01-104587 City of Federal Way
Community Development Services Mechanical Permit #:01 - 104587 - 00 - ME
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: CARR-LAWLER
Project Address: 5340 SW DASH POINT Rd Parcel Number: 321020 0305
Project Description: MECH-Changeout gas hot water heater in existing residence.
Owner Applicant Contractor
Bobbie Lee Carr-Lawler WASHINGTON ENERGY SERVICES CO WASHINGTON ENERGY SERVICES CO
5340 SW DASH POINT RD 2800 THORNDYKE AVE W 2800 THORNDYKE AVE W
FEDERAL WAY WA 98023-2043 SEATTLE WA 98199 SEATTLE WA 98199
(206)282-4700
/144'/,4 /1110/
Mechanical Valuation 500 Over the Counter Permit Yes
PERMIT EXPIRES May 29,2002,IF NO WORK IS STARTED.
Permit issued on November 30,2001
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: ` ciQ( ��C� Date: 0 I 3.0 Io
NOV-29-01 13:47 FROM-NORTHWEST-CASSIMAR 206-374-0834 T-834 P.01/04 F-045
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'r Mr FIi_ APPLICATION NU^ MBER: - LQ 9513 7-Q f1
Inn�] %I APPLICATION NUMBER: - -
Nov APPLICATION NUMBER: _ - J - - -
Y OF FLoaHAL AI AY I
k1I�tl1[d 1.6quired information—Please print(in ink)or type** i9� Lax_
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a sop a application.
r PROPERTY INFORMATION
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SSESSOR'S TAX/PARCEL 7f 1 dab
SITE ADDRESS: 5340
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
- - . _ ■: PROJECT INFORMATION -
.' ! �-. 1 - �. � - �'����� Cf ICAL ❑ DEMOLITION
TYPE OF PROJECT(This application): 0 BUILDING , JN°(,NE RING FIRE PREVENTION SYSTEM
. 0 ELECTRI
1 ./
PROJECT DESCRIPTION(Provide detailed des on
ltd c. '.SCJ 0 • '
PROJECT NAME: 11A14 16-9
- - -II-PEOPLEZNFORMATION
NAME: D�G7,\ '
PROPERTY OWNER: �Q,a�01._ / 4 �.�J J 1 `I
MAILING ADDRESS(STREET ADDRESS;CITY,Y,$TAti
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CONTRACTOR: NAMt-. ( j C6 -4`1OO
MAILING �-,14 (SET ....7 ;• ,SY/TE,ZIP): I • oi� • • ((�C/a/ /� �4��
• SOA �� J ' �rNUMtiERt
QFA7C
TY OF FEDERAL WAY BUSINESS LI , 5E NUMBER: - - F _
CAN'W�CrOR5 RGGI1TRAllON NUMBER Q� ZlON/DATE: O
DAYRML ntoNE:
op-
APPLICANT: nsur �T .�
MAIIING ADORMS$(STREET ADDRESS:WY,STATT:,ZIP): EEVLNING NIONC: -
__
REWTIONSHIP TO PROJECT; ^
fa NUMBCR
❑ ARCHITECT 0 TENANT ❑ OTHER(DESCRIBE): ( ) _
E-MAIL ADORESS!
CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER 0 APPLICANT /" CONTRACTOR
111111.111111111 M DETAILED BUILDING INFORMATION
EXISTING USE: _ EXISTING BUILDING ASSESSED/APPRAISED VALUATION I_G��(�
PROPOSED USE:
PROPOSED VALUATION FOR.IMPROVEMENTS: $ SCC '
SPRINKLERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: 0 YES _❑ NO
WATER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA Q PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
NOV-29-01 13:47 FROM-NORTHWEST-CASSIIAAR 206-374-0834 T-834 P.02/04 F-045
' ' **NEW RESIDENTIAL CONSTRUCTION ONLY— co--1.1...\.c.."
NUMBER
OF BEDROOMS' EQTED SENG PRICE: $
0111111.11. ■ PROJECT FLOOR AREAS •
FLOOEC EXISTING •
.FT. PROPOSED S•.FT. TOTAL
BASEMENT
FIRST •
SECOND ----
• THIRD
FOURTH -1:OTHER FLOORS(DESCRIBE) —�—
DECK ^�
GARAGE
HOW MANY FLOORS? ----
TOTAL
t
it: Mill1111111
Indicate number of each type of fixture
MECHANICAL
GAS LOG(S) REFRiG.SYSTLM(S;
_ EVAPORATIVE COOLER(S) _ GAS S) --� woo G.S ST M
AIR HANDLING UNIT(S) FAN(S) "-- I OO ((S) MISE.(,
_. Bf3Q(S) FIREPLACE INSERT(S) —
'—!'
BOILER(S)
COMPRESSC,R(S) , FtlRNACE(S)
_ DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE; 0 ELECTRIC 0 GAS
PLUMBING I
LAVATORY(S) URINAL(S) WATER EATERS'
BATHTUB(S)ISWASHRAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC
DRINKIN N FOUER(SSHOWER(S) WASH MACHINE OUTLET
DRINKING UT Er(s) (S) SINK(S) WATER CLOSET(S) _ MISC.(^___.
GAS PIPE TORS) _ SUMP(S)
INTERCEPTORS)
r 'DISCLAIMER/SIGNATURE BLOCK
I certify•
under penalty of perjury that the information furnished by me is true and correct to the best off myknowledge, I
al
further, to holdaulhorized harmless cite city ofthe of the above FederalWay as to any claim(duding costsises to perform the work,expenseor whichs,andhe attttorney?fees incurred In tj
further agreeIncluding the undersigned,and filed against the City
Investigation and defense of such daint),which may be made by any person,including its officers and employees,upon the accura
Federal Way,but only where such daim arises out of the reliance of the city,
of the Information supplied to the city as a part of this application.� `
n f� �_.. \ L/— DATE: ( `1a�I 0 ( .btAME/YITLE: l %y"T1` -
❑ PROPERTY OWNER 0 APPLICANTCONTRACTOR
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tMUNm.0efgOPNt(3!T Sr3W I •33530 FIRST WAY SOUTH•P.O.00X 9718•FCDGRAL WAY,WA 98063.9718•253.661-5000•FAX:253-GG1-4129