02-102949City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: THOMPSON
Mechanical Permit #: 02 - 102949 - 00 - ME
Project Address: 30415 10TH S
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Project Description: MECH - Remove/replace gas water heater
Inspection request line: 253.835.3050
Parcel Number: 091900 0080
Owner
Applicant
Contractor
Carol Jean bmhw !'A 0 m p f J
FAST WATER HEATER COMPANY
FAST WATER HEATER COMPANY
30415 10TH AVE S
12601 132ND AVE NE
12601 132ND AVE NE
FEDERAL WAY WA
KIRKLAND WA 98034
KIRKLAND WA 98034
98003-4118
(425)814-8381
Mechanical Valuation..........................................449 Over the Counter Permit...................................... Yes
PERMIT EXPIRES January 8, 2003, IF NO WORK IS STARTED.
Permit issued on July 12, 2002
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the us ill be ' accord Fe with the laws, rules and regulations of the State of Washington and
the City of Federal Way. oee in
Owner or agent:
Date: '? • 1 $ • o 2
` EIV D 1V FgR�MG � APPLICATION NUMBERL4 - -L02--t- -
APPLICATION
i NUMBER:11.200APPLICATION ---------
,�lJL
"The following is required information - Please print (in ink) or type" 731048
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application. gE7,� t
SITE ADDRESS: 30415 10 AVE S, FEDERAL WAY, WA 98003
ASSESSOR'S TAX/PARCEL #: 0919000080
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ® MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
Remove/Replace Gas Water Heater
PROJECT NAME: THOMPSON, CAROL
PROPERTYOWNER:
CONTRACTOR:
APPLICANT:
■ PEOPLE INFORMATION
NAME: DAYTIME PHONE:
THOMPSON, CAROL
(253)941-0662
MAILING ADDRESS (STREET ADDRESS, CITY, STATE, IIP):
30415 10 AVE S FEDERAL WAY, WA 98003
NAME:
DAYTIME PHONE:
FAST WATER HEATER COMPANY
(425)814-3124
MAILING ADDRESS (STREET ADDRESS, QTY, STATE. IIP):
EVENING PHONE:
12601 132ND AVE NE
KIRKLAND WA 98034
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
19-87000047-00-bi
425 814-9516
CONTRACTORS REGISTRATION NUMBER:
EXPIRATION DATE:
(copy of card required) FASTWHC052DF
02/16/2003
NAME:
DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS, CITY, STATE, ZIP): EVENING PHONE:
<Street> <Cit > <Zi >
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑TENANT ❑OTHER (DESCRIBE):
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT M
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ $449.00
SPRINKLED BUILDING? ❑ YES Q NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑HIGHLINE ❑TACOMA C3 PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑HIGHLINE ❑ PRIVATE (SEPTIC)
W-76
*'_'NEW RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS' ESTIMATED SELLING PRICE: $ -
FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED Sq. FT.
TOTAL
BASEMENT
ALTERATION ❑ REPAIR
❑ TENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
0
FIRST
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES
CNO
SEG a TOWNSHIP RANGE
NEW ADDRESS REQUIRED?
YES ❑ NO ❑
0
SECOND
ado
0
THIRD
0
FOURTH
0
OTHER FLOORS (DESCRIBE)
0
DECK
0
GARAGE
HOW MANY FLOORS?
0
TOTAL:
0
0
0
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLERS) GAS LOG(S) REFRIG. S*TEM(S)
BBQ(S) FANS) HOODS) WOODSTOVE(S)
BOILERS) FIREPLACE INSERTS) RANGE(S) MISC. { )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ G AS
PLUMBING
BATHTUBS) LAVATORY(S) URINALS) I WATER HEATER(S)
DISHWASHERS) RAIN WATER SYS. VACUUM BREAKER(S) Cj ELECTRIC 6 GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) WATER CLOSET(S) MISC.
INTERCEPTORS) SUMP(S)
DISCLAIMER/ SIGNATURE BLOCK
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 attorneys' fee 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 where such claim arises out of the reliance of the city, including Its officers and employees, upon the accuracy
of the Information suDDlied to the city as a oart of this application.
NAME/TITLE. `° Y "._.__�_� Permit Mgr DATE: 07/08/2002
❑ PROPERLY OWNER ❑ APPLICANT $] CONTRACTOR
FOR OFFICE USE ONLY:
❑ NBN ❑ ADDITION ❑
ALTERATION ❑ REPAIR
❑ TENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
BUILDING SHELL ONLY?
❑ YES ❑ N:)
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES
CNO
SEG a TOWNSHIP RANGE
NEW ADDRESS REQUIRED?
YES ❑ NO ❑
PLATTED LOT? 0 YES ❑ N:) I
CHANGEOFUSE? DYES
ado