES ONLY" NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
Indicate number of each type of fixture that is to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECNAAMCAL ^/',,AValue of Mechanical Work $ Iva-,i
•-AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(e.omaa.q WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES
'COMPRESSORS FURNACES ` GM WATER HEATERS MISC(Describe)
DUCTS GAS PIPE OUTLETS
•
PLUMBING
BATHTUBS(.r Tub/Shower Combo) _ SHOWERS WATER CLOSETS(Tao MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES URINALS HPSE BIBBS
LAVS(8+thr..n Sink VACUYM BREAKERS ELECTRIC WATER HEATERS
.
■ DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the informaition furnis d by me is b-ue and correct to the best of my
knowledge,and further, that I am authorized by the owner of the abo�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'fee.s 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 Wa ,but only where such claim arises out of the reliance of the city,
including its officers nd�eAmploloyee port the accuracy . he information supplied to the city as as art o thisisapplication.
NAM /
E/TITLE: ✓✓Ldc d DATE: [ _ I
(S( , (Title) -
RELATIONSHIP TO PROJECT':CT: O Property Owner O Applicant Contractor �=d Architect •� e-%(y/Jp"-�(..>>
it42..--r-710 3 2-cPP
z=O(3E USEGNLYy `
.•''NEW,:";:;;.;:•, ;•,-_;Q_ADDITION ,,, .G ALTERATION o REPAIR
' � .4,TENANT,IMPROVEMENT
+BUILIDING!'SHELLONL`Y?.'; "•.Y ,•,..-•jj"'YES:o NO -
,BASIC'PLAN?. O YES* a NO
ZORING;DESIGNATION: •"
' �'" ,CIi1�`iti:GL OF USE? a YES a NO:
NEN/►DURESS REQUIRED? OYES o NO UP/SEPA/SU? a YES o NO
-PLATTED.LOT? o YES o NO DEMO PERMIT REQUIRED? a YES o NO +
I;IUI1clin ;t 1(1() -,l.rrni.-Lr\ I.400-I Page 2