01-104156 City of Federal Way Mechanical Permit #:01 - 104156 - 00 - ME
Community Development Services
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253 661.4129 Inspection request line: 253.835.3050
Project Name: SILVER rie""
Project Address: 34915 23RD SW Parcel Number: 176110 0300
Project Description: MECH-Install(1)freestanding stove and associated gas piping in existing residence.
Owner Applicant Contractor
JOE/SUSAN L SILVER WASHINGTON ENERGY SERVICES CO WASHINGTON ENERGY SERVICES CO
34915 23RD AVE SW 2800 THORNDYKE AVE W 2800 THORNDYKE AVE W
FEDERAL WAY WA 98023 SEATTLE WA 98199 SEATTLE WA 98199
(206)282-4700
Mechanical Valuation 1000 Over the Counter Permit Yes
Mechanical Fixtures
Description Quantity Descr ptiOnt j ,AQuantity) Descriptiop4 Quantity
Gas Piping 1
PERMIT EXPIRES April 29,2002,IF NO WORK IS STARTED.
Permit issued on October 31,2001
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: C ., a-9-CA-• • ��— Date: 4/O I
S aS
(cJ '12 / t/
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e c k , FT.(/‘ �,l Cp /G / z--
0110-01 08:43 FROM-NORTHWEST-CASS I MAR 206-374-0834 T-569 P.03/04 F-607 -
c.a.*c.a. G
_ESVEit— APPLICATION NUMBER: O/ - L D X $ ,a)
APPLICATION NUMBER: _
'APPLICATION NUMBER:.
**The following is required information—Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
1 ` ■ PROPERTY INFORMATION
SITE ADDRESS: 3 �f \S to y7vie S" ASSESSOR'S TAX/PARCEL#: L- 4 6110 - 030o
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
•- : r. PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING 0/MECHANICAL 0 DEMOUTION
- 0 ELECTRICAL 0 ENGINEERING❑ FIRE PREVENTION SYSTEM
• • PROJECT DESCRIPTION(Provide detailed description): — V• 1L„ CY-e-e sk)v,p
W • GS i / •
JJ ,
PROJECT.NAME: • c,.e r V C Y
• PEOPLE INFORMATION ,
PROPERTY OWNER: NAM DAYTIME DAME PHONE:
`
ver' (2-) 3) 661 - 1 ?'30
NAMING AODREss(STREET ADDRESS;taTY.STATE.ZIP):
3 vt `t t S _ 04---f 5 --J
CONTRACTOR: NAME: • DAYnME PSE:
•
!WING ADDRESS prow A000ss4 QTY.STATE,ZIP): EVENING PHONE:
g.ro o --tVitmALlCe 1.14 Se q ekj t l 'j (dao ) - v o
an,OF FEDERAL WAY 31./SIN SE NUMBER: FAX NUMBER.:
( ) -
CONTRACTORS REGISTRATION NUMBER EXPIRATION DATE:
W .tr � CjC 1,a) Ib /OZZ
APPLICANT: W1FIE: -DAYTIME PHONE:
'Warm ADDRESS(STREET ADDRESS.(XTY,STATE.ZIP); EVENING PHONE:
)
• REIATIOHP•TO PROJECT: FAX NUMBER
0 ARCHITECT 0 TENANT 0 OTHER(DESCRIBE): ( ) -
£-MAA ADDRESS:
CONTACT PERSON FORTH'S PROJECT: 0 PROPERTY OWNER 0 APPLICANT 1CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USF; F r2 EXISTING BUILDING ASSESSED/APPRAISED VALUATION $_
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ 12 D•d o
SPRINKLERED BUILDINI? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES 0 NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN 0 HYGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
,/010-01 08:43 FROM-NORTHWEST-CASS114AR 206-374-0834 T-569 P.04/04 F-607
% "NEW RESIDENTIAL0011SfRUC ION ONLY"
ESTIMATED SEUYNG PRICE:
NUMBER OF KO ROOMS:
■ PR07ECT FLOOR AREAS
EXISTING S••-FT. PROPOSED
Fl TOTAL
FLAG R
BASEMENT11111111111111
FIRSTIIIIIIIIIIIIIIIIIIIMIIIIIIIINIIMIIIII
SEODND IIIIIIIIIIIIIMIII"IIIIIMNIIIIIIIII
' THIRD MIIIIIIIIIIIIIIIIIIIIIIIIIIIMIIIII
11111111.111111111111111111111111-
f FOURTH
t. OTHER FLOORS(DRIt3E)
DECK
GARAGE
HOW MANY FLOORS? IIIIIIIIIIIIIIOIIIIIIIIIIIIIIIIIIIIIIIII
1
a
TOTAL: 111111111111111111111
.r .FixTURES .
-, Indicate number of each type of fixture
MECHANICAL
: ` LOG(S) REFRIG.SYSTEM(
_ AIR HANDLING UNIT(5) �- EVAPORATIVE Coot-ER(s) GAS LO ) �- E1 RIG VE(s)
Bt3Q(� Fart(s) r OOD(S) MISC.L�
BOILERS) � FIREPLACE INSERT(S)
OONPRES:�OR(S)
---
%— �RNAS) HEAT SOURCE: ❑ ELECTRIC GAS
__, DticT(S) _ GAS PIPE OUT1fT(S)
PLUMBING
BATHTUB(S) LAVATORY(S)
URINAL(S) WATER HEATER
_ VACUUM BREAKER(S) 0 ELECTRIC GAS
!_^.PISHWrA:iEt�t(S) �� RAIN WATER ,.
SHOWER(S) WASH MACHINE OUTLET
^� GAS MISC.C_—
DAFOUNTAIN(S) SINK(S) WATER CLOSET(S) �-
PIPE,OVTLli7YS)
INTERCEPTOR(S) - SUMP(S)- -
M 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,
tion is made.
further,that I authorized by theo
y o f�ral Way as to any claim above premises to (incl ding costs, xp the work for ich the permit� and attorneys'fees Incurred it
further agree to hold harmless the tyupon the Goa
lavr'aHgation and defense of such claim),which may be made by any person,including the undersigned,and filed against the Cl
Federal Way,but only where such claim arises out of the reliance of the city,including Its officers and employees, p°
of the information supplied to the city as a part of this application.
DATE: ____L;9/ 3/22-1----
�
❑ PROPERTY OWNER ❑ APPLICANT ri•CONTRACTOR
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ceMMUe4[uy OEVELorNt130-SERVi(s•33530!Misr WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 96063-9718.753-661-1000-FAx:253-66111: