03-104326City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Mechanical Permit #:03 -104326 - 00 - ME
Inspection request line: 253.835.3050
Project Name: LARSON
J�
Project Address: 30445 10TWS Parcel Number: 091900 0060
Project Description: Remove/replace gas water heater
Owner
Applicant
Contractor
Gordon Larson & Madonna Larson
FAST WATER HEATER COMPANY
FAST WATER HEATER COMPANY
30445 10TH AVE S
12601 132ND AVE NE
12601 132ND AVE NE
FEDERAL WAY WA
KIRKLAND WA 98034
KIRKLAND WA 98034
98003-4118
(425) 814-8381
Mechanical Valuation..........................................449
Over the Counter Permit ...................................... Yes
PERMIT EXPIRES March 17, 2004.
Permit issued on September 19, 2003
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: See�D AL �r,qt` Date:
Mechanical rough -in:
Date
` o
FINAL MECHANICAL: (�
to
RECEIVED BY CONSTRUCTION PERMIT A PLICAnON
CITY OF UNnY DEVELOPMENT iDEPAPTMENT
Federal WadW 19 2003PPLICA710N NUMBER- L L Z(
w
**Yhe* Mllo'winq is required information — Please print (in ink),or type* 018981
Please note, Electrical, Fire Prevention Systems and Engineering permits may require a separate appliotion,.
PROPERTY INFORMATION
SITE ADDRESS.- 30445 10 AVE S, FEDERAL WAY, WA 98003 ASSESSOR'S TAX/PARCEL #. 0919000060
LEGAL DESCRIPTION OF 5UB3ECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
1 0 PROJECT INFORMATION
TYPE OF PROJECT (This application): a BUILDING n PLUMBING X MECHANICAL a DEMOLITION
a ELECTRICAL o ENGINEElanG to FIRE PREVENTION SYSTEM
PA03ECT DESCRIPTION (Provide detailed description): Remove/Replace Gas Water Heater
PROJECT NAME: AD NNA
PRo3Ecr INFORMATION
PPOPERTYOWNER- -FW4E"
DAYfWE
LARSON, GORDON & MADONNA, _[-
((253)139-1669
WAIUG AWRESS (mwrr ADME55CTTY, -STATI, ZIP)�
30445 10 AVE S FEDERAL WAY, WA 98003
U IT90, - 7 a
NW.E: FAST WATER HEATER COMPANY
DAYVIM9 PKM:;
((425)$14-3124
0iiUlifiid ADDRESk, (�CT AODWS'5; CM, �WATF, 24P),
EVEMM "ME;
12601 132ND AVE NE KIRKLAND, WA 98034
CITY or MUVA WAY mismss UCEWR NUMBM
Mx MAts".
87 - 000047 00
(425 ) 814-951.6
CONTRACTOR'S RMSTRAMN MMKR,
VCMAT" CWn'
Itapy at Card h4uktd) FASTWHC052DF
02/16/2065
MALM A0D9f5S (557REET .AMkM- CHY, STAIX, IrP): EVtNtNG PHO NE-
WAMNSHIP TO PAO=. FAX NUMIM
to ARCHITECT o TENANT 0 OTHER ( DESCRIBE): ...... . ... ...
CONTACT PERSON FOR THIS PROJECT- 0 PR43PEM OWNER 0 APPLICANT A COKTRACT)OR
EXISTING USE,: EXISTING BUILDING ASSESSEDAPPRAMD VALUATION
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $449.00
SPRINKLERED IWILDING? a YES a NO FIRE SUPPRESSION SYSTEM PROPOSEDIREQUIRED: u YES a NO
WATER SERVICE PROVIDER* o LAKEHAVIEN n RIGHLINE a TACOMA o PRIVATE (WELL)
SEWER SERVICE PROVIDEW 0 LAKEHAVEN 0 H14GHLINE 0 PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
.i
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE:
PR03I Ci FLOOR AREAS
indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNITS) EVAPORATIVE LER(S) GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S) FAN(S) HOOD(5) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT($) � RANGE(S) MISE. ( �)
COMPRESSOR(S) FURNACE(S)
OUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: t3 ELECTRIC 1j GAS
PLUMBING
UATHTUR(S') LAVATORY(S) URINAL($) 1 WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC 3( GAS
DRINKING FOUNTAIN(S) SHOWER(S) ._ WASH MACHINE OUTLET
DSAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC. ( j
INTERCEPTOR(S) SUMP(S)
7ISCLAIMERISIGNATURE RLC
I comfy underpenalty of penury that the Information tarnished 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 tai hold hanniess the City of Federal Way as to any claim (including casts, expenses, and attomesys'fetes incurred In 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 onty where such claim arises Gaut of the reliance of the city, including its officers and employees, upon the accuracy
of the Information supplied to the city as a part of this application.
NAME}TrTLE:- �- '�'°`� ,Permit Mgr. DATE 09/17/2003
Ca PROPERTY OWNER 0 APPLICANT N CONTRACTOR
C0" MUN T1r DeVEU"EW SWVrCrS * 33530 FIRST WAY SOUTTt • PO BOX 9710 • FWtR& WAY, WA 98063.9718 •253 -00 -OW • FAX; 253-"1-4129