04-100992 City or Federal Way
Community Development Services Plumbing Permit #:04 - 100992 - 00 - PL
Community
33530 1st Ray S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: PAYNE
Project Address: 29612 2ND SW Parcel Number: 513730 0120
Project Description: Remove and replace water heater.
Owner Applicant Contractor
PATRICK PAYNE STERNOD ROOTER&PLUMBING SERVICE STERNOD ROOTER&PLUMBING SERVICE
29612 2ND AVE SW 13825 13TH AVE CT 13825 13TH AVE CT
FEDERAL WAY WA 98023 TACOMA WA 98445 TACOMA WA 98445
(253)460-3392
Plumbing Fixtures
Description ]Quantity Description Quantity Description jQuantity
Water Heaters I
PERMIT EXPIRES September 18,2004.
Permit issued on March 22,2004
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.
See or agent: See Application Date: Cab' 22- –o'(
P/6/414 . p �� /(- Z — o 1(C.■
COMMlMITyDEVELLOPM NTTDEP EN7
MARS 2004 I'°° .,ron'•"A 5,0110.1-Y/Jb P
Federal Way PERMIT APPLICATION ( � 257.66141J5•FAX:259-661-0129
unum eiNoffertern11vn1t.mm
Per Office U. ONy: •, _ . TD:
FW File Number: 0 . 4. 0 (2 G� S 1C;) / • /
The ollotu in• is re,uiredinormation-an--itincom•tetea.,licataohtiil?iBtbeacce•ted. Please •rint le.ibl (in ink)or •
■ PROPERTY INFORMATION
SITE ADDRESS: 2_9(011- 24J ) Ave 5to SUITE/APT#
ASSESSOR'S TAX/PARCEL#: b 1 3 1 30- O 1 Q SQUARE FOOTAGE OF LOT: p
LEGAL DESCRIPTION (eg:Acme Estates,Lot I) MO`, C-4021 T -L..+- L f'— 12_
(Attach separate page for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT(This application): 0 BUILDING )s(PLUMBING O MECHANICAL O DEMOLITION
0 ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onitJ:
R -A,:2. ea g---01-le (C-- Lt)f�Tt:7"L 2—
PROJECT NAME(Name 0 Business/Owner Last Name):SIT" • 1■111r > FU 7 •. •
• PEOPLE INFORMATION
PROPERTY NAME:
PRIMARY PHONE:
OWNER `'Kq_ ck:-- `PA4► (263) 31S -15t(
MAILING ADDRESS(STREET ADDR SS;): CITY,STATE,ZIP
2?(o(L--2-ND Ave ()..) -,nd_._ LLIA i I,O 95O2 3
CONTRACTOR: NAME COMPANY
OFFICE PHONE:
S1 a 1btc 12oa�L z $ ftoMMPALY. SUtCt/Lcts, 253 ) `kJ -3P9 -
MAIUNG-A�D�DRESS(STREET ADDDRESS;)- Cr1YISTATE,ZIP ,' ` CELL PHONE:
- B L "I ' Ave ex 6 T ccoevl/1r 1/.) ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: EXPIRATION DATE: FAX NUMBER:
Z0 - 0 '2 L 0--+-1 - q8 IZ/3t /tom ( +7 - j1
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required w C -.T'' 1�_ith each application)J C.. e EA g_e q 8 6_40 07/ I(o /��-
LENDER NAME:
(If Proposed Wise>$5,000) DAYTIME PHONE:
( )
MAILING ADDRESS(STREET ADDRESS;): CITY,STATE.ZIP l 1
APPLICANT: NAME: COMPANY OFFICE PHONNE:S 0( l�-Cy5rOi � alikr (��•� 60Y � (6 3) fe. (�
-- -?-f12_
MAILING (CITY, EVENING PH 12-A-926—I Sit dlt' er a T c.(AA IAA 9L346 (2-63) LI'W -3 z
RELATIONSHIP TO PROJECT: FAX NUMBER:
O Architect O Tenant ,Other(Describers jots— (�Y,7)) t-�7t- 22E
CONTACT PERSON FOR THIS PROJECT: O Property Owner % ontractor U Applicant E-MAIL ADDRESS: 1
• DETAILED BUILDING INFORMATION
EXISTING USE: PROPOSED USE:
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK: $
SPRINKLERED BUILDING? ❑ YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: 0 YES O NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN O HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER a LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ. FT. 1 PROPOSED SQ. FT. .__TOTAL
BASEMENT
FIRST --- —
SECOND — — —
•
THIRD
FOURTI I ----
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 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(comme,em WOODSTOVES
__- BOILERS FIREPLACE INSERTS - RANGES MISC(Describe)
_COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS for Tnb/ShoNrr combo) SHOWERS WATER CLOSETS(roses MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES URINALS HOSE BIBBS
LAYS(Deuvoom Sink VACUUM BREAKERS r 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 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^p2art of this application.
NAME/TITLE: Y� O ee - MAJ 4 & DATE: �J•11 `VT
(Signature) (Tidcl ----
RELATIONSHIP TO PROJECT: ❑ Property Owner t] Applicant contractor ❑ Architect ❑
FOR OFFICE USE ONLY: •
•
o NEW ❑ADDITION o ALTERATION ri REPAIR c TENANT IMPROVEMENT
BUILDING SHELL ONLY? u YES a NO BASIC PLAN? u YES u NO
ZONING DESIGNATION: CHANGE OF USE? �u •r:YES n NO
— -- - —
NEW ADDRESS REQUIRED? :AYES i!NO UP/BFPO/SU? YES NO
PLATTED LOT? c YES r NO DEMO PERMIT REQUIRED? 0 YES fi NO
•