10-100612 • Plumbing
City of Federal Way
Community Development Services LEPermit #: 10-100612-00-PL
P.O.Box 9716
Federal way,wa ssoss71s yaw Inspection Request Line: (253) 835-3050
Ph:(253)635-2607 Fax:(253)635-2609
Project Name: GRONOWSKI
Project Address: 30728 12TH PL SW Parcel Number: 178830 0080
Project Description: Remove/replace electric water heater
Owner Applicant Contractor
ROBERT&DOREEN MIER SOUTH WEST PLUMBING SOUTH WEST PLUMBING
30728 12TH PL SW 2401 SW ALASKA ST SOUTHWP071C6(4/1/11)
FEDERAL WAY WA 98023-8231 SEATTLE WA 98106-1445 2401 SW ALASKA ST
SEATTLE WA 98106-1445
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Water Heaters 1
PERMIT EXPIRES Wednesday, August 11, 2010
Permit Issued on Friday, February 12, 2010
I hereby certify that the above formation isorrect and that the construction on the above described property and
the occupancy and the us- be in a danc- with the laws, rules and regulations of the State of Washington
an. he City of Federal Way.
Owner or agent: i Date: �f
FI WA1.1. 1> fro/p
THIS CARD IS TO IN ON-SITE
FOF i Construction Ins ction Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 10-100612-00-PL Address: 30728 12TH PL SW
Owner: ROBERT & DOREEN MIER FEDERAL WAY, WA 98023-8231
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.
0 Plumbing Groundwork(4190) 0 Rough Plumbing(4230) El Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date By Date By Date •
❑ Final-Plumbing(4075)
Approved
By, Date ilze,//0
0 Rough Electrical El Final Electrical ® Right of Way
Approved Approved Approved
By Date By Date By Date
-* EIVE
Fede --, I' ripPERMIT SF MF CO ME EL.CP2.), 30E EN FP
APPLICATION / i
: . . . .
CalcIllifIVTTY DEVELOBENT SERVICES .. ,
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253-83S-Zr7.FAX 25 91
MUM Br 2 2010
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SUITE!CNI ZONING ASSESSOR'S TAX/PARCEL#
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NAME OF PROJECT ..
(Tenant or Homeowner Name) rYl1/4(2Aso. GeokioLA)sk-. (
0 BUILDING (PLUMBING190 MECHANICAL.
TYPE OF PERMIT
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION
1?
PROJECI DESCRIPTION e/e 3(_,‘11t (-1 , ( ) I-
Detailed description of work to i'--I 0 0 peCAr k.trA., e,c.,e • crth A et QP
be included on this
permit only
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NAME ,‘ k., PRIMARY PHONE
9
PROPERTY OWNER V\k& 6/3‘ C. 1 a ono uoSk 1
. . (z,.-1 33 6 2 1 64-
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MAILING ADDRESS CITY
STAIN,ZIP /F. 1>dre./C,L.ko(141
301-Q._8 ta 41" PL. S,(,\ w & c 18 c 21
OWNER IS ALSO: 0 CONTRACTOR 0 APPLICANT 0 PROJECT CONTACT
NAMEPRIMARY PHONE
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V • •PITRACTOR S 04.-k--- A W(261- vAf•tN kr\,,. . 1,2-02 1/32 - t 77-3
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MAILING ADDRESS,CITY,STATE,ZIP
a
. Le,.
X i FAX Lt 0 t ,s-A,0 , oL 4..c-140 -. '-i-- i,J406, (1"b)733 -/57. (0
WA STATE CONTRACTOR'SB7
Sol * EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE 9
/'PITD /C G / icr- ci67-/e 7i -
NAME PRIMARY PHONE
APPLICANT s .404:1c C3 V.0.5 0 f) 1
(42610 7413 -154cil
MAILING ADDRESS,CITY,STATE,ZIP
-C, 6"1-Itt- o 0 FAX
o1 s:, k A) , i()-(--el--Y(64 , wv4- s I ( ) -
PROJECT CONTACT NAME PRIMARY PHONE
(The_individuaLta receive and W C-- / S Pio, 1 ECC(Vtr ( )
respond to all correspondence MAILING ADDRESS,CITY,STATE,ZIP FAX
concerning this application)
( ) -
ALTERNATE CONTACT NAME: PRIMARY PHONE
( ) -
PROJECT FINANCING NAME
<_1
‘""-C
1 WV SL 0 'S i 0 .0‘,0144.1e, C2c--OWNER-FINANCED
Required for projects with
value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE
(RCW 19.27.095)
( )
I certify under penalty of perjury that lam the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge,the information submitted in support of this permit application is true and correct I certify that I will comply with
all applicable City of Federal Wag regulations pertaining to the work authorized by the issuance of a permit I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
/further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses, and attorneys'fees incurred
in the investigation and • 4.,• of h claim), which may be made by any person, including the undersigned,and filed against the
city, but only where such -,aim • out f the reliance of the city, including its officers and employees,upon the accuracy of the
information supplied to , city , a fthis application.
SIGNATURE:
Jdi& /
DATE 2 — 12 -7(0
PRINT NAME S'781) .-- 2/7; A)S C9 PI
Bulletin#100-January 1,2010 Page 1 of 4 k:11-landouts\Pennit Application
•
Value of Mechanical Work$ - - - (A COPY OF BID OR ESTIMATE MUST BE PROVIDED)
Indicate number of each type offixture to be installed or relocated as part of this project Do not include existing fixtures to remain.
_ _ _ __
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
____ . ...4
AIR CONDITIONER ' FIREPLACE INSERTS HOODS(c. .
_ -
BOILERS FURNACES HOT WATER TANKS(G.)
COMPRESSORS _ GAS LOG SETS REFRIGERATION SYST
DUCTING ____ PIPING WOODSTOVES
__ -
. . PLUMBINWF131TUREgmiMmmm.;m::mim:::-':mE:::::imumilimiom
Indicate number of each type offixture to be installed or relocated as part of this project Do not include existing fixtures to remain.
BATHTUBS 0:rt./show.combo) LAVS(Hand Snake) _ _ _TOILETS WATER PIPING
____ DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
- __ _
DRINKING FOUNTAINS SINKS KA...quaky) (7:) WATER HEATERS(Eirarir)
___ HOSE BIBBS ' - _____SUMPS WASHING MACHINES . ::']::,--:,.. ]:•::-:•••:.:i,...::.:--.1'etrAti-1117111.111titiiiii•ii::::•::::'
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PROJECT VALUATION WATER PURVEYOR . SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$
‘3C00 .(9° -
1 ,
$
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
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AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL
FOR OFFICE USE
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FIRST FLOOR(or Mobile Home)
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EXISTORI PROPOSE( TOTAL
Area Totals
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ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIA: ::::Iii4---.N.:.1...E.W.:-,:..1.A1711)::::; ... ITIONH:.iiiiiiiniiii'ii:$11-.1.g.:Iiiiiiiiiiiiiiiiiiiiii.gitigliiiiiiii.g.iiiiikliliinggiiiIiiiiiiiiiIiiiiiME
AREA DESCRIPTION Area Construction #of
Occupancy Group(s) Additional Information
in Square Feet Type Stories
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ADDITION
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AREA DESCRIPTION Area - Construction #of -- ,
Occupancy Group(s) Additional Information
in Square Feet Type Stories
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TENANT AREA ONLY
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Bulletin#100-January 1,2010 Page 2 of 4 k:\Handouts\Permit Application