01-104158 City of Federal Way Mechanical Permit #:01 - 104158 - 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: ROSS fkjd
Project Address: 29621 2ND SW Parcel Number: 513720 0110
Project Description: MECH-Install gas piping outlet only for future gas log.
Owner Applicant Contractor
LYNDA ROSS WASHINGTON ENERGY SERVICES CO WASHINGTON ENERGY SERVICES CO
29621 2ND 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 500 Over the Counter Permit Yes
Mechanical Fixtures
ILL
.. . L L. Quantity fi;,',. 1P ppeacnotl ` tJr ( uantltf
Number of Gas Outlets 1
CONDITIONS:
1.Separate permit required for the installation of gas log fireplace.
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: , Date: C673/ ()/
•
•
Ct5 for'
OCT-30-01 08:41 FROM-NORTHWEST-CASS I MAR 206-374-0834 T-569 P.03/06 F-606
--"'"'-'14 *Tel:IF-M=11- APPLICA` ION NUMBE R: 4 l -LO4//,_,P . -ao -kFr APPLICATION NUMBER: - _ �-
APPLICATION 14:1140.F.11! - y' ,% •
-
. *Fite following is required information—Please print an ink)or type**
• . ,- • Please note Bei 1,Fire Prevention Systems and Engineering permits may require a separate application. •
■ PROPERTY INFORMATION
SITE ADDRESS: .r)- f C 1 .2"'CI 09 V P - ASSESSOR'S TAX/PARCEL#: S 1. 3 a D- Q L L
- LEGAL DESCRIPTION OF SUEIJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
a PROJECT INFORMATION , • .
TYPE OF PROJECT((This application): - 0 BUILDING 0 PLUMBING ciPMECHANICAL 0 DEMOLITION
. 0 ELECTRICAL 0 ENGINEERING❑ FIRE PREVENTION SYSTEM
-
PRO7ECT•DESCRIPTION(Provide detailed description): S I. t • CA-S . ; ,‘A_ O r-'e
c- _1ilr, ' cs 0S
r
1:147,-.A..0..1‘11.1.!-I.,:, .
- M?ELD' 'r• rti S S
IN
■ PEOPLE INFORMATION '
PROPERTYOWNER: WANE: • DAYnMEPHONE:
Ly _o(t-,
COCO5' (a.1 .3) ?yl - ,Cq/'
. Maki S Aoo*ESS(STREET ADDRESS;cry.STATE,ZIP):
. -°I 6(),l 2,a t41--t. S '-^-)
•
CONTRACTOR: E% DATUI1e PHONE:
r HAILING ADORES(STREET ADDRESS`i QTY,STATE,ZIP); .,
1 , , / EVENING PHONE:
QTY GP FEDERAL WAY BUSINESS IIrWM, NUMBER: PAX NUMBER:
. - - ( )
OONTNAcroesRECISr TPATLON NUMBER: Ex—w-- .;=R ION'll -TION
Di 5tf . �s2 1cw oz_ / c6 / c2
APPLICANT: NNw - -- cantle PHONE:
( ). -
NA LING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PRONE:
( )
REIAIWNSNIP 1U PROJECT: FAX NUMBER:
0 ARCHITECT 0 TENANT' 0.OTHER(DESCRIBE): ( ) -
r .
• E-MAIL ADDRESS:
CONTACT PERSON FORTH'S PROJECT: 0 PROPERTY OWNER 0 APPLICANT ` CONTRACTOR
1.1.111.11111 ■ DETAILED BUILDING INFORMATION
EXISTING USE: c '/4) EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED U _ _ PROPOSED VALUATION FOR IMPROVEMENTS: $ S
SPRINKLERED BUIL.DING7' D YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES 0 NO
WATER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HEMLINE 0 PRIVATE(SEPTIC)
OCT-30-01 08:41 FROM-NORTHWEST-CASSIMAR 206-374-0834 T-569 P.04/06 F-606
*NEW RESIDENTIAL Ottit—
•.�. ' •NUMBER OF BEDR DOMS: ESTIMATED SEUING PRICE: $.
II PROSECT FLOOR AREAS
111111111111.1111111 • —
FLOOR EXISTING SQ.Ft. PROPOSED SQ.FT.T TOTAL
BASEMEN'
FIRST •
SECOND
THIRD
•
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
•
• GARAGE
HOW MANY FLOW S7
TOTAL:
■ FIXTURES
• Indicate number of each type of fixture
' MECHANICAL
AIR.HANDLING EVAPORATIVECOOLER(S) GASL`)S) REFRIG.SYSTEM
(S)
,_ WOODSVOVE(S)
50EFAN(S)
ILR(S)
FIREPLACE INSERT(S) RANGE(S) _ MISC.(____.—
• - COMP R(S) HEAT SOURCE: 0 ELECTRIC (E�P GAS
��
DUCT(S) GAS PIPE OUTLET(S)l ET(S)
PLUMBING
LAVATORY(S) , URINAL URINAL(S) WATER HEATER(S)
•„_• _ _.DISHWASHEl(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC 0 GAS
DRINKING FOUNTAIN(S) _ SHOWER(S) _._._ WASHER AC INE ET )TET MLSC.[
GAS PIPE outRET(S') K(5)'
• IN ER. PTOR(S) SUMP(S)
1111111111111111 ■ 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 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
lnvvesU3gation 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%vhere such claim arises out of the reliance of the city,including Its officers and employees,upon the accuracy
of the Information supplied to the city as a pa f this application.
NAME/Mips t %�- c`
DATE: -' (77':5f
❑PROOWNER ❑ APPLICANT "ICONTRACTOR
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CMM=PEVBJ71,*C4T setV[CES•33530 rum-I-WAY SOUTH•P.O.SOX 9718•FEDERAL WAY,WA 980634718.293461-1000•FAX:2576614129