11-102669 r •City of Federal Way • Plurnbiii'g
Community Development Services Permit #: 11-102669-00-PL
P.O.Box 9718
Federal-260, Fax
(25F ILE Request Line:3-9718 (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 Inspection
Project Name: EVERETT
Project Address: 2613 S 272ND ST Unit 23 Parcel Number: 757480 0230
Project Description: Replacing an electric water heater.
Owner Applicant Contractor
MARCIA EVERETT JENSEN PLUMBING LLC JENSEN PLUMBING LLC
26824 27TH PL S UNIT 23 PO BOX 98647 JENSEPLO4IRQ (11/26/12)
FEDERAL WAY WA 98003 DES MOINES WA 98198 PO BOX 98647
DES MOINES WA 98198
P`lumbin• f 0
Water Heaters 1
PERMIT EXPIRES Monday, January 2, 2012
Permit Issued on Wednesday, July 6, 2011
I herebycertify 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: �' Date:
1 1�t�.�LED */1 �
. • THIS CARD IS T MAIN ON-SITE
CITY OF Construction I ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT#: 11-102669-00-PL Address: 2613 S 272ND ST Unit 23
Project: MARCIA EVERETT FEDERAL WAY, WA 98003-8265
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) El Rough Plumbing(4230) CI Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date By Date By Date
El Fina Plumbing(4075)
Approved
B Date(---7, ( -7 I
0 Rough ElectricalEl Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
I
_IL - ± O O` (o a q
art or A •Way MF CO ME 0 DE EN FP
2It
CO5MUN83 ITY 607.FAX 3-835-2609 SERVICES
APP L I C A T I v oi1
www.dtuoffederalwau.com ��
JUL 0 6 2011
SITE ADDRESS
-� i So. 2�2_v'--
..,) S� CITY OF FEDERAL WAY SUITE/UNIT
3
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 93'4 ( OD ,,l 13
0 — •0 0 0 0 — 2 3
TYPE OF PERMIT ❑ BUILDING A PLUMBING 0 MECHANICAL
❑ DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) E%ft r I Mas L i ei
PROJECT DESCRIPTION Rel 1a Ct W a / �' +r— a,,& Sr-:,,,i ,.y, 4-v Co�e
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER /l it r . a v i•c-f__-4 2.06 -3 00— 363b
MAILING ADDRESS
22 21{ 2-0=1.1Pi, S o E-MAIL
$
N/K'l
CITY STATE ZIP
FC.4v�� � .- agG.32
NAME
S-t'J t PbKvnu,1 f LLC 206- �' 24t-7'7(7
MAILING ADDRESS E-MAIL
CONTRACTOR 1 -o. boric Y96/,� J q7 S Q-nJRr f ike,..4 e co eo'mm(4,Ke(-
CITY STAT ZIP FAX J
Qef /`'�o:��J w �8 f�t� tot - -(-7 SI
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS CENSE N
j•E/V.cEPL01412Q it / 26 / 1
NAME PHONE
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
PROJECT CONTACT NAME eq PHONE d � 00
(The individual to receive and J 'T��f -2 O 6��Z`l 7 7 7 .' j`�`-
MAILING ADDRESS
respond to all correspondence n / E-MAILEMAIL 1
concerning this application) L 6'4k c 80q� erltnpit^wib.n [<' co"-tear-4%8144-
_.
CITY STATE ZIP FAX
1)CJ ('l0.inP1 c,�a gSt9�s 206-8211---/2s9
ALTERNATE CONTACT NAME:jam/ PHONE E-MAIL
PROJECT FINANCING NAME
Z i] OWNER-FINANCED
Required value of$5,000 or more
(RCW 19.27.095) MAILING ADDRESS,CITY,STATE,ZIP PHONE
I certify under penalty of perjury that 1 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 arty 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: h/Sc- `o /ffj✓' Vt ,_.`;; t -
DATE 7��— (f
�t J
PRINT NAME: cel CV. "15-C v(
Bulletin#100—April 14,2010 Page 1 of 3 k:\Handouts\Permit Application
MECHANICAL FIXTURES
VALUE OF MECHANICAL WORK $ (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
PLUMBING FIXTURES
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) LAYS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) I WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES I TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$ 13L(-0O
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
Yes ❑ No n_ Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ # OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square FeetType Stories
NEW BUILDING
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square FeetType Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100-April 14,2010 Page 2 of 3 k:\Handouts\Permit Application