04-102124 City of Federal Way
Community Development Services Plumbing Permit #:04 - 102124 - 00 - PL
It33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: ARIZ
Project Address: 28900 11TH S Parcel Number: 720570 0120
Project Description: Remove and replace water heater
Owner Applicant Contractor
David M Ariz &Shirley F Ariz FAST WATER HEATER COMPANY FAST WATER HEATER COMPANY
28900 11TH PL S 12601 132ND AVE NE 12601 132ND AVE NE
FEDERAL WAY WA KIRKLAND WA 98034 KIRKLAND WA 98034
98003-3706 (425)814-8381
Plumbing Fixtures
Description Quantity P Description Quantity Description "Quantity]
Water Heaters 1
PERMIT EXPIRES November 24,2004.
Permit issued on May 28,2004
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: See Application Date: 17 5(o�
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THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 p
PERMIT #: 04-102124-00-PL
Owner: FAST WATER HEATER COMPANY
Address: 28900 11TH PL S
FEDERAL WAY, WA 98003-3706
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
By ;led Date 40 /1 d
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Federal PERMIT o - to i=-D
CCMMUNAY DEVELOPMENT SERVICES SF MF CO ME E PL DE EN FP
33530 FIRST WAY,WA 98063-9718•PO BOX 9718 A P P�� >
FEDERAL WAY,FAX 53- 1-912 p / I
253-661411A•FAX253d614129 EPARTMENT
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The ollowin. is re.wired in ormation-an inco •lete aI:�I.'caszoh Griot be acce•ted. Please •rint le.ibl (in ink)or .
PROPERTY INFORMATION
SITE ADDRESS 28900 11 P1 S Fprlpral Way WA 98Q03 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 7205700120 - — _ _ _ LOT SIZE(sj)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Aaach separate page for lengthy laid desaiptionl
PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING XI PLUMBING 0 MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL 0 ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
REmove/replace electric water heater
PROJECT NAME(Name of Business or Owner Last Name) ARIZ, David
PEOPLE INFORMATION
PROPERTY NAME
PRIMARY PHONE
OWNER Ariz, David (253 )839-1-555
MAILING ADDRESS CITY,STATE,ZIP
28900 11th P1 S FEderal Way WA 98003
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
Fast Water Heater (425 )814-3124
MAILING ADDRESS
CITY,STATE,ZIP CELL PHONE
12601 132 Ave NE Kirkland WA 98034 ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
-CL 0_4_7 _O _0 --B L / ( 42 814-9516
CONTRACTORS REGISTRATION NUMBER(copy of card required with each applications EXPIRATION DATE
FASTWHC052DF 2 / 16 / 05
APPLICANT COMPANY NAME - APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMB ER
❑ Architect ❑ Tenant 0 Agent 0 Other(Describe) ( )
CONTACT NAME PRIMARY PHONE
E-MAIL ADDRESS
LENDER
Per RCW 19.27.095: Lender information -, NAME
required ff project value exceeds$5,000".;=
MAILING ADDRESS CITY,STATE,ZIP
DETAILED BUILDING INFORMATION
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EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ 349. 00
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
r _
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ. FT. PROPOSED SQ. FT. TOTAL
.1-BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EIOSTmG TOTAL.PROPOSED TOTAL E=asrma MD PROPOSED —
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of future 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(a,Tub/Shower Combo) SHOWERS WATER CLOSETS(mile) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIERS
LAVS(Bathroom sinks) VACUUM BREAKERS 1 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 part of
this application. �J s
NAME/TITLE Permit Manager DATE 5-26-04
(Signature) (Title)
RELATIONSHIP TO PROJECT ❑ Owner 0 Agent IX Contractor ❑ Architect 0 Other
FOR OFFICE USE ONLY
o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES a NO BASIC PLAN? ' o YES o NO
ZONING DESIGNATION CHANGE OF USE? a YES o NO
NEW ADDRESS REQUIRED? a YES CI NO UP/SEPA/SU? - 0 YES a NO
PLATTED LOT? a YES o NO DEMO PERMIT REQUIRED? o YES a NO
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Bulletin#100—March 30,2004 Page 2 of 4 k\Handouts—RevisedU'ennit Application