10-103715 F LE
MechanicalCity of Federal Way • �
Community Development Services Permit #: 10-103715-00-ME
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: (253) 835-3050
Ph (253)835-2607 Fax.(253)835-2609
Project Name: NOWACZYK
Project Address: 1936 S 368TH PL Unit 209 Parcel Number: 721245 0210
Project Description: Remove/replace 50 gallon gas water heater
Owner Annlicant Contractor
BARBARA NOWACZYK AMERICAN RESIDENTIAL/RESCUE ROOTER AMERICAN RESIDENTIAL/RESCUE
1936 SW 368TH ST 175A ROY RD SW SUITE 101 ROOTER
FEDERAL WAY WA 98003-7776 PACIFIC WA 98047 RESCUR*007Q7(12/31/10
175A ROY RD SW SUITE 101
PACIFIC WA 98047
•
Mechanical Valuation 1730.24 Is this an Online or O.T.C.application? Yes
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Hot Water Tanks 1
PERMIT EXPIRES Sunday, February 27, 2011
Permit Issued on Tuesday,August 31, 2010
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: �f�wDate:004
rct•LAtM.T.) f$/t0
THIS CARD IS T EMAIN ON-SITE • . .
CITY OF - �'--.- 0 Construction I pection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 10-103715-00-ME Address: 1936 S 368TH PL Unit 209
Owner: BARBARA NOWACZYK FEDERAL WAY, WA 98003-7751
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 Mechanical Rough-in(4165) ❑ Gas Piping(4125) ❑ Final-Mechanical(4065)
Approved Approved to release test �J /Approved
By Date By Date By , / "`,//Date / /
0 Rough ElectricalCI Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
/ o / 037- / s
;:::::::: :: •PERMIT )152
�
Federal Wad MF CO �C $ E FP
COhIRIrNITYDEVELOIMENTSERVICES APPLICATION RE \�+e
253-83FAX 5-2607•F 253-835-2609 "
;ru+t,:;ttt;r;;,JOU:;t'aq.ccrst
AUG 31 201:0
SITE ADDRESSF I L.•,� WAY
A
( 436 S 36g 4-k ?L 'de al ^��y On f '• `" CDS
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ /766, oc 2 S_ - co _a A_ a
TYPE OF PERMIT 0 BUILDING itt<EUMBING 0 MECHANICAL
0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/HomeownerLast Name) 0 V"i `7_y l
PROJECT DESCRIPTION T�
Detailed description of work to Re--0 ` SC) . sc (o v. 0.% R? i ftc 1 .LS!( ffectier
be included on this permit only
PRIMARY PHONE
PROPERTY OWNER rAOCACC.- O 01/4.)&LZ\jV
MAILING ADDRESS 3c 4 38 1-L p L E-MAIL
T•Pca2.cc,1 Vf4 y w Z ,Do -3
ue Rooker by er►c Re.k.fI41 chAN ?7a.-69/
jMAILING ADDRESS(�_ p E
CONTRACTOR t 75 A (� ,l� S SiJ+ C0
VxC c i'c UJi Zp AX 1gO J7 ( ) 7L- a
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE DERAL WAY BUSINESS LICENSE#
R .1SCuR 'co7Q? 12/31 i in 0-a7"-iCtoia(-de-t1.-
NAME .
- L
NAMES cc PHONE
N TCit-CC v. . r Resa ) r
APPLICANT MAILING ADDRESS ( E-MAIL
7v 1 z'ti "MJ SSS brie )( 1 FAX
cri)0.eicit jA 'tc147
PROJECT CONTACT NAME/� PHONE
(The individual to receive and r V /1 t Soo w\ 20‘ -510- --1(E
E
`,
respond to all correspondence MAILING ADDRESS 4 E-MAIL
concerning this application) 175 A Pth) L) SW k 10 1
CITY / STATE Z FAX
Pctelyltl� /1 � 7
ALTERNATE CON ACT NAME: PHO E-MAIL
M a r�i v. Pull WVAIA �
PROJECT FINANCING NAME
OWNER-FINANCED
Required value of$5,000 or more
(RCW 79.27.095) MAILING ADDRESS,CITY,STATE,ZIP PHONE
I certify under penalty of perjury that I am 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 Way 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.
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,
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 asJc part of this application. -•
SIGNATURE: '1 '�/ 12 J DATE 9 3l /C/
PRINT NAME: A
Bulletin#100—April 14,2010 Page 1 of 3 k:\Handouts\Permit Application
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VALUE OF MECHANICAL WORE $ I [ 3) ?Y (a copy of bid or estimate must be provided)
Indicate how many of each type of fixture 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) -.
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST '
DUCTING GAS PIPING WOODSTOVES
•
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Indicate how many of each type of fixture to be installed or relocated as part of this project Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo) LAVS(Han)sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS 1 OTHER(Describ;)
DRAINS SHOWERS VACUUM BREAKERS 5CAS W
DRINKING FOUNTAINS SINKS(Kitchen/utility) WATER HEATERS(Electric) J —
HOSE BIBBS SUMPS WASHING MACHINES EEiE'C3`f'41': F1S: % I ;
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CRITICA
LAREAS ON PROP
ER...TY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
::::...........
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes❑ No ❑ Yes o No
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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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COVERED ENTRY
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GARAGE 0 CARPORT 0
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E7OSTffiO PROPOSED TOTAL
Area Totals
ESTIMATED SELLING PRICE$ # OF BEDROOMS
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Area Construction #of
AREA DESCRIPTION Occupancy Group(s) Information
in Square Feet • TYPa Stories
}: 55
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ADDITION
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Area Construction #of
AREA DESCRIPTION in Square Feet Occupancy Group(s) Typa Stories Additional Information
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TENANT AREA ONLY
Bulletin#100–April 14,2010 Page 2 of 3 k:\Handouts\Permit Application