09-100026'City of Federal Way � • Mechanical
Community Development Services Permit #; 09-100026-00-ME
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609 i Inspection Request Line: (253) 835 -3050
Project Name: PERRIN
Project Address: 103 S 297TH PL
Project Description: Replace existing gas water heater.
Parcel Number: 776420 0150
Owner
Applicant
Contractor
NEIL PERRIN
NEIL PERRIN
NEIL PERRIN
KAY PERRIN
103 NW 297TH PL
103 NW 297TH PL
103 S 297TH PL
FEDERAL WAY WA 98003 -3629
FEDERAL WAY WA 98003 -3629
FEDERAL WAY WA 98003 -3629
Mechanical Valuation ................ ............................300 Is this an Online or O.T.C. application? ................. Yes
Hot Water Tanks ............................ 1
PERMIT EXPIRES Saturday, July 4,
Permit Issued on Monday, January 5, 3
I hereby certify that the above in rma#io ' ' correct and that the constructor
the occupancy and the use w' a in a ance with the laws, rules and rel
d the City of Federal Way.
Owner or agent:
FWALED
r�
he above described property and
ions of the State of Washington
Date: a ( k z
de kv 0
0'\
THIS CARD IS TO REMAIN ON -SITE
p
CITY OF - fommunify De velo m t Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 09- 100026 -00 -ME
Owner: NEIL PERRIN,
Address: 103 S 297TH PL
FEDERAL WAY, WA 98003 -3629
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.
❑ Mechanical Rough -in (4165)
Approved
By Date
❑ Gas Piping (4125)
Approved to release test
By Date
0 Final - Mechanical (4065)
Approved
Date /
For ins or reference onl
--fit , - -- Y
D Rough Electrical ❑ FINAL - Electrical
Approved Approves
By Date By Date
�r
Federal Way SAN p 5 20 ;KCATION MIT �� 1
COMMUM7Y DEVELOPM&ff 3ERV1CW
3332S Sm FEDERAL WA ,OATH • 63 971(9X8 FED
FEDBRAL WAY, WA 9853063 -9718 ��
+ 253 -835- ?607• FAX 2 .'{►ii�.x46�1jy�
,., 7,AAX2 . COS
SF MF CO O EL PL DE EN FP
The fallowing is required ins formation - an incomplete application will not be accepted. PUase print ie9fl*/ (in" or bjp&
SITE ADDRESS
sUrm /UNIT #
ASSESSOR'S TAR /PARCEL # 7 % G �_ 2 - D__!_ S C LOT SIZE (sf)
LEGAL DESCRIPTION (e.g. Acme Estates Lot 1)
TYPE OF PERMIT
.,.•PROJECT DESCRIPTION (Provide
❑ BUILDING ❑ PLUNBING r�CHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ R GII�iESRING ❑ FIRE PREVENTION SYSTEM
description of;vork included on
j
--- 'PROJECT NAME (Name of— Am -m-gs or Owner Last Name) �F VV N . �L--
PEOPLE INFOMIATION
i
• 14 4 z-4- To �.
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAME
APPLICANT NAME
/OFFICE PHONS
( l -
tq
PRIMARY PHONE
CELL PHONE
-
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
FAX NUMBER
CONTRACTOR'S RZOMTRATION NUMBER SRPIRATION DATS
EMAIL ADDRESS
MAIUNG ADDRESS
, STAP ZIP
E-MAIL ADDRESS
COMPANY NAME
0
APPLICANT NAME
/OFFICE PHONS
( l -
OMNO ADDRESS
CITY, STATE, ZIP
CELL PHONE
-
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
FAX NUMBER
CONTRACTOR'S RZOMTRATION NUMBER SRPIRATION DATS
EMAIL ADDRESS
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY. STATE, ZIP
CELL PHONE
—
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other
FAX NUMBER
( -
NAME PRIMARY PHONE EMAIL ADDRESS
NAME
Par RCW 19.57 095.
Lender faformadon is required ilprolect vahm =coeds "OW
MAILING ADDRESS
CITY, STATE, ZIP
P HONE
EXISTING ASSESSED /APPRAISED
USE
VALUE Ok-l!]�OPOSED WORK $
SPRINKLERED BUILDING? .� 1�YLrS ❑ NO FIRE SUPPRESSION SYSTEM PROP'
RO /ItEQUIIZEDP ❑YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVA L)
SEWER SERVICE PROVIDER ❑ LAIEHAVEN ❑ HIGHLINE ❑ PRIVATE isEPTICI
AREA DESCRIPTION
FMSTING
. FT.
PROPOSED
SQ. FT.
TOTAL
. FT.
BASEMENT
a YES o NO
BASIC PLAN?
FIRST
a NO
ZONING DESIGNATION
SECOND
CHANGE OF USE?
a YES
a NO
THIRD
o YES o NO
UP /SEPA /SU?
ADDITIONAL FLOORS (DESCRIBE)
o NO
PLATTED LOT?
❑YES a NO
DECK (❑ COVERED OR ❑ UNCOVERED ?)
DEMO PERMIT REQUIRED?
a YES
a NO
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
sussmo
TWAL
lom Oaw
1VM#R*P0s=sr
TOIILB'
"ASWHOAMONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of _ --of ftr[urtto3e ' taUed or relocated as part of this project. Do not include existing frvdtuvs to remauL
of Mechanical Work% "mil L (A �PYOFBM OR ESTIIILATE MUST BE INCLUDED WIT'HAPPLICATIONJ
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS _t_ GAS WATER HEATERS MISC (Describe)
BOILERS FIREPLACE INSERTS HOODS LAW
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REMO. SYSTEMS
BATHTUBS (,eRie jsew..rc -o* LAVE pub. emsh** URINALS MISC (Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS Irma
ZL2=RIO WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
I Certo under penalty of psrjurg that I ant the property owner or authorised agmet of the trepertki owner. ,r cert(& that to the best of my
knowledge, the iryormat[on mftdtted in support of this permit apptteafion is bus and oorruet r 44rdA that t will cw pfg with ail opplioable
City of Federal Way regulations pertaining to the work authorised by the issuance of a peemeit I understand that the issumtoe of this permit
does not remove Lice ow►rtsras ty f r mpliance with loca4 stad� or fedsral laws reguaattng construction or enetronmentak laewi.
I jUrther agree to hold the D eder,al Way acs to any claim /inchoW -g costs; 09mmes„ and attorneys' fees incurred in the
inwatigaaon and defense of may be mauls by ang person, including the undsrstgne4 and flied against the alt & but only
Where such claim arises out o Fe atA including its q(/i— and employees, upon the accuracy of the information supplied to
the city as apart of this
SIGNATURE: DATE
_ --�, Pm Owner and /or Authorized Agent
o NEW a ADDITION
a ALTERATION
a REPAIR a TENANT IMHROVEMENT
BUILDING SHELL ONLY?
a YES o NO
BASIC PLAN?
a YES
a NO
ZONING DESIGNATION
CHANGE OF USE?
a YES
a NO
NEW ADDRESS REQUIRED?
o YES o NO
UP /SEPA /SU?
o YES
o NO
PLATTED LOT?
❑YES a NO
DEMO PERMIT REQUIRED?
a YES
a NO
Bulletin #100 — January t, 2009 Page 2 of 4 Mandouts\Permit Application