07-105460t 4 .
City of Federal Way
Community Development Services Mechanical Permit #: 07- 105460 -00 -ME
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph. (253) 835 -2607 Fax: (253) 835 -2609 Inspection Request Line: (253) 835 -3050
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Pro ect Name: WELLS
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Project Address: 2640 SW 320TH PL L Parcel Number: 873190 0120
Project Description: Remove /replace gas hot water heater
Owner
Applicant
Contractor
NORMAN R WELLS
ACTION WATER HEATERS ONLY INC
ACTION WATER HEATERS ONLY INC
DEBRA J WELLS
12704 NE 124TH ST SUITE #43
ACTIOWHO55DP 1/17/09
2640 SW 320TH PL
KIRKLAND WA 98034
12704 NE 124TH ST SUITE #43
FEDERAL WAY WA 98023 -2268
KIRKLAND WA 98034
Additional <Permlt° Information
Mechanical Valuation .................... ........................2995.50 Over the Counter Permit? ...................................... Yes
Mechanical kiii�ke _
Hot Water Tank ............................. 1
PERMIT EXPIRES Friday. October 2. 2009
I hereby
the occ
Owner or agent:
a
,OCT 0 2 20 07
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' THIS CARD IS TO REMAIN ON -SITE
CITY OF Community Development Inspection Record
Federal way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 105460 -00 -ME
Owner: NORMAN R WELLS
Address: 2640 SW 320TH PL
FEDERAL WAY, WA 98023 -2268
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 (4.165) ❑ Gas Piping (4125) ❑ Final - Mechanical (4065)
Approved Approved to release test Approved
By Date By Date By 4:::' L.J Date
For in_Lector reference only _
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By . Date
RECEIVED BY — ,.�
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COMMUNITY DEVELOPMENT DEPARTMENT
Federal Way OCT o 2 nv PERMIT REGEIVEP - - — — T —
COMMUNITY DEVELOPMENT ,sERVICES MF CO, ME L PL DE EN .FP
33325 AVENUE SOUTH • PO 971 9718 A p p L I C A T I O T o e 20 9
FEDERAL WAY, FAX 98063 -97]8
253- 835.2607• FAX 253- 835 -2609
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The following is required information -`an incomplete applicutioii w JtC� `9WVg. Please print legibly (in ink) or type.,
SITE ADDRESS 2&_4 0 V 20-111 A-1 jj�� SUITE /UNIT #
+
ASSESSOR'S TAX /PARCEL # 3 - lJ LOT SIZE (sj
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach separate page for tergMV iegat description)
PROJECT • •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING I� MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ��'❑ "`ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only
PROJECT NAME (Name of Business or Owner Last Name) 1ir,� AVC ,V OtZ-
PEOPLE •• •
PROPERTY
OWNER
CONTRACTOR
COPY of cerd rognired
with enc applicetlon
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAME C � � �/�
PRIMARY PHONE /
MAILING ADDRESS
�� 320 Pte
CITY S TE, 1P
'
E-MAIL ADDRESS
C0X,*NTrM E LICANT NAME
WATER
(OFFFICE PHONE �fir t /dam
l �, 92e-) �G Y
CELL PHONE _
MAILIN
c
704 N E 124th ST # 43 CITY, STATE, ZIP
CITY OF FEDF)y BN3i41LyS SE EXPIRATION DATE
FAX NUMBER
(42s')
MAIL
12704 N E 124tth� ST # 4d3
CONTRAtCTO REGISTRATION, N�UMBER EXPIRATION DATE
E -MAIL ADDRESS
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11 %
AC / s r y 1 k 55 Q P
E
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cAT7M EW,A . LY I
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� PLICA T NAME
I��v G
OFFICE PHONE
T
(42s')
MAIL
12704 N E 124tth� ST # 4d3
CITY, STATE, ZIP
CELL PHONE
-
,p
kher 1 anr44C'l0 r Fit' IV j"
❑ Acrchit�c� "t�� ennannt WbAgl"`
E
7
EXISTING ASSESSED /APPRAISED VALUE $_
SPRINKLERED BUILDING? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN
SEWER SERVICE PROVIDER 0 LAKEHAVEN
Per RCW 19.27.095.
Lender information is required if project value exceeds $5,000
CITY, STATE, ZIP PHONE
PROPOSED USE
VALUE OF PROPOSED WORK $ -:� 9 1?6 e 50
FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED? ❑ YES ❑ NO
• HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
• HIGHLINE ❑ PRIVATE (SEPTIC)
AREA DESCRIPTION
EXISTING
S . FT.
PROPOSED
S • . FT.
TOTAL
S . FT.
BASEMENT
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
FIRST
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES
,SECOND
SUMPS
o. YES
ONO
THIRD
o YES o NO
UP /SEPIA /SU?
ADDITIONAL FLOORS (DESCRIBE)
o NO
PLATTED LOT?
o YES 'a NO
DECK•(O COVERED OR O UNCOVERED ?)
DEMO PERMIT REQUIRED?
ti YES
o NO
GARAGE O CARPORT O
NUMBER OF FLOORS
axtsnhe.
PROPOSED
TOTAL
TOTAL, X rsrmo ar
TOW, PAIGPOSSOar
TOTAL Er
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture 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 —7� - OAS PIPE OUTLETS WOODSTOVES
BBQS . FANS GAS WATER. HEATERS M1SC (Describe)
BOILERS FIREPLACE INSERTS HOODS (commercia))
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS T- REFRIG. SYSTEMS
PLUMBING
BATHTUBS lorrub /shower combo)
LAVS (Bathroom Sinks)
URINALS MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS (Toile)
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES
HOSE BIBBS
SUMPS
o. YES
I cert(ly under penalty of perjury that the information furnished b4' Vie. G".6d correct to the best of -my knowledge, and further, that I
am authorised by the owner of ,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 claim /including costs, expenses, and attorneys' fees incurred in the investigation and ¢efenae of
such claim), which may be made by any person, including the undersigned, and filed against the City of Federal Way, but only where such claim
arises out of the reliance of the city, includi g its officers and employees, upon the accuracy of the information supplied to the city as a part of
this application.
NAME /TITLE DATE
ignat 7., _...,e (Title)
RELATIONSHIP TO JECT ❑ Owner ❑ Agent PContractpi - r p4rri hitect O Other
❑ NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY?
o YES o NO.
BASIC PLAN?
o YES
n NO
ZONING DESIGNATION
CHANGE OF .USE?
o. YES
ONO
NEW ADDRESS REQUIRED?
o YES o NO
UP /SEPIA /SU?
o YES
o NO
PLATTED LOT?
o YES 'a NO
DEMO PERMIT REQUIRED?
ti YES
o NO
Bulletin #,100— April 2, 2007 .
Page 2 of 4
k \Handouts\Permit Application