04-100139 ►r
H2D
City of Federal Way
Community Development Services Plumbing Permit #:04 - 100139 - 00 - PL
33530 1st Way 5
Federal Way,WA 98003-6210
Ph.253.661.4000 Fax:253.661 4129 Inspection request line: 253.835.3050
Project Name: BENSON
Project Address: 156 S 329TH UnitA
Parcel Number: 928870 0610
Project Description: Remove and replace electric water heater
Owner Applicant
KEN BENSON Contractor
WASHINGTON CORROSION SRVC INC WASHINGTON CORROSION SRVC INC
156 S 329TH PL UNIT A 1425 BLAINE AVE NE
FEDERAL WAY WA 98003 1425 BLAINE AVE NE
RENTON WA 98056-2774 RENTON WA 98056-2774
(425)228-1393
Plumbing Fixtures
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LWater Heaters A "uafitily) ,T . ,, -4desSGrll}'10(i . Q4fic�(a`Itj
PERMIT EXPIRES July 14,2004.
Permit issued on January 16,2004
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.
Owner or agent:
Date: / "_ / / ('f
t‘'°(
7/
COMMUNITY DEVELOPMENT SERVICES
C of �•i JJ5J0 f/RSTWAY SOUTH•PO BOX 9718
Federal Way PERMIT APPLICATION P L- 253666z-4115.
,WA 98063-9718
r N53-61129
For Office vg Only: FW File Number: Q ✓-i - I 0 0 L 3. C _ o To:
S1
0! / l C_ 10 k(
The ollowin. is re•uired in ormation-an inco •tete a.•lication will not be acce.ted. Please •rint le.ibl (in ink)or .
• PROPERTY INFORMATION
5 l'l�✓fiC.E% 1
SITE ADDRESS: /S� ,5 3 Z j � SUITE/APT# �%
ASSESSOR'S TAX/PARCEL#: - A FO 9 WA
RE OTAGE
_ OF LOT:
( LEGAL DESCRIPTION(eg:Acme Estates, Lot 1) u,JC..?'T 60✓0 .I . _(fib I s
(Attach s orate page for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT(This application): ❑ BUILDING ,)PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESRIPTION(Provide detailed description of work included on this permit onitj)
"?e,/./710-- - /()f2777c_ 1 4z.'/G` f%
PROJECT NAME(Name 0 Business/Owner Last Name):
• PEOPLE INFORMATION
PROPERTY NAME:
• PRIMARY PHONE:
OWNER l/e-','"7 & /"i�O H (ZS3 )I//S. -22.? 3
MAILING ADDRESS(STREET ADDRESS;(: CITY,STATE,ZIP
/57,9 s.. 3 7 q s°- 7/ ' ,-0' /g C7 &/,9s1 98o6 3 _
CONTRACTOR NAME COMPANY
OFFICE PHONE:
_ L.1/ 6-2/17i j. -✓,475A (o oe0 ;0//l (47QS1 G28 -/59 '
MAILING ADDRESS(STREET ADDRESS;(: CITY,STATE,ZIP CELL PHONE:
Y �
/ft-2-C- /-5:...L /Y� /(1� . 7.0.--77 ,--, ^'ty.)< ( ) -
CITY OF FEDERALAY BUSINESS LICENSE NUMBER: EXPIRATION DATE: FAX NUMBER:
- / I ( ) -
CONTRACTORS REGISTRATION NUMBER: �,/
�/ 5� /C SP �ci 5 EXPIRATION DATE:
(copy of card required with each applieatio ✓ L.,1' V.^ C/
LENDER NAME: J
(If Proposed Va. $5,000/ DAYTIME PHONE:
( )
MAILING ADDRESS(STREET ADDRESS(: CITY,STATE,ZIP
APPLICANT: NAME: COMPANY
OFFICE PHONE:
( ) -
MAILING ADDRESS(STREET ADDRESS): CITY,STATE,ZIP EVENING PHONE:
( ) -
REIATIONSHIP TO PROJECT: FAX NUMBER:
❑ Architect ❑Tenant ❑ Other(Describe): ( )
CONTACT PERSON FOR THIS PROJECT: ❑ Property Owner ❑ Contractor ❑Applicant • E-MAIL ADDRESS:
• DETAILED BUILDING INFORMATION
EXISTING USE: PROPOSED USE:
(
EXISTING ASSESSED/APPRAISED VALUE $ (It/, VALUE OF PROPOSED WORK: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE ❑ TACOMA O PRIVATE(WELL) '
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ 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? semi.EXISTING TOTAL PROPOSED roam.EXISTING MID PROPOSED
NEW HOMES ONLY NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• FIXTURES
Indicate number of each type of fixture that is 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(comm�ail WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLE 11,
PLUMBING
BATHTUBS or TubIShowrrcombo) SHOWERS WATER CLOSETS Iroucq MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES URINALS HOSE BIBBS
LAYS(Bathroom sulk VACUUM BREAKERS / 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. Ifurther 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: / i'L� (,l% i DATE:
(Signature) (Title)
RELATIONSHIP TO PROJECT: ❑ Property Owner ❑ Applicant ylCcontractor ❑ Architect ❑
FOR OFFICE USE ONLY
a NEW ❑ADDITION a,ALTERATION n REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES a NO BASIC PLAN? a YES a NO
ZONING DESIGNATION: CHANGE OF USE? a YES ❑NO
NEW ADDRESS REQUIRED? a YES ❑NO UP/SEPA/SU? ❑YES o NO
• PLATTED LOT? a YES ❑NO DEMO PERMIT REQUIRED?. a YES ❑NO
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