01-100824City of Federal Way
Community Development Services Plumbing Permit #: 01 - 100824 - 00 - PL
33530 1st Way S
Federal Way, WA 98003-6210 Inspection request line: 253.661.4140
Ph: 253.661.4000 Fax: 253.661.4129
(3:30pm cut-off for next day inspections)
Project Name: OSBORN
Project Address: 28601 21ST S Parcel Number: 422200 0130
Project Description: PL - Replace electric hot water tank,
Owner
Applicant
Contractor
William L Osborn
NETCLERK, INC
FAST WATER HEATER COMPANY
2860121 STAVE S
880 DUBUQUE AVE S
FAST WATER HEATER COMPANY
FEDERAL WAY WA
SAN FRANCISCO CA 94080
12601 132ND AVE NE
98003-3339
1 (425) 814-8381
Plumbing Fixtures
Description Quan#' ` Description Quanti Descri kion Quantity
Water Heaters
PERMIT EXPIRES August 26, 2001, IF NO WORK IS STARTED.
Permit issued on February 27, 2001
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 L Date: — 7 D
APPLICATION FOR BUILDING PERMIT
PLEASE PRINT
BUILDING DmsioN
33530 FIRST WAY SOUTH
FEDERAL WAY, WA 98003
(253) 661-4000
Fax (253) 661-4129
APPLICATION # Q I` I 0 0 0 j'1— 0 L—
3tTE"Li1CAIION Site address 28601 21ST AVE S Federal Way WA 98003
Tenant name Lot # Assessor's Tax # 4222000130
Building Owner's Name William Osborn Address 2860121 st Ave S
city Federal Way I state WA zip 98003 Phone 2538397091
Description of work Remove/replace electric water heater
AAPLICAN
Name (F, M, L) NetClerk Inc
Address 720 Dubuque Ave
city South San Francisco
state
zip 94080
Contact Person
Day Phone
Other Phone
Fax
BUt 40i - GONTRAG iOR
Federal Way Business License #
Company Name Fast Water Heaters Company
Address 12601 132nd Ave. N.E.
city Kirkland
State WA
zip 98034
Contact Person Pamela Hill X133
Phone 4258143124
Fax
Contactor's # (Card must be presented) FASTWHC052DF
Expiration Date
02/16/2001
Verified []Yes []No
ARGHITEGT,
Name
Address
City State zip
Contact Person Phone Fax
Legal Description
Please Complete Reverse Side
U�l2E
_ -
Existing Use
City
Proposed Use
Zip
Permit Includes
❑ Building
0 Plumbing
❑ Mechanical
❑ Other
Type of work:
® Residential
[] Commercial
❑ New ❑ Remodel
0 Addition ❑ Repair
❑ # of bedrooms_
❑ Garage
❑ Deck
❑ Shed
Enter 1st Floor
Area Basement
sq ft 2nd Floor
sq It Decks
sq ft 3rd Floor
sq ft Garage
sq ft
sq ft
Existing Floor Area
Proposed Total Area
Q
Water Availability ❑
Sewer Availability ❑
On site Septic System Availability ❑
Project Valuation
$ 349.00
Zoning
Lot Size
Existing Bldn Valuation
$
i}ER
For new residential only - Proposed selling cost: $
15 - 20 Tons
0
Name
Q
Range
Address
Air Handling > = 10,000 CFM Q
City
0
--------......-- .....................
Fum <100K BTUs
State
Zip
sq ft
sq ft
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified El Yes ❑ No
PLUMBI! NT TO ,
Contractor Name
Address
Sinks
City
State
Zip
Contact
Phone
Fax
License #
Expiration Date
Verified ❑Yes ❑ No
Water Closets
0
Sinks
Q
Urinals Q
Lawn Sprinklers
Q
Bathtubs
Q
Dish Washers
Q
Drinking Fountains Q
Other
0
Showers
Q
Electric Water Heaters 1
Sumps Q
Lavatories
Q
Washing Machine
0
Drains Q
Totai 9 �[re Count 1
HANICAL: UNIT COUNT
MECHANICAL EVALUATION ONLY $
Fuel Type (gas/electdc/other) Q
Gas Dryer
0
Air Handling < = 10,000 CFM 0
15 - 20 Tons
0
Length of Gas Piping
Q
Range
0
Air Handling > = 10,000 CFM Q
30 - 50 Tons
0
--------......-- .....................
Fum <100K BTUs
-
Q
---
Gas Log
0
Unit Heater 0
+50 Tons
0
Frun >100 BTUs
.... _.......... _........ -._._..............................
Gas Hwt
.................. _..-.-.__.-_-... --.............................................
Conv Burner
- ........ _.... .............. _.__ .. _ ...........
BBQ's
Q
_... _....... _..... .
0
0 ....... , ..
0
.........................-
Fans
-................................_._........_..
Hood
—_._........._... _.... _............. _...------
Duct Work
_._........ _._...... __................................ ........
Wood Stoves
0
Q .... _............................. ._..._.._..
Q
_... _ --- .. __
Q
Miscellaneous 0
_ ..__..- ................. _......... ----
Boilers 0
__._.._._.._._......_............--- ....
0- 3 Tons Q
.........---... ............... _..__.— ...... ... _......
3 - 15 Tons 0
Fuel Tanks
- --
Above Ground
Underground
TotI 1 Unit Court
0
0
0
Q
DISCLAIMER: I certify under penalty of perjury that the information fumished by me is true and correct to the best of my knowledge, and further, that I am
authorized by the owner of the above premises to perform the work for which permit application is made. I further agree to save harmless the City of
Federal Way as to any claim (including costs, expenses, and attomeys' fees incurred in Investigation and defense of such claim), which may be made by
any person, including the undersigned, against the City of Federal Way, but only where such claims arises out of the reliance of the city, including its offi-
cers and employees, upon the accuracy of the information supplied to the city as a part of this application.
Owner/Agent: Date: 02/15/2001
BUILDING/APP
REVISED 5/18/99