07-100959City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609
e
Plumbing Permit #: 07- 100959 -00 -ILL
Project Name: BERTOLIN
Project Address: 29709 1ST AVE S
Project Description: Replace electric water heater
Inspection Request Line: (253) 835 -3050
Parcel Number: 513710 0020
Owner
Applicant
Contractor
BARBARA BERTOLIN
WASHINGTON CORROSION SRVC INC
WASHINGTON CORROSION SRVC INC
29709 1 STAVE S
1425 BLAINE AVE NE
WASHICS055KC 5/4/08
FEDERAL WAY WA 98003
RENTON WA 98056 -2774
1425 BLAINE AVE NE
RENTON WA 98056 -2774
Plumbing Fixtures
Water Heaters . ............................... 1
` THIS CARD IS TO REMAIN ON -SITE `
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 100959 -00 -PL
Owner: BARBARA BERTOLIN
Address: 29709 1 ST AVE S
FEDERAL WAY, WA 98003 -3641
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.
❑ Plumbing Groundwork (4190) ❑ Rough Plumbing (4230) ❑ Gas Piping (4125)
Approved to cover Approved Approved to release test
By Date By Date By Date
❑ Final - Plumbing (4075)
Approved
By G. Date
Mrs a-7 _ a
Federal W —
59
� Ci PERMIT -`
• COMWIMNDEVELOPMEN SE taaIV SF MF CO ME EL DE EN FP
33325'8*" AVENUE SOUTH • PO BOX 9718
FEDERAL WAY, WA 98063.9718 To
.253- 835.2607• PAX 253
www.dtuaffedemhunn.w-83 m'" 2 2 2 007 A P P L I CA T 10 N
The following I#,rQt0j,4b FeAka"n -an incomplete application will not be accepted. Please print legibly (in ink) or type.
- nt ut nihlrr narrr
SITE ADDRESS 67 l U % / (/� : o SUITE /UNIT #
ASSESSOR'S TAX /PARCEL # _ _ - LOT-SIZE (sf)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
. lAtuwh - p- -tepogef- lengthy legal d-aooW
PROJECT INFORMATION
TYPE OF PERMIT O BUILDING �LUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING Q FIRE PREVENTION SYSTEM
PROJE DESCRIPTION (Provide detailed description of work included on this permit onlu)
Aro,®l A oic _ lr, / ) ,A 7-,---,P
PROJECT NAME (Name of Business or Owner Last Name) GJ 1
1
PEOPLE • •
PROPERTY
I NAME PRIMARY PHONE
OWNER
CONTRACTOR
CorY or e d :eym -d
with e. aPPH"tI.n
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
Gee i _0
?ah.� .�?/ �S
(�) zzg - /393
MAILING ADDRESS
CITY ZIP �O
f
CITY, STATE, ZIP
E -MAIL ADDRESS
EXPIRATION DATE
/ v
W
EXPIRATION DATE
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
Gee i _0
?ah.� .�?/ �S
(�) zzg - /393
MAILING ADDRES� U
SS t�
CITY ZIP �O
f
CELL PHONE -
CITY OF FEDERAL WAY BUSINESS LICENS NUMBER
EXPIRATION DATE
FAX NUMBER
CONTRACTOR'S REGISTRATION NUMBER
EXPIRATION DATE
E -MAIL ADDRESS
s -iL .-08
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 E-MAIL ADDRESS
NAME
PEr RCW 19,27.095:
Lender irtformation is required if project value exceeds ,$5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
PROPOSED USE
EXISTING ASSESSED /APPRAISED VALUE $_ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER D LAKEHAVEN ❑ HIGHLINE O TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
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
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUC S
3 ,
BATHTUBS (or Tub /Shower Combo)
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBS
(A COpY OF BID -OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
EVAPORATIVE COOLERS
GAS PIPE OUTLETS WOODSTOVES
FANS
GAS WATER HEATERS MISC (Describe)
FIREPLACE INSERTS
HOODS pommerciep
FURNACES
RANGES
GAS LOG SETS
REFRIG. SYSTEMS
LAVS (Satbroom Sinks)
URINALS MISC (Describe)
RAINWATER SYST
VACUUM BREAKERS
SHOWERS
WATER CLOSETS rroikQ
SINKS
WASHING MACHINES
SUMPS
BASIC PLAN?
I certify under.penalty of pe ;fury that the information furnished by me is true and 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 ci j/j including its offtce� d employees, upon the accuracy of the information supplied to the city as apart of
this application.
NAME /TITLE
(Signature)
RELATIONSHIP O P OJECr ❑ Owner
O Agent a Contractor
DATE
(Title) '
o Architect ❑ Other
.- -z-07
a NEW o ADDITION
o ALTERATION o REPAIR ❑ TENANT IMPROVEMENT.
BUILDING SHELL ONLY?
a YES
o NO
BASIC PLAN?
o YES a NO
ZONING DESIGNATION
CHANGE OF USE?
o YES o NO
NEW ADDRESS REQUIRED?
a YES
o NO
UP /SEPA /SU?
o TES o NO
PLATTED LOT?
a YES
o NO
DEMO PERMIT REQUIRED?
o YES o NO
Bulletin ## 100 — January 1, 2007 Page 2 of 4 MtlandoutAPermit Application .