02-103190City 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: KEIZER w-/
Project Address: 27748 23RD/S
Mechanical Permit #:02 - 103190 - 00 - ME
Project Description: MECH - Remove/replace GAS water heater
Inspection request line: 253.835.3050
Parcel Number: 757561 0120
Owner
Applicant
Contractor
CHRISTY KEIZER
FAST WATER HEATER COMPANY
FAST WATER HEATER COMPANY
27748 23RD AVE S
12601 132ND AVE NE
12601 132ND AVE NE
FEDERAL WAY WA 98003
KIRKLAND WA 98034
KIRKLAND WA 98034
(425) 814-8381
Mechanical Valuation..........................................449
Over the Counter Permit ...................................... Yes
PERMIT EXPIRES January 22, 2003, IF NO WORK IS STARTED.
Permit issued on July 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: do Date:Z�IOI/
bee Xvv
Mechanical rough -in:
Gas pipe:
FINAL MECHANICAL: �.
Date
Date
VO'` � ��� APPLICATION
APPLICATION NUMBER: ------ ---
- ,r_.p�RTner�— — — — — — — —
Y
—The following is required information - Please print (in ink) or type** 735810
Please note: Electrical, Fire.Aua2ti& 2g6olns and Engineering permits may require a separate application.
PROPERTYINFORMATION
SITE ADDRESS: 27748 23 AVE S, FEDERAL WAY, WA 98003
ASSESSOR'S TAX/PARCEL #: 7575610120
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: KEIZER, KEVIN & KRISTI
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
■ PEOPLE INFORMATION
NAME:KEIZER, KEVIN & KRISTI DAYTIME PHONE:
(253)946-5832
MAILING ADDRESS (STREET ADDRESS, CITY, STATE, IIP): _ —"
27748 23 AVE S FEDERAL WAY, WA 98003
NAME:
FAST WATER HEATER COMPANY
DAYTIME PHONE:
(425)814-3124
MAILING ADDRESS (STREET ADDRESS, CITY, STATE, ZIP):
EVENING PHONE:
12601 132ND AVE NE
KIRKLAND WA 98034
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
19-87000047400-b1
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, IIP): EVENING PHONE:
<Street> <Cit > <Zi >
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑TENANT ❑OTHER (DESCRIBE):
CONTACT PERSON FOR THIS PRO]ECT: ❑ PROPERTY OWNER ❑ APPLICANT M CONTRACTON
DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ $449.00
SPRINKLED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑YES ❑ NO
WATER SERVICE PROVIDER: Q LAKEHAVEN ❑HIGHLINE ❑TACOMA ❑PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑HIGHLINE ❑ PRIVATE (SEPTIC)
ea -716
, APkNeW-RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS' ESTIMATED SELLING PRICE: $
BASEMENT
THIRD
HOW MANY FLOORS?
TOTAL:
FLOOR AREAS
EXISTING S . FT.
PROPOSED S . FT.
TOTAL
❑ NBN ❑ ADDITION
0
❑ 7ENANTIMPROVEMENT
CENSUS CODE:
0
ZONING DESIGNATION:
0
❑ YES ❑ NO
COMP PLAN DESIGNATION
0
ENO
secnIlN TOWNSHIP RANGE
0
YES ❑ NO ❑
PLATTED LOT? ❑ YES ❑ NO
0
adO
0
0
0
0
0
FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNrr(S) EVAPORATIVE COOLER(S)-GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S) FAN(S) HOODS) WOODSTOVE(S)
BOILERS) FIREPLACE INSERT(S) RANGE(S) MISC. ( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ G AS
PLUMBING
BATHTUB(S) LAVATORY(S) URINALS) I WATER HEATER(S)
DISHWASHERS) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC E] 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
`urther, that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I
'urther agree to hold harmless the City of Federal Way as to any claim (Including costs, expenses, and attorneys' fee incurred in the
nvestigation and defense of such claim), which may be made by any person, Including the undersigned, and filed against the City of
�ederal Way, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy
)f the Information suoolied to the citv 4s.a Dart of this application.
NAME/TITLE.''��✓� "'` permit Mgr DATE: 07/22/2002
❑ PROPERLY OWNER ❑ APPLICANT $] CONTRACTOR
FOR OFFICE USE ONLY:
❑ NBN ❑ ADDITION
❑ ALTERATION ❑ REPAIR
❑ 7ENANTIMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
BUILDING SHELL ONLY?
❑ YES ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES
ENO
secnIlN TOWNSHIP RANGE
NEWADDRESSREQUIRED?
YES ❑ NO ❑
PLATTED LOT? ❑ YES ❑ NO
I CHANGE OF USE? ❑ YES
adO