05-103943 City of Federal Way Mechanical Permit #: 05 - 103943 - 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
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Project Name: DUTTON
Project Address: 29718 4TH/SW Parcel Number: 062104 9107
Project Description: Replace gas hot water tank.
Owner Applicant Contractor
William R Dutton WASHINGTON ENERGY SERVICES CO WASHINGTON ENERGY SERVICES CO
29718 4TH AVE SW 2800 THORNDYKE AVE W 2800 THORNDYKE AVE W
FEDERAL WAY WA SEATTLE WA 98199 SEATTLE WA 98199
98023-3512 (206)282-4700
Mechanical Valuation 600 Over the Counter Permit Yes
PERMIT EXPIRES February 8,2006.
Permit issued on August 12,2005
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 acc rdance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: I✓ Date: et 210
C,
FII\IALE
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THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE #(253) 835-3050
PERMIT#: 05-103943-00-ME •
Owner: WILLIAM R DUTTON
Address: 29718 4TH AVE SW
FEDERAL WAY, WA 98023-3512
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 Fin - echanical(4065)
Approved Approved to release test Approved
By Date By Date y Date k Z 4
AUG-3-?005 12: 16 FROM: 0 T0:12538352609 P.10
F�dera Way -C. 5 - / 0 .19 Y. _,5
CO,MUl WYDEVELOPMENTSERVICES PERMIT SF MF C�L PL DE EN FP
33530 FIRST WAY SOUTH•10 80X 9778
2SX-61 APPLICATION
IrP / i
SJ WAY,WA
The ollowi • is re•uired
in ornlation-an Inco •fete . .,licatiorr will not be acce•ted. lease •tint Ie,
• ink/or j._,
q /p�J PROPERTY INFORMATION
�`
SITE ADDRESS 7` Ave s4.) SUITE/UNIT#
ASSESSOR'S TAX/PARCEL It O 2 l ei T - .. L O LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(At'°h'epa'°tepegefer lengthy legal desafpQo I
PROJECT INFORMATION
TYPE OF PERMIT O BUILDING Q PLUMBING (MECHAD(ICAL
O DEMOLITION O ELECTRICAL ❑ ENGINEERING O FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this vermit onlu►
q q *.f t- ) — h"_-1-e.-- rhezry_96'
CD 9ca eiatyr
PROJECT NAME(Name of Business or Owner Last Name) 7) 0 e/ e r" ,
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PEOPLE INFORMATION
PROPERTY NAME
OWNER WI/1(
Z) 77zjvn PRIMARY PHONE
1D�MAILING ADRESS f� r I C ,ZLu 47 LeA I1 4::::,
1?
CONTRACTOR COMPANY NAME APPLICANT NAME
mons
W,t S!-1l Yt �(f _ mFFICE eta.) aZ -(rxr)
MAILING AD ,STATE,ZIP2aDa DR KC-- Ave S'e� Ca. Cc!
�I II ICELLPHO1NE -
CITY OF FEDERAL WAY BUSINESS UCENSE NUMBER EXPIRAT1Oe DATE FAX NUMBER
24::°— U3- /OVZ_TV-Ck9-B L 7 / / ( _
CONTRACTORS REGISTR
ATIION NUMBERIcopy of card required with saeh appUcationl
EXPIRATION DATEIWfJt/ /( -19F71 oil ? a‘.
APPLICANT COMPANY NAME PU ME e
L
L v wP / OFFICE PHONE
_ �
MAIUNO ADDRESS CITY,STAT,p,ZIP
P^O Fa /K 2^3' l J`E C P�HONE
RELATIONSHIP TO PROJECT
e-
0 t�elf"rerl�-? - (ty ) 7?c)- 32
Architect ❑ Tenant O Agent O Other(Describe) /�� FAX NUMBER
( I
CONTACT .- NAME • Jot. PRI RY PHONE
E-MAIL ADDRESS
LENDS
Per420.0..19"2?-S: Z `dinfm"*oeis±'e
NAME
hastr rvjeeCvatt
itcEids 01 00.: ",:
ES - - �•
MAILING ADDR
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 PROPOSCD/REQUIRED? O YES O NO
WATER SERVICE PROVIDER a LAKEKAVEN 0 HIGHLD?(E O TACOMA O PBEVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEKAVEN 0 UIGHLINE 0 PRIVATE(SEPTIC
AUC-3--?`05 12:16 FROM: • TO:12538352609 P.11
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?
f TOTAL,earre
.TISO To .rRomossa TOTAL COmraa MO n Orusw
"NEW HOMES ONLY" NUMBER OF BEDROOMS I ESTIMATED SELLING PRIC t $
FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain..
MECEIAJ1ICAL / ��/�
Value of Mechanical Work $ Lid VV(
MR HANDLING UNITS EVAPORATIVE COOLERS GAS LOOS REFRIG.SYSTEMS
BBQS FANS HOODS(c..a, WOODSTOVES
BOILERS FIREPLACE INSERTS / RANGES ^T MISC(Describe)
COMPRESSORS FURNACES ! GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
•
PLUMBING
BATHTUBS prTub/Shower coma) SHOWERS WATER CLOSETS tr.oeq MISC(Describe)
DISHWASHERS SINKS DRINKING FOINTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS ..au.en VACUUM BREAKERS ELECTRIC WATER HEATERS
—_ —_ DISCLAIMER/SIGNATURE BLOCK
Jr.certify snider penalty of perjury that the Mf.rmation 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 Cts of Federal Way,but only where such claim
arises out of the reliance of the city including its officers an• employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE 1141;66141- AO� DATE d6 /
(Signature) (Title)
RELATIONSHIP TO PROJECT o Owner :ent 0 Contractor o Architect 0 Other
•
o NEW d ADDITION o ALTERATION a REPAIR ()TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? - o YES S NO
ZONING DESIGNATION CHANGE OF,USE? o YES o NO
NEW ADDRESS REQUIRED? a YES ,o NO UP/SEPA/SII? o YES a NO
PLATTED LOT? o YES a NO DEMO PERMIT REQUIRED? a YES a NO
pq fe.
2? 71,- cfixt4,,Jed
Bulletin#100-March 30,2004 Page 2 of 4 k\handouts-Rcvised'.Pcrmit Application