04-100268 2 Nz°
City of Federal Way
Commununity ity Development Services Plumbing Permit #:04 - 100268 - 00 - PL
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: EDMUND
Project Address: 33016 17TH S UnitB202 Parcel Number: 298690 0300
Project Description: Remove/replace electric water heater
Owner Applicant Contractor
MARY EDMUND FAST WATER HEATER COMPANY FAST WATER HEATER COMPANY
33016 17TH PL S 12601 132ND AVE NE 12601 132ND AVE NE
FEDERAL WAY WA KIRKLAND WA 98034 KIRKLAND WA 98034
(425)814-8381
Plumbing Fixtures
L Description _ Quantity Description 1Quantity Description Quantity'
Water Heaters 1
PERMIT EXPIRES July 25,2004.
Permit issued on January 27,2004
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.
A sec pplication
Owner or agent: See f A pnlicatlon • Date: t
•
rill \
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4 IMUNITYDEEVELOPMENTDEPARTMENT • 71
crrr OF 63COMMUNITY DEVELOPMENT SERVICES
Federal Way JAN 2 3 a• 1- 33530 FIRST WAY SOU771•Po BOX 9718
FEDERAL WAY,WA 980 .97,8
MIT APPLICATION 25306144115.FAX:2536614129
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For Office U.,ONY° TO: •
FW File Number: r, � C a • -
The ollowin• is re.uired in ormation-an incom.(ete app lication will not be acce•ted. Please •rant Ie•ibl (in ink)or
-- • PROPERTY INFORMATION
SITE ADDRESS: 3301 6 17 P1 S #B202 ASSESSOR'S TAX/PARCEL #: 2986900300 -
LEGAL DESCRIPTION (cg: Acme Estates, Lot 1)
SQUARE FOOTAGE OF LOT: (Attach separate pagexor lengthy-legal description)
• PROJECT INFORMATION
TYPE OF PERMIT (This application): o BUILDING X PLUMBING 0 MECHANICAL 0 DEMOLITION
0 ELECTRICAL 0 ENGINEERING a FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only[
Remove/replace electric water heater
PROJECT NAME(Name 0 Business/Owner Last Name): Edmund
•
is PEOPLE INFORMATION
PROPERTY NAME:
OWNER Mary Edmund I PRIMARY PHONE:
MAILING ADDRESS(STREET ADDRESS): CITY,STATE,ZIP (253 )927-4-771
33016 17 P1 S #B202 Federal Way WA 98003
CONTRACTOR: NAME
COMPANY OFFICE PHONE:
FAst Water Heater (425 ) 814-3124
MAILING ADDRESS(STREET ADDRESS: CITY,STATE,ZIP
12601 132 Ave NE CELL PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: Kirkland WA 98034 ( ) -
EXPIRATION DATE: FAX NUMBER:
87 004047200 _ -
- — 12- 1 - / ( 425) 814-9516
CONTRACTORS REGISTRATION NUMBER:
a FASTWHC 0 5 2DF EXPIRATION DATE:
(copy o[cud required with each application)
LENDER NAME:
02/16 /05
in Proposed Value>$5.0001 (DAYTIME PHONE:
MAILING ADDRESS(STREET ADDRESS;(: I ` -
CITY,STATE,ZIP
APPLICANT: NAME:
COMPANY (OFFICE PHONE:
MAILING ADDRESS(STREET ADDRESS: ` f
CITY,STATE,ZIP EVENING PHONE:
RELATIONSH I P TO PROJECT: (
a Architect a Tenant a Other(Describe): FAX NUMBER:
ICONTACT PERSON FOR THIS PROJECT: 0 Property Owner ai Contractor
❑ Applicant E-MAIL ADDRESS:
• DETAILED BUILDING INFORMATION
EXISTING USE:
PROPOSED USE:
EXISTING ASSESSED/APPRAISED VALUE $
VALUE OF PROPOSED WORK: $ 349. 00
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: a YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE a TACOMA 0 PRIVATE(WELL)
,
SEWER SERVICE PROVIDER a LAKEHAVEN ❑ FUG-RUNE a PRIVATE(SEPTIC)
L.
• PROJECT FLOOR AREAS
' AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ. FT. TOTAL
BASEMENT
FIRST ►
SECOND ;,
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?) l __
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
•'NEW HOMES ONLY" NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
a 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 FLOODS(commem!WI WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tubrsnowrcomn•I SHOWERS WATER CLOSL lb Ir,;k,l MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES URINALS HOSE BIBBS
LAVS(ruauvom side 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 ant 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
t oof this application.
NAME/TITLE: ��/� DATE: �K/v
(Signature)�� p + (Title) /RELATIONSHIP TO PROJECT: O Property Owner pplicant $b Qontractor ❑ Architect 0
FOR OFFICE USE ONLY:
a NEW ❑ADDITION o ALTERATION ❑REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES ❑NO BASIC PLAN? ❑YES a NO
ZONING DESIGNATION: CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES ❑NO UP/SEPA/SU? a YES a NO
PLATTED LOT? o YES ❑NO DEMO PERMIT REQUIRED?' ❑YES o NO
l Ll i... .i 0. .ti 1 F i. . .
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