11-104968 ° / - / O � 6 2
$ kCEWEERMIT 1F CO ME DDE EN Federal
COMMUNITY DEVELOPMENT SERVICES , APPLICATION
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253-835-2607.FAX 253 835-260h 6 C 1 6
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r ?f!_r er or co,_,
7 F FEDERAL\NAY
SITE ADDREo1
.�,• •Y o CD SUITE/UNIT#
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL IV'
$ ( • _, 757if ? 0 - COZ0
TYPE OF PERMIT ❑ BUILDING ,U PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT % L
(Tenant Name;Homeowner Last Name) /,F, , ,"4"4.,- PN le 01 le,
U�1'
PROJECT DESCRIPTION �eI
Detailed description of work to
be included on this permit only
NAME .1IVPRIMARY PHONE
PROPERTY OWNER To/(e/
CO/ss IVt N S.S.0 -.did '-9 ,
MAILING ADD SS E-MAIL
°1'/6 NE l,'//A,eVIcw k
CITY STATE ZIP
NAME
L---e(---- PHONE
4)1
MAILIN- ADDR S E-MAIL
,.
CONTRAC g' ' 0
4 CI / STATE ZIP FAX
IW ST L -. •CTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME 0. e 7 PHONE
Vim— '�Up\3/._
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
PROJECT CONTACT ( NAME PHON7 p
(The individual to receive and w )�Nl ,",- 3/0 /�j G,
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application)
CITY STATE ZIP FAX
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCIN TMATMF
D OWNER-FINAND
Required vat 5,000 or more
.W 19.27.095) 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 as a part of this application.
SIGNATURE: `--N DATE / Z -A-
PRINT NAME: �,.--+n-r5 fru,c...^.1
Bulletin#100—January 1,2011 Page 1 of 3 k\Handouts\Permit Application
•
VALUE OFMECHAMCAL WORK $ . -.y of bid or estimate must be provided)
Indicate how many of each type of fixture to be installed or r- .cote. . .art of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREP INSERTS HI IS Icommerdaq
BOILERS F ACES HOT WATER TANKS(Gas( _
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
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(Hand sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Icitehen/Utility) r WATER HEATERS(Eier nq
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES.
V GENFRAi INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPR ' ION SYSTEM?
❑Yes ❑ No ❑ Y-: ❑ No
g, �(1 iayggg
AREA DESCRIPTION(in squ. e feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
t y
FIRST FLOOR(or Mobile Home)
1 O£?ND kP91
COVERED ENTRY
• mss `
GARAGE ❑ CARPORT ❑
s
EXISTING .•.V 'OPOSED TOTAL - 's'__.-..._._..._..—_--... ___ __...__....._... _..._.....—--.. _._........_.__._.
Area Totals y�a� ATE
.'k't + +w�WJ','1, 5fi,,'++1�•.,., .'< ;`�,..,Ysr ••q.. '4' �':
ESTIMATED SELLING PRICE$ # OF BEDROMS
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet .e Stories
NEW BUILDING 5 � �
ADDITION
� REAMOI ITh ANT I:Y'lI Ei.l� EMENTS
_ --- --
•
AREA DESCRIPTION Area Occupancy Group(s) Construction j # of Additional Information
in Square Feet Type Stories
a a I < 1P - — ---
TENANT AREA/ONLY
PROJECT AREA ONLY
Bulletin#100—January I,2011 Page 2 of 3 k:AHandouts\Permit Application
* 1 ,
Plumbing
City of Federal Way - 1
Community&Econ.Dev.ServicesFPr Perlit #: 11-104968-00-PL
33325 8th Ave S
Federal Way,WA 98003 '" i. ,.i..r,? iL,,,,,
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: SAYBROOK CONDOMINIUMS-BLDG 1 UNIT 2
Project Address: 2621 S 272ND ST Unit 2 Parcel Number: 757480 0020
Project Description: Replacement of electric hot water tank.
•
Owner Applicant Contractor
FEDERAL HOME LOAN MORTGAGE GENE JOHNSON PLUMBING&HEATNG GENE JOHNSON PLUMBING&HEATNG
5000 PLANO PKWY 10011 GREENWOOD AVE N GENEJJP924RT(1/11/13)
CARROLLTON TX 75010 SEATTLE WA 98133 10011 GREENWOOD AVE N
SEATTLE WA 98133
Water Heaters 1
PERMIT EXPIRES Wednesday, June 13, 2012
Permit Issued on Friday, December 16, 2011
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: 1 J- _� Date: )2 —/6----//
P1 tvire fli
THIS CARD IS TO REMAIN ON-SITE
,
�
CITY OF Federal
Construction Ir lection Record
Federal Way • INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 11-104968-00-PL Address: 2621 S 272ND ST Unit 2
Project: FEDERAL HOME LOAN MORTGAG FEDERAL WAY, WA 98003-8265- ,f-.
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) El 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 itir Date g"-`7 —*
❑ Rough Electrical Final ElectricalCI Right of Way
Approved Approved Approved
By Date By Date By Date