12-101840r s 9
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: SEWKIN
Project Address: 36804 3RD AVE SW
Project Description: Remove/replace gas water heater
u
Mechanical
Permit #: 12 -101840 -00 -ME
Inspection Request Line: (253) 835-3050
Parcel Number: 218820 1005
Owner
ARnlicant
Contractor
ROBERT A SIMPKIN
WASHINGTON CORROSION SRVC INC
WASHINGTON CORROSION SRVC INC
36804 3RD AVE SW
1425 BLAINE AVE NE
WASFUCS055KC (5/4/12)
FEDERAL WAY WA 98023-7333
RENTON WA 98056-2774
1425 BLAINE AVE NE
RENTON WA 98056-2774
Additional Permit Information
Mechanical Valuation............................................1737.85 Is this an Online or O.T.C. application? ................. Yes
Mechanical Fixtures
Hot Water Tanks ............................ 1
PERMIT EXPIRES Monday, October 22, 2012
Permit Issued on Wednesday, April 25, 2012
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. C
Owner or agent: Date: �� � 5 " I -�--
�- '�U ? q1tto
CITY OF 4A�p
Federal Way
PERMIT #:
Project:
THIS CARD IS TOMAIN ON-SITE
Construction In ection Record
INSPECTION REQUE TS: (253) 835-3050
12 -101840 -00 -ME Address: 36804 3RD AVE SW
ROBERT A SIMPKIN FEDERAL WAY, WA 98023-7333
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.
❑ Mechanical Rough -in (4165)Gas
Piping (4125)
Final - Mechanical (4065)
Approved
Approved to release test
Approved
By Date q _ t Q _
By Date rl L
By 0 V�— Date J1 q
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
My of
Federal Way
COMMUM9YDEVELOPMENT SERVICES
253-835-2607- FAX 253-835-2609
mums cityoffederalwaUxom
*PERMIT
APPLICATION
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MF CO 6E PL DE EN FP
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APR 2 5
SITE 3&�of -3� Avz- SCJ 'Fele yr RESS IiY OF FE ► IU.AY
PROJECT VALUATION
ZONING
ASSESSOR'S TAS/PARCEL #
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING VMECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant NarneJHomeoumer Last Name)
CY h
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME C1 PRIB ARY PHONE
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E-MAIL
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E-MAIL
CONTRACTOR
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xFtRATION
FAX
ATE CONTRACTOR'S LICENSE • DATE
C -S Ie_ c v"'�
FEDERAL WAY BUSINESS LICENSE N
PHONE
G ADD
E-MAIL
APPLICANT
CITY STATE ZIP
FAS
PROJECT CONTACT
Mie individual to receive and
respond to all correspondence
concerning this application)
i'1 C iL- S
PHONE
L4 US " Z_
GAD KESS .� /.
&-MAH'
STATE
ZIP
FAX
ALTERNATE CONTACT NAME: PHONE
E-MAIL
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5,000 or more
(RCW 19.27.095)
MAILING ADDRESS, CYPY, STATE, Zip
PHONE
I cerft 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 eertVy 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 taws 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,tiled 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 thq4ty as a part of this application.
SIGNATURE: DATE 1 Z 2—
PRINT NAME:
PRINT
Bulletin #100 —January 1, 2011 Page 1 of 3 k:\Jlandouts\Pennit Application
9 0
VALUE OF MZCMMCAL W01W $
BATHTUBS (or 17ub/shower combo)
fa copy of bid or estimate must be provided)
Indicate stow many of each type of fixture to be installed or relocated as part of this project Do not include extst#Wftyftwes to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS
HOODS (commemiai)
BOILERS
FURNACES
HOT WATER TANKS (Gas)
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING
GAS PIPING
WOOD -STOVES
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 17ub/shower combo)
LAYS (Hand Sinks)
TOILETS WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS mtchmmtiHty)
WATER HEATERS (m( trie)
HOSE BIBBS
SUMPS
WASHING MACHINES TOTAL FIRTURES
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF MUSTING IMPROVEMENTS
FMSTING/PREVIOUS USE LOT SIZE (In Square Feet) MOSTING FIRE SPRMXLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No ❑ Yes ❑ No
AREA DESCRIPTION I �ea Feet I Occupancy Group(s)
Area
ADDMON
Construction# of
..._ �_ _ J _ _I Additional Information
AREA DESCRIPTION I Area Aare Feet Occupancy Groups) Construction Stories Additional Information
TENANT AREA ONLY
PTARFh.OIifL.�'
Bulletin #100 — January 1, 2011 Page 2 of 3 k:\Iandouts\Permit Application