07-105903CtityDe Development ntS Mechanical Permit #: 07- 105903 -00 -ME
1.',ommuility Development Services
P.O. Box 9718
Federai Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609 Inspection Request Line: (253) 835-3050
Project Name: CORTEZ
Project Address: 28632 21ST AVE S Parcel Number: 422200 0070
Project Description: Installation of tankless gas water heater with 6' gas piping
Owner
Applicant
Contractor
DAVID & BEVERLY CORTEZ
NORTHWEST PERMIT INC
WASHINGTON ENERGY SERVICES CO
28632 21ST AVE S
1345 GULF ROAD
(WESCO)
FEDERAL WAY WA 98003
POINT ROBERTS WA 98281
WASHIES9710B 9/2/07
2800 THORNDYKE AVE W
SEATTLE WA 98199
Additional Permit lntormation
Mechanical Valuation .................... ........................3461.39 Over the Counter Permit? ...................................... Yes
lillstzapibl Fixtures q ;,
Hot Water Tank ............................. 1
PERMIT EXPIRES Monday, October 26, 2009
Permit IssaW on °Friday, October 26,; 2007 ,
I hereby certify that the above inforrrlation is correct and that the construction on #* above described property and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washin
a City of Federal Way.
Owner or agent: C'. t�� 4
C �,Q Date: (.e —(J
-ld
THIS CARD IS TO REMAIN ON -SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 105903 -00 -ME
Owner: DAVID & BEVERLY CORTEZ
Address: 28632 21 ST AVE S
FEDERAL WAY, WA 98003 -3339
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) ❑ Gas Piping (4125) ❑ Final - Mechanical (4065)
Approved Approved to release test Approved
By Date By Date By 1 Date
For inspector reference only______
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
10- 24 -'07 10;04 FROM- T -736 P007/012 F -566
RECEIVED /0 -67()
()
Federal Way OCT 2 4 2007 PERMIT
- ~
cauxrolvr7y n�vst oPxravr sJarlv)cas SF Mr CO ,�L PL DE EN FP
33325 inl AVENUE SOUn? • PO &09 9718 /�
Pensnn! Iver.IVA 99063 v Y OF FENER ?PLI CATI OlV �7
353.835.2G07•Fn7(3�389 BUILDING D
WWIItf.IWR((£fiR�g)e�v rom
The -following is required f0formation - an incam iete a Iicatiott will plot be acre ted. P1ea5e erint W- ibl (in ink) or
PROPERTY INVORMATION
SITE ADDRESS 28632 21 STAVE S SUITE/UNIT H
ASSESSOR'S TAX /PARCEL # 4 2 2 2 0 0 0 0 7 0 LOT SIZE (Sfi
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Allach aepWale p oj" te111ft legal deSOVitortl
N PROJECT INFORMATION
TYPE OF PERMIT C) BUILDING ❑ PLUMBING ,( MECHANICAL.
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING Q FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION tProv(de detailed descrrotton or uwrk included on this hermit onlit)
Install tankleSS gas water heater with 6' gas piping
PROJECT NAME WN'ome of Business or Oujrter La9t Name) rnaTaZ
PROPERTY
OWNER
APPLICANT
CI•IiTIli tTilco
LENDER
NAMF. PNLMARY PHONE
DAVID CO RTEZ ( 263 ) 839 -8399
MMt,TNG ADDRESS CIY'Y, STATE, ZIP
28632 21ST AVE S Federal Way, WA 98003
COMPANY NAME
APPLICANT NAME
OPPICE PHONE
WESCO
Naida Khan
(206 ) 378 6649
MNLINO ADDRESS
CITY, STATE. ZIP
CELL PRONE
2800 Thorndyke Ave W
Seattle WA 98199
( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
2.0 -4-3-1942 -3 -4-BL
12 /31 /07
( ) -
CONTRACTOWS RECISMMON NUMHICtt (copy or car4 m;u -red WA eaon appLoatlon)
EXPIRATION DATE
W A S H I E S 9 7 1 O B
09 /02 /09
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
Northwest Permit Inc
Naida Khan
( 36D ) 945 -2787
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
1345 Gulf Road
Point Roberts, WA 98281
( ) -
RFIAMONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant Agent ❑ Other (Describe)
( ) -
NAME PRIMARY PHONE E- MAIl.AUDRFSS
Naida Khan 360 945 - 2767 melis9a @nwpermil.o m
1'erRGI4;19:3y.095q LenQerigJormattnriiz<•••
. rcgtiir¢d �Dj'Q1eCi'valu�•�rcugds:$.6,P00 ;
NAME
MAILING ADD
CITY. STATE, ZIP
PHONE
EXISTING USE SFR
PROPOSED USE
EXISTING ASSESSRZ /APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLkRED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /RF,9UIRED? R YES
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIQHLINE 0 TACOMA 0 PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE Q PRIV,AITE (SMIC)
7�fi7
0
10- 24 -'07 10;04 FROM- T -736 P008/012 F -566
1
AREA DESCRIPTION
EXISTING
S . FT.
PROPOSED
89. FT.
TOTAL
S . FT.
BASEMENT
o ALTp XXf1ON
a RI PAIR o TXNANT IMPROVEWNT
FIRST
BAsxc'PLAN? a YES
c NO
SECOND
CHANGE OF USE? DYES
TI-110
NEW ADDRESS REQUIRED? c YES n NO
UP %SEPA /SU? a YES
FOURTH
PLATTED LOT? a YES Q NO
DED+IO PERMIT RFQUIRED? a YES
ADDITIONAL FLOORS (DESCRIBE)
DECK (COVERED?)
GARAGE M CARPORT Q
NUMBER OF FLOORS
MMINO
plkwaua
Taro.
2arAL@]a*M0rr'
TOTAL 0*0WEDW
TOTN. er
"NEW HOMES ONLY•' NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
type
MECHANICAL 346139
Value of Mechan(cal Work $
AIR tIANDLING'UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
BACH'l'U8$ (nr71,h /snoM+er COmDO)
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHM99
Or relocarea as
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERT$
FURNACES
GAS PIPE OLITLETS
SHOWERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
not
to
GASLOOS REFRIO, SYSTEMS
WOODS tWmmnrotnll WOODSrovES
RANGES MISC (Dcacribe)
GAs WATER HEATERS
WATER CLOSLgS rrottq _ MISC (Desorlbe)
DRINKING FOUNTAINS
RAiNWATF -R SYST
HOSE BIBBS
ELECTRIC WATER BEATERS
I cert{fg under penalty of perjury that the information furnished by me Is true and correct to the best of my knowledge, and further, that Y
nm authori —d by the owner QF 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 atairx (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, andJiled against the City ¢f Fcdcral Way, but only where such ciaior
arises out 4f the reliance of the city, including its ofjleers and employees, upon the accuracy of the irfbrmation supplied to the city as a part of
this application, � � l� J NAME /TITLE ' `r " "
(91Yrlantrcl (Tick)
RELATIONSHIP TO PROJECT O Owner WAgent o Contractor G Architect o Other,
.. •
'FORS ...FcI
C) NEW o ADDI'T'ION
o ALTp XXf1ON
a RI PAIR o TXNANT IMPROVEWNT
BUILDING SHELL ONLY? a YES a NO
BAsxc'PLAN? a YES
c NO
ZONING DESIGNATION
CHANGE OF USE? DYES
ONO
NEW ADDRESS REQUIRED? c YES n NO
UP %SEPA /SU? a YES
a NO
PLATTED LOT? a YES Q NO
DED+IO PERMIT RFQUIRED? a YES
a NO
Bulletin #100 — January 1, 2006
Page 2 of 4
Mandout0ermit Application
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