02-101753City Federal Way it
Community Development Services Mechanical Permit #:02 - 101753 - 00 - ME
33530 1st Way S
Federal Way, WA 98003-6210 �" a
Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050
Project Name: CHANEY
Project Address: 4272 SW 337TH P Parcel Number: 921152 0100
Project Description: MEC - Replace gas water heater
Owner
Applicant
Contractor
Matthew R & Deborah S Chaney
ACTION WATER HEATERS ONLY INC
ACTION WATER HEATERS ONLY INC
4272 SW 337TH PL
12704 NE 124TH ST SUITE 43
12704 NE 124TH ST SUITE 43
FEDERAL WAY WA
KIRKLAND WA 98034
KIRKLAND WA 98034
98023-3200
1 (425)820-8848
Mechanical Valuation..........................................850.36
Over the Counter Permit......................................Yes
PERMIT EXPIRES October 23, 2002, IF NO WORK IS STARTED.
Permit issued on April 26, 2002
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: � od iy_ Ama/ Date:
,CONSTRUCTION PERMIT APPLICATION
RECEIVED BY
y _
VVR D AMM/ELOPMENT DEPARiME PPLICATION NUMBER:
COMMON" DEVELOPMENT DEPS 'APR 10 2002 APPLICATION NUMBER:
APR .2 5, 2002 APPLICATION NUM BE = RECEIVED BY_ -
**The following is required information - Please print (in ink) or type**
,i)_ APR t 2002
Please note Electrcaj, Fire PreveliEion Systems and Engineering permits may require a separa apple tion.
SITE ADDRESS: -a 2 sq-, .�� 1 C/ ASSESSOR'S TAX/PARCEL #: l l l 2 (,) - O 0 o
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application); ❑ PLUMBING( ;�D
ElELECTRICAL ❑ ENGINEER
I
PROJECT DESCRIPTION (Provide detailed description): 1\,e lr,c
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
DEMOLITION
ON SYSTEM
!15b Z 0:1
N C
vt4/- �t- b, � �S l Yl
MAILING
DAYTIME PHONE:
h) 7 - SNi
ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
CITY
q
EVENING PHONE: i
) oFAX
OF FEDERAL WAY BUSINESS LICENSE NUMBER:
NUMBER:
FNTRACTOR'S REGISTRATION NUMBER:rEXPIRATION
of card required)
G �(� �1 /�
DATE:opy
/ % /0-45 0r45
NAME:
MAILING
, STA
KtL,IIUNSHIP TO PROJECT:
❑ ARCHITECT ❑ TENANT ❑ OTHER ( DESCRIBE):
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
EXISTING USE:
PROPOSED USE:
SPRINKLERED BUILDING?
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
/DAYTIME PHONE:
l ) -
EVENING PHONE:
FAX NUMBER:
E-MAIL ADDRESS:
EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED VALUATION FOR IMPROVEMENTS: $ �'
❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN ❑HIGHLINE El PRIVATE (SEPTIC) j 0
CONSTRUCTION ONLY"
NUMBER OF BEDRbOMS:
ESTIMATED SELLING PRICE:
. .. ■ PR03ECT FLOOR AREAS ' ` .
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING UNIT(S)
BBQ(S)
BOILER(S)
COMPRESSOR(S)
DUCT(S)
w
BATHTUB(S)
DISHWASHERS)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTOR(S)
Indicate numb of fixture
MECHANICAL
EVAPORATIV GAS LOG(S) REFRIG. SYSTEM(S)
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACEINSERT(S) RANGE(S) MISC.( )
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINK(S)
SUMP(S)
URINAL(S)
VACUUM BREAKER(S)
WASH MACHINE OUTLET
WATER CLOSET(S)
%TCCI ATMFDICT[:NATIIRF RLC
WATER HEATER(S)
❑ ELECTRIC -I GAS
I certify under penalty of perjury that the information furnished 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 the permit application is made. I
further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attomeys' 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 of
Federal Way, but only whgre such claim aris t of the reliance of the city, including its officers and employees, upon the accuracy
of the information sunnli _to. he-eit o - - �t s€ 141'
DATE: 9112
❑ PROPERTY OWNER t] APPLICANT
FOR OFFICE .USE ONLY:
COMMUNITY DEVELOPMENT SERVICES - 33530 FIRST WAY SOUTH - PO BOX 9718 - FEDERAL WAY, WA 98063-9718 - 253-6661-4000 - FAX. 253-661-4129
www.dtvoffederalway.com