12-100107' 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: BRUELL
Project Address: 30008 23RD AVE SW
Project Description: Replace gas hot water tank.
0 Miechanical
Permit #: 12 -100107 -00 -ME
Inspection Request Line: (253) 835-3050
Parcel Number: 012103 9087
Owner
Applicant
Contractor
DAVID BRUELL
WASHINGTON CORROSION SRVC INC
WASHINGTON CORROSION SRVC INC
JANICE BRUELL
1425 BLAINE AVE NE
WASHICS055KC (5/4/12)
30008 23RD AVE SW
RENTON WA 98056-2774
1425 BLAINE AVE NE
FEDERAL WAY WA 98023
RENTON WA 98056-2774
Additional Permit Information
Mechanical Valuation............................................995 Is this an Online or O.T.C. application? ................. Yes
Hot Water Tanks ............................ 1
PERMIT EXPIRES Saturday, July 7, 2012
Permit Issued on Monday, January 9, 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 n cordance with the laws, rules and regulations of the State of Washington
an a ity ofral Way.
c�
Owner or agent: Date: Z-
FINgtLQb 3I.;qtZ
CITY OF
Federal Way
PERMIT #
• THIS CARD IS TO REMAIN ON-SITE J.
Construction I4ection Record
INSPECTION REQUESTS: (253) 835-3050
12 -100107 -00 -ME
Address: 30008 23RD AVE SW
Project: DAVID BRUELL FEDERAL WAY, WA 98023-2309
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
By Date
By Date3 0/��_
❑
Rough Electrical
Approved
E]Final
Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
Federal Way
COMMUNITY DEVELOPMENT SERVICES
253-835-2607• FAX 253-835-2609
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*PERMIT R EAIVER PL DE EN FP
APPLICATION l''
JAN 0 9 20
..Y-r.i ^p aCnr-QAL WAY
SITE ADDRESS
CDS
SUITE/UNIT !
t oo tA Ste'
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL ii
o
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING-a-VIECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
6Q LM
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
i7 -\j uo
PRIMARY PHONE
(e 7, Ll
MAILING ADDRESS
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E-MAIL
CITY ,
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STATE
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NAME
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PHONE
,
MAILING ADDRESS
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E-MAIL
CONTRACTOR
CITY
STATE
ZIP /���
FAX
WA STATE CONTRACTOR'S LICENSE X
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE N
NAME
PHONE- J
APPLICANT
MAILING ADDRESS
oto �' �C�t -� CA Sc
E-MAIL
CITY.n `�
STATE U
ZIP � � `J �j �
FAX
PROJECT CONTACT
NAME"5� � w
ec (/v� ,V
PHONE
(The individual to receive and
MAILING ADDRESS
E-MAIL
respond to all correspondence
concerning this application)
CITY
STATE
ZIP
FAX
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
Required value of $5,000 or more
"
MAILING ADDRES , STATE, ZIP
PHONE
(RCW 19.27.095)
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 apart of this application.
SIGNATURE: DATE
iJw t
PRINT NAME:
Bulletin 4100 -January 1, 201 1 Pagel of 3 k:AHandouts\Permit Application
F-11
0 qF
PLU1NIB NG FIYTURES
tndicute how many of each type of future to be installed or relocated as part of this project. Do not include existing futures 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 (Kitchen/utdity) WATER HEATERS (Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENF-RAI, INFORMATION
MECHANICAL FIXTURES
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
# of
Stories
Additional Information
NEW BUILDING
VALM OFMECIIAWCAL WORK
/ (a copy of bid or estimate must be provided)
EXISTING FIRE SPRINKLER SYSTEM?
Indicate how many of each type of f xture 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 (Deseiribe)
AIR CONDITIONER
FIREPLACE INSERTS GODS (commercial)
HOT
COMMERCIAL -- :;moDELJTENANT I-NIPROVEMENTs
BOILERS
FURNACES WATER TANKS (Gas)
Area
in Square Feet
COMPRESSORS
GAS LOG SETS REFRIGERATION SYST
# of
Stories
DUCTING
GAS PIPING WOODSTOVES
PLU1NIB NG FIYTURES
tndicute how many of each type of future to be installed or relocated as part of this project. Do not include existing futures 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 (Kitchen/utdity) WATER HEATERS (Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENF-RAI, INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
# of
Stories
Additional Information
NEW BUILDING
EXISTING/ PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
ADDITION
I
❑ Yes ❑ No
❑ Yes ❑ No
RESIDENML NEW OR ADDITIOiti
AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
,, --- _.... _.._..._ ............... — —
'BASEMENT � `� '
FIRST FLOOR (or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
t,OTHER (describe)
EXISTING PROPOSED TOTAL
Area Totals
"NEW SONES ONLY"
ESTIMATED SELLING PRICE $ # OF BEDROOMS
C OMNIFRCIAL — NF-w/ADDITION
AREA DESCRIPTION
Area
in Square Feet
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
NEW BUILDING
ADDITION
I
COMMERCIAL -- :;moDELJTENANT I-NIPROVEMENTs
AREA DESCRIPTION
Area
in Square Feet
Occupancy Group(s)
Construction
a
# of
Stories
Additional Information
TOT. -',L BUILDING
TENANT AREA ONLY
i
PROJECT AREA ONLY
Bulletin #100— January], 2011 Page 2 of 3 k:\Handouts\Permit Application