05-100854 City of Federal Way Plumbing Permit #: 05 - 100854 - 00 - PL
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718 •Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-305a
♦'
Project Name: SMITH TALEY
Project Address: 30840 22N Parcel Number: 053700 0545
Project Description: Replace existing electric water heater and install expansion tank and earthquake straps
Owner Applicant Contractor
Alicia L Talley PAT'S PLUMBING INC PAT'S PLUMBING INC
30840 22ND AVE S P.O.BOX 426,KENT WA 98035 P.O.BOX 426,KENT WA 98035
FEDERAL WAY WA
98003-4931 (253)854-4080
Plumbing Fixtures
Description Quantity Description (Quantity Description 1Quantity]
Water Heaters
PERMIT EXPIRES February 23,2007.
Permit issued on February 23,2005
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use w' 1 - �,rdance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: .4 Date: '7 37;
•
F� a
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-100854-00-PL
Owner: ALICIA L TALLEY
Address: 30840 22ND AVE S
FEDERAL WAY, WA 98003-4931
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
Bc� Date 3
1 . ` RECEIVEP C
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Federal Way FEB 2 3 ; PERMIT
COMMUNITY DEVELOPMENTS SF MF CO ME ; DE EN FP
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33JZFED Rai war WAn98063-97 °F FE DERq"PP L I C AT I O N TD
253-835-2607•FAX 253-835-260PDILDING DE
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The oltowin• is re.uiredinormation-anincom•letea.•lication will not beacce•ted. Please •rtntIe•ibl (in in or •
Jr/eel-96(L a//PROPERTY INFORMATION
SITE ADDRESS Jr 22- ,4 r "J SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# Ft 5 3 i4 ib- J V if LOT SIZE(sf)
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)
%Mod,separafepo9c for lengthy legal desc■pOon)
PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL [] ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJEC ESCRIPTION(Provide detail d d cription of w rk in Jude on this permit only
( � � lS e detail
� � dt5to� 1,� 3
i col t gar /
PROJECT NAME(Name of Business or Owner Last Name) 45:441-4 - -7;-`(
• PEOPLE INFORMATION
PROPERTY NAME k PRIMARY PHONE ,
OWNER F 4f(. /W a 4(6.4$0,w1 ( ) -
MAILIN A DRES r f CITY TA ,ZIP
" 4y S 0,ry" Way W4 f f#3
CONTRACTOR CO PANT NAME APPLICANT NAME / OFFICE PHONE
LING j% M fi1C• 'G f/r't,Pv ii ( 253)
M�?LIINN/G ADD ESS ITY,ST E, 1 CELL PHONE
CITY F F RAL V A BUSINESS ICENSE NUMBER EXPIRA ON DATE FAX NUMBER
— _ - / I ( )
B L
CONTRACTOR'S REGISTRATION NUMBER(copy of cud required with each application) AEXPIRATION DATE
e1L pt aFog . N5 M7 / lx'e l f s.
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
( )
MAILING ADDRESS CITY,STATE,ZIP — CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect ❑Tenant ❑Agent ❑ Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
( )
LENDER �g r 6*.,,, . -•" NAME
a� ,� TM •
MAILING ADDRESS CITY,STATE,ZIP
• ■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN CI HIGHLINE ❑TACOMA ❑ PRIVATE(WELL) •
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ. FT. SQ. FT.
BASEMENT
-
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
•
DECK(COVERED?)
GARAGE ❑ CARPORT❑
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING SP- TOTAL PROPOSED sr - TOTAL Sr
."IWHOMES 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(commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(ortRb/sho.zeComboq SHOWERS WATER CLOSETS troaey MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAYS(Bathroom sinks) VACUUM BREAKERS I ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
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 Wa as to any claim(including costs, expenses, and attorneys'fees incurred in the investigation and defense of
such claim), which may be ma- erson,including the undersigned, and filed against the City of Federal Way,but only where such claim
arises out of the reliance J((jjJ• eluding its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE /ff. /
)Title) DATE Z
23(iv-5-
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i i�`
RELATIONSHI ��• •.. ❑ Owner ❑ Agent Contractor ❑ Architect ❑ Other
as a r s
REPAIR %TENANT T1ISPROYEMENT m'
Ufb,NQ HELL Ai;LY?;a r b YES NO BASIC PLAPI? " „ o YES 1N0 t;47-46
N I G 1 N ESIGNATION a t i CHANGE OF<USE?,$ 0.YES -p NO.Wa3.
'�„RESS-REQUIRED? a YFS n NO OT-t- UP/,SEPA/SU?= 44 a YES aNO
EA AT"? 4 t a, i's'YES tNO DEMO,I'ERMIT UII2EDp� E u ti YES Q ;"
Bulletin#100—January 7,2005 Page 2 of 4 k\HandoutsPPermit Application