05-102667 r p
City of Federal Way Mechanical Permit #: 05 - 102667 - 00 -$F
Commtuuty Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax•(253)835-2609 Inspection request line: (253) 835-305C
Project Name: WHITE lx.jQ,
Project Address: 30618 3RD&SW Parcel Number: 556000 0490
Project Description: Replace gas hot water tank.
Owner Applicant Contractor
Lawrence P White WASHINGTON ENERGY SERVICES CO WASHINGTON ENERGY SERVICES CO
30618 3RD AVE SW 2800 THORNDYKE AVE W 2800 THORNDYKE AVE W
FEDERAL WAY WA SEATTLE WA 98199 SEATTLE WA 98199
98023-3909 (206)282-4700
Mechanical Valuation. 525 Over the Counter Permit Yes
PERMIT EXPIRES December 6,2005.
Permit issued on June 9,2005
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 / 1Owner or agent �~ ' / iG�� f Date:
THIS CARD IS TO REMAIN ON-SITE ,
art .. Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-102667-00-ME
Owner: LAWRENCE P WHITE
Address: 30618 3RD AVE SW
FEDERAL WAY, WA 98023-3909
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 C Date 1743—p
JUN-6-2005 08:40 FROM: ' T0:12538352609 P.4 _
Fare e2ie Way -Q. 5 - ' A. .
tIOMMVI YDEVELOPM7NT SERVICES PERMIT S F MF C� L PL D E EN FP
33530 F12 r WAY SOUTH.10 BOX 9711
pEDERAI.WAY,
WA APPLICATION AX 253461 �
www-dWoffeaknilwausorn
The oflowin• is re•uired i ormation-an Inca •fete • ••licatiort will not be acce.ted. Please •rint le. • in i or
PROPERTY INFORMATION
SITE ADDRESS 3(j I ? ,(,.l f ki
t �^� SUITE/UNIT I
J
• ASSESSOR'S TAX/PARCEL i 5 ID 0 OC) - 6 ti LOT SIZE(sn
LEGAL DESCRIPTION(e.g.Acme Estates,Lot I)
/Mach separate pope/.lcpflw Segal doot)1e„1 -
PROJECT INFORMATION
•TYPE OF PERMIT ❑ BUILDING a PLUMBING MECHANICAL
a DEMOLITION O ELECTRICAL a ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
a_________9__JA-__/ 1..L4_ / CAA ir 46
3 0 e.,__l C.ovl_v.. , ,,
PROJECT NAME(Name of Business or Owner Last Name)
PEOPLE INFORMATION
PROPERTY NE P RY PHONE
OWNER c.vercevlce �h (-)? '/ ---
MAIUNG ADDRESS ' CITY STATE,ZIP
34)4/F 3 /9vJ e j j Gci4 cjc 92o23 —
CONTRACTOR COMPANY NAME I APPLICANT NAME OFFICE PHONE
WASK l h `v
f/MAILING`��- DRES CITY,STATE,ZJP_Q�I ' ^"(4 lir AIM -
SeLL 1.0 W (Qq (LL PHONE I -
CITY OF FEDERAL WAY BUSINESS UCENSE NUMBER RATION DATE FAX NUMBER
P.21:3- 03- /Oi/`2 .8 3 41l-CC L i / ( ) _
CONTRACTORS REGISTRATION NUMBER(aPy of card regalted with each application( EXPIRATION DATE
(,v i+X l-f !�s 47"7z Ota CT / Z / a4-
COMPA
APPLICANT 71-e NAMEh�ri- Ei /P,;Wet& ME OFFICE PHONE -
MAIUNG ADDRESS CITY,STATE,ZIP CE PHONE
f o&X. 7Q3`1 ' t ? GJA T161-3 (cam) 7? - 7Z1
RELATIONSHIP TO PROJECT 'FAX NUMBER
0 Architect o Tenant ❑Agent 0 Other(Describe) ( ) -
CONTACT cf. .NAMELtPRI RY PHONE E-MAIL ADDRESS
F"''�' �CA`LJ � rado� ? �''n4.��.rt ( x") 770 -32
LENDS •Pa?RW
4795: ,6±4d zf fie 5tts:iq NAME
' :_r� Ili tfp"roJect hat4ie eceeis 0 ;00 ;;
},
MAIUNG ADDRESS CITY,STATE,ZIP
DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALVE OF PROPOSED WORK $
SPRINKLERED BUILDING? a YES O NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES 0 NO
WATER SERVICE PROVIDER O LAKEHAVEN O HIGHLINE 0 TACOMA CI PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ IUGIILINE ❑ PRIVATE(SEPTIC)
JUN-6-2005 08:41 FROM: TO:12538352609 P.5
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? TOTAL CUSTOM TOTAL rnorosco TOTAL rammta,uta raorosm -
"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 fixtures to remain.
MECHANICAL
Value of Mechanical Work $ ' i - •
AIR HANDLING UNITS EVAPORATIVE COOLERS OAS LOOS REFRIO.SYSTEMS
BBQS FANS HOODS(c mmuet.t) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES / GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS or Tub/Shower Combo) SHOWERS WATER CLOSETS(T.arq MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
OAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIRDS
LAVS(Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and further,that I
ant authorised 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 to 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
arises out of the reliance of the city,in ding its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application. I
NAME/TITLE `''"��4Q DATE �` � ec
(Signature) llhtk)
RELATIONSHIP TO PROJECT 0 Owner *ge ❑ Contractor 0 Architect o Other
t 0 , k10E uSE,ONIrY/ 4,, '
a NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN?r o YES a NO
ZONING DESIGNATION CHANGE OF USE? o YES a NO
NEW ADDRESS REQUIRED? a YES o NO UP/SEPA/SU? a YES a NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? o YES a NO
70 Co a- 3/J J
Bulletin$1100—March 30,2004 Page 2 of 4 k\Handouts—Revised\Permit Application