05-100010 'r7"----. a
cP-'ery of Federal Way
Community Development Services Plumbing Permit #: 05 - 100'010 - 00 - PL
P.O.Box 9718
Federal Way,WA 98063-9718
Ph.(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Na . RJVARD
Project A 31841 18TH SW Unit42B Parcel Number: 856110 1630
Project Description: Replace electric hot water tank.
Owner Applicant Contractor
r
Kimberly May Rivard WASHINGTON CORROSION SRVC INC WASHINGTON CORROSION SRVC INC
1718 SW 318TH PL#42-B 1425 BLAINE AVE NE 1425 BLAINE AVE NE
FEDERAL WAY WA RENTON WA 98056-2774 RENTON WA 98056-2774
98023-5155 (425)228-1393
Plumbing Fixtures
Description Quantity Description Quantity Description Quantity
Water Heaters J 1 J
CONDITIONS:
This parcel Is located within a Wellhead Protection Area(Capture Zone 5)and must comply with FWCC,Chapter 22,
Article XIV"Critical Areas" and fill out a Hazardous Materials Inventory Statement,if applicable.
PERMIT EXPIRES July 3,2005.
Permit issued on January 4,2005
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 and
the City of Federal Way. `� ,l
Owner or agent: 0
JO . .
14C1 W)5 Date: ,• oq, V S
f
1
1 A__
THIS CARD IS TO REMAIN ON-SITE
CITY OF °r Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-100010-00-PL
Owner: KIMBERLY MAY RIVARD
Address: 31841 18TH AVE SW Unit 42B
FEDERAL WAY, WA 98023-5157
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)
Approved to cover ❑ Gas Piping(4125)
Approved Approved to release test
By Date By Date
By Date
❑ Final-Plumbing(4075)
Approved
By ) Date/42?....03
CITY Of` I ECEI V EL%. 0 - ( D 0 6 1 0
Federal Way PERMIT
SF MF CO ME EL(DOE EN FP
COMMUNITY DEVELOPMENT SERVICES JAN 0 APPLICATION
33325 8*"AVENUE,WA 9•Po BOX 9718 TO — /
FEDERAL WAY,WA 98063-9778
253-835-2607•FAX 253-835-2609 CITY OF FEDhRAL Wqy
uvuu.anro/Iederahwµmm BUILDING DEPT.
The following is required information-an incomplete ap•lication will not be accepted. Please •rint Iegibly(in ink)or type.
J. S Py�R/�OPERTY/INN�FORMATION
SITE ADDRESS / 7 /e ' i /I/ fi� y z G- 13 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL # Ta tt R rs Cho- 0�_�11 0 —;6 LOT SIZE(sfl
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)
(Atta.h separate page for lengthy legal desrnphon)
. :r ,• :. - •. PROJECT INFORMATION . .
TYPE OF PERMIT ❑ BUILDING E PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only) 1
7Repm&t iJ,5 -e Y fr2e, eV ( Zc / )
PROJECT NAME(Name of Business or Owner Last Name)
R PEOPLE INFORMATION
PRI ARY PHONE
OWNER PROPERTY NAM '/��rib,���' ,/ y eJ4 kd () . 7 -
OWNER MAILINGA RESS r CITY,STATE,ZIP
/7/ Sr;�✓3i/th `104,3 -011 ,✓r
CONTRACTOR COMP NY NAME A PLICA T NAME OFFICE PHONE
kOh (10rr-Cie i, I I . LU(€i w 15 /M )220 -/313
991LING A DR Cl STATE,ZIP CELL PHONE
/� f�(a' r�2 e v-e /, ti ,ri- ( I
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
I / ( )
— — —
B L
ONTRACTORS REGISTRATION NUMBER(copy of card required with each application( EXPIRATIO DATE
tvA5 el 6. sS' /< c_, 0510 1 4
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE -
"IYxx C s ( 11141 c ( )
IL1■0 ADDRESS CITY,STATE,ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect ❑ Tenant ❑Agent ❑ Other(Describe) ( )
CONTACT /, ,(� (/� ( PRI ARY H9LNE. E-MAIL ADDRESS
NAM il/�'—f G-144 / ! ] (11 ) �JC, -I j
LENDER Per RCW 19./27.095: Lender information is NAME
required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP
.. : 7 .■ DETAILED BUILDING INFORMATION `
EXISTING USE - PROPOSED USE
�/ 6' v
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ - (7
SPRINKLERED BUILDING? ❑YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS .
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT, TOTAL,
BASEMENT
FIRST
SECOND
THIRD
FOURTH
—
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?) —
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
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.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(comn,rc ) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLE I S
PLUMBING
BATHTUBS for TubFShouer Combos SHOWERS WATER CLOSETS ao.uo MISC Describe
DISHWASHERS SINKS DRINKING FOUNTAINS MISC(Describe)
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAYS(Battuoom sinku VACUUM BREAKERS f ELECTRIC WATER HEATERS
=;;DISCLAIDIER/SIGNATURE BLOCK: . . X
I certify under penalty of perjury 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 he city,including its officers and employees, upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE 1.A.1)(m)) e .1 L5
J DATE
(Signature] (tick/
i RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent O Contractor O Architect ❑ Other
I
FOR OFFICE USE ONLY
a NEW o ADDITION a ALTERATION a REPAIR ❑`TENANT IMPROVEMENT
j BUILDING SHELL ONLY? o YES a NO BASIC PLAN?
❑YES a NO
t ZONING DESIGNATION CHANGE OF,USE? o YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a YES o NO
PLATTED LOT? o YES a NO DEMO PERMIT REQUIRED? a YES a NO
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Bulletin#100—March 30,2004• — Page 2 of 4 k\Handouts—Revised\Permit Application
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