07-106474City of Federal Way
Community taevelopment Services
P.O. box 9718
Federal Way, WA 98063 -9718
` Ph: (253) 835 -2607 Fax: (253) 835 -2609
Project Name: WILLIAMS
Project Address: 29808 3RD AVE SW
Mechanical Permit #: 07-106474-00-ME
Project Description: Remove /replace gas water heater
Inspection Request Line: (253) 835 -3050
fay Parcel Number: 720532 0260
Owner
Applicant
Contractor
DOROTHY WILLIAMS
ACTION WATER HEATERS ONLY INC
ACTION WATER HEATERS ONLY INC
29808 3RD AVE SW
12704 NE 124TH ST SUITE #43
ACTIOWHO55DP 1/17/09
FEDERAL WAY WA 98023 -3510
KIRKLAND WA 98034
12704 NE 124TH ST SUITE #43
KIRKLAND WA 98034
AMYItt0yft(',"h�a"1.ttti01''nc't')fl1I' "4
Mechanical Valuation .................... ........................1129.82 Over the Counter Permit? ...................................... Yes
DEC 0 32007
FINLAI-IED
DEC 0 32007
_� THIS CARD IS TO REMAIN ON -SITE
CITY OF 4 . Community Development Inspection record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 - 3050
PERMIT #: 07- 106474 -00 -ME
Owner: DOROTHY WILLIAMS
Address: 29808 3RD AVE SW
FEDERAL WAY, WA 98023 -3510
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 Date
` For inspector reference only _
O Rough Electrical 0 FINAL - Electrical
Approved Approved
By Date By Date
Y
RECEIVED BY
• • MMUNITYDEVELOPMENTDEPARTMENT RrmovF-6 7. / 0 6 d
CITY Of v /
Federal Way DEC 0 3 2007 PERMIT r —
' •COMMUNITY DEVELOPMENT SERVICE'S DEC Q 3 200PF MF CO �E EL PL DE EN
• 33325 D AVENUE SOUTH • 63 971 9718 A p p L I C A T
FEDERAL WAY, WA 98063 -9778 7D '
253.835.2607• FAX 253.835 -2609 ("�ERAL AY 1 /
www.c tuoftederuhouu,mm
BUILDING DEPIh.
The following is required information —an incomplete application will not be accepted. Please print legibly (in ink) ' or type
ASSESSOR'S TAX /PARCEL J2 5
20 ? L Q
SUITE /UNIT N
LOT SIZE (sj
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
.. (Attach eepa-te pope for I-W0 g legal desoiptioN .
PROJECT • •
TYPE OF PERMIT
PROJECT DESCRIPTION
ke,M A7A-e
❑ BUILDING ❑ PLUMBING MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
detailed description of work included on this vermit onlul
PROJECT NAME (Name of Business or Owner Last Name) LtJ Ltli ff)
PEOPLE •- •
PROPERTY
OWNER .
CONTRACTOR
COPY ofcuil_gatnd �
with fggh PPII.%tI n
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
COXpt3y-NAryt�l ! A /A
MMLIN 1 11Ji'r YY
704 N E 124th ST # 43
WC,A T NAME _
CITY, ( /STATE, 21PI�TLev
/OFFICE PHONE
l� / a� -'
CELL PHONE
CITY OF FEDF�yq( y(�y HIIISIN�S SE
EXPIRATION DATE
FAX NUMBER
CONTRACTOR'S REGISTRATION NUMBER
C-i'1 055 n _
EXPIRATION DATE
c:t-/
E MAIL ADDRESS
Utz dk " "r..e-nur
C• "' 1 T t %t , ' LY I
(r" T NAME
OFFICE PHONE -
1 �v.G
(42r) k2o -�
MAIL D9
12704 N E 124th ST # d3
CITY, STATE, ZIP
CELL PHONE
RELATION S}JJpP'FpaPRt�ECtti� WA. lg�r1Y re 4theT IiOUri %r
O Pachit c e�ln�LLan/Jt
r
(F�AX.NUMHE�R�j p
NAME
PRIMARY PHONE
E -MAIL ADDRESS
NAME
Per RCW I9.27.095.
Lender information is required ifproject value exceeds $5,000
MAILING ADDRESS
CM,.STATE, ZIP PHONE
EXISTING ASSESSED /APPRAISED VALUE $
SPRINKLERED BUILDING? O XES D NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN
SEWER SERVICE PROVIDER O LAKEHAVEN
PROPOSED USE
VALUE OF PROPOSED WORK $ 1 \ 2 (. V 2
FIRE SUPPRESSION SYSTEM PROPOSED / REQUIRED? ❑ YES ❑ NO
❑ HIGHLINE .0 TACOMA O PRIVATE (WELL)
❑ HIGHLINE 0 PRIVATE (SEPTICI
AREA DESCRIPTION
EXISTING
S . FT.
PROPOSED
S • . FT.
TOTAL
S . FT.
BASE)JENT
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
FIRST
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES
,SECOND
sUMPS
THIRD
ONO
NEW ADDRESS REQUIRED?
o YES o NO
ADDITIONAL FLOORS (DESCRIBE)
UP /SEPA /SU? o YES
o NO
PLATTED LOT?
DEC&(D COVERED OR D UNCOVERED ?)
DEMO PERMIT REQUIRED? o YES
o NO
GARAGE D CARPORT D
NUMBER OF FLOORS
axtsrtso
rnorosSD
TOTAL
TOTAL S,vsrmo Sr
TOTAL rgorosaD Sr
TOMLIr
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
N FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHAAWAL 4 *7 G1 Q/-7
Value of Mechanical Work $ b (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WVH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS OAS PIPE OUTLETS WOODSTOVES
BBQS . FANS GAS WATER. HEATERS MISC (Describe)
BOILERS FIREPLACE INSERTS HOODS icomm ,.;q
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG. SYSTEMS
BATHTUBS )or Tub /Showeroombo)
LAV.S (6ethm.w Sinks)
URINALS MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS rr.0 q
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES
HOSE BIBBS
sUMPS
I Ber y under enal ty of perjury that the information furnished j .t+ n t- ;0 atg
nd 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 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 of Federal Way, 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.
NAME /TITLE DATE 4 0
(Signature) s (Title)
RELATIONSHIP TO PROJECT
O Owner o Agent
ontracAoir, k 61rgthitect 0 Other
i
o NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY?
o YES o NO .
BASIC PLAN? o YES'
ONO
ZONING DESIGNATION
CHANGE OF .USE? o YES
ONO
NEW ADDRESS REQUIRED?
o YES o NO
UP /SEPA /SU? o YES
o NO
PLATTED LOT?
o YES b NO
DEMO PERMIT REQUIRED? o YES
o NO
Bulletin #1100 — April 2, 2007 .
Page 2 of 4
k \Handouts\Permit Application