09-100896arrOC ECEIV ( _ / V 0 911, ( Y
Federal Way PERMIT -- - - - - --
roAanVarn•DEVELOPvlE.yr,,Ai� 1 2��9 SF MF CO ME EL�PL E EN FP
3.123 I) ai'EYUI). W. 'I ,06: APPLICATION
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31)JFEpERAL WAY U 3 �� ��
The following is requieo rmation - an incomplete application will not be accepted. Please print legibly (in ink) or type.
PROPERTY 1 • •
SITE ADDRESS 3� -` '(�° % i �/f f SUITE /UNIT #
ASSESSOR'S TAX /PARCEL # 3— Q -2- % - 2 LOT SIZE (sfn
LEGAL DESCRIPTION le.g. Acme Estates. Lot 1)
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PROJECT 1 • •
TYPE OF PERMIT ❑ BUILDING ,PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this nennit onlLO
,� h1 i� N i <� - - •mil << %ri• (° � --
PROJECT NAME (Name of Business or Owner Last Name)
PEOPLE 1 • •
PROPERTY
OWNER
CONTRACTOR
O
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
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2 1, 1 1 c' IJ L 1 '
�NE
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A . NC ADDRESS ❑
7Y. STATE. 'LIP
E -MAIL ADDRESS
APPLICANT NAME
OFFICE PHONE
QC�.�ELL
•,�
-
: \I1.NC. : \UUF2E:S5
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C'Il' C P 4. E. . \VA E `SINIiSS LICENSE: NUMEiER
CITY. STATb:. "LIP _
r
EXPIRATION DATE
PHONE
FAX NUMBER
CONTRACTOR'S REGI�SSTRATION NUMBER
L '/I
EXPIRATION DATE
-
E-MAIL ADDRESS
COMPAW NAME:
APPLICANT NAME,
OFFICE PHONE
\i :\ILIN(; ADDRESS.
T:! )YSi II!' TO PROJECT
Architect a Tenant ❑ Agent ❑ Other
CITY. ST'A'TE. 7.IP
CELL PHONE
FAX NUMBER
\x11:
LgeeT
PRIMARY I ONE
F -MAIL ADDRESS
—I
nN. "/ ^.
T J ! ( +
Per RCW 19.27.095:
Lender information is
required if project value exceeds $5,000
\I: \I L!Sil :\DDF2E:SS • .-�
CITY. SPATE. ZIP
I
PHONE
LK3
EXISTING ASSESSED /APPRAISED VALUE $_
SPRINKLERED BUILDING? ❑ YES ❑ NO
PROPOSED USE
VALUE OF PROPOSED WORK $
FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER -- LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
re
0
AREA DESCRIPTION
EXISTING
S . FT.
PROPOSED
S . FT.
TOTAL
S . FT.
BASEMENT
FANS
GAS WATER HEATERS
MISC (Describe)
FIRST
FIREPLACE INSERTS
HOODS comn,r <i q
NO
SECOND
FURNACES
RANGES
I
THIRD
GAS LOG SETS
REFRIG. SYSTEMS
ADDITIONAL FLOORS (DESCRIBE)
- NO
PLATTED LOT? -YES -NO
DECK (❑ COVERED OR ❑ UNCOVERED ?)
LAVS (aan. .... n,
URINALS
MISC (Describe)
GARAGE ❑ CARPORT ❑
RAINWATER SYST
VACUUM BREAKERS
NUMBER OF FLOORS
EXISTING
PROPOSED
TOTAL
TOTAL EXLSTING SF
TOTAL PROPOSED SF
TOTAL SF
* *NEW HOMES ONLY ** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
Value of Mechanical Work $ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS PIPE OUTLETS
WOODSTOVES
BB9S
FANS
GAS WATER HEATERS
MISC (Describe)
BOILERS
FIREPLACE INSERTS
HOODS comn,r <i q
NO
COMPRESSORS
FURNACES
RANGES
CHANGE OF USE? YES
DUCTS
GAS LOG SETS
REFRIG. SYSTEMS
PLUMBING
- NO
PLATTED LOT? -YES -NO
BATHTUBS
LAVS (aan. .... n,
URINALS
MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS IT<,u,o
ELECTRIC WATER I IEATERS
SINKS
WASHING MACHINES
HOSE BIBBS
SUMPS
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best of my
knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with all applicable
City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the issuance of this permit
does not remove the owner's responsibility for compliance with local, state, or federal laws regulating construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in the
investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the city, but only
where 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 part of this application. �Z
SIGNATURE: DATE J /�
P pertp Ow6e -r and/or Authorized Alrent
FOR OFFICE USE ONLY
NEW c ADDITION
i ALTERATION
REPAIR TENANT IMPROVEMENT
BUILDING SHELL ONLY? = YES -: NO
BASIC PLAN? - YES
NO
ZONING DESIGNATION
CHANGE OF USE? YES
- NO
NEW ADDRESS REQUIRED? -
YES -NO
UP /SEPA /SU? YES
- NO
PLATTED LOT? -YES -NO
DEMO PEIV.!IT REQUIRED? YES
- NO
Bulletin #100 —January 1, 2009
Page 2 of 4
k \Handouts\Permit Application
' . Plumbing.
City of Federal Way
Community Development Services Permit #: 09-100896-00-PL
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax (253)835-2609 p q
Ya
Project Name: HUFFMAN
Project Address: 35906 6TH AVE SW Parcel Number: 302104 9071
Project Description: Replacement of electric water heater
Owner Applicant Contractor
RAYMOND HUFFMAN HAROLD'S PLUMBING HAROLD'S PLUMBING
35906 6TH AVE SW DBA:GILBERT BROTHERS,LLC HAROLD*911B3 (1/21/11)
FEDERAL WAY WA 98023 124 W MAIN ST DBA:GILBERT BROTHERS,LLC
AUBURN WA 98001 124 W MAIN ST
AUBURN WA 98001
•
Rpt #rx
Water Heaters 1
PERMIT EXPIRES Sunday, September 6, 2009
Permit Issued on Tuesday, March 10, 2009
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
an he City of Federal Way.
Owner or agent: [� Date: moi"/O— a
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 09-100896-00-PL
Owner: RAYMOND HUFFMAN
Address: 35906 6TH AVE SW
FEDERAL WAY, WA 98023-7212
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.
0 Plumbing Groundwork(4190) 0 Rough Plumbing(4230) 0 Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date By Date By Date
— 0 Final-Plumbing(4075)
Approved
By Date
For inspector reference only_
❑ Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
Building Division
CITY OF 33325 Eighth Avenue South
v„ ,,,..- Fed a ra I \Nay Federal Way,WA 98063-9718
Phone 253-835-2607
Fax 253-835-2609
CORRECTION NOTICE
ADDRESS: 3 6- 9O 5---u/
f i 4V't PERMIT#: f pi(
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-WHEN /117 cA -1
IF YOU HAVE ANY QUESTIONS CALL 253) 835- 2-6-
WHEN
CORRECTIONS HAVE BEEN MADE, CALL (253) 835-3050 FOR RE-INSPECTION. SEE BACK OF CARD
FOR DETAILS. NOTE: ELECTRICAL CORRECTIONS ARE REQUIRED TO BE MADE WITHIN 15 DAYS.
%Pill/ A_7---
DATE INSPECTOR
DO NOT REMOVE THIS NOTICE
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