02-104198City 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: SMITH f�J�
Project Address: 30619 11TH S
Mechanical Permit #:02 - 104198 - 00 - ME
Project Description: MECH - Remove/replace GAS water heater
Inspection request line: 253.835.3050
Parcel Number: 091900 0130
Owner
Applicant
Contractor
Robert L & Sandra I Smith
FAST WATER HEATER COMPANY
FAST WATER HEATER COMPANY
30619 11TH AVE S
12601 132ND AVE NE
12601 132ND AVE NE
FEDERAL WAY WA
KIRKLAND WA 98034
KIRKLAND WA 98034
98003-4121
1 (425)814-8381
Mechanical Valuation..........................................449
Over the Counter Permit ...................................... Yes
PERMIT EXPIRES March 26, 2003, IF NO WORK IS STARTED.
Permit issued on September 27, 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: IP11.0 AcatianDate:Z3(OZ
See NIP
Mechanical rough -in:
Gas pipe:
FINAL MECHANICAL:
Date
1�11h_3
Date
lw APPLICATION NUMBER• _ _ _ E
—� RECEIVED BY NUMBER:— _ — _ — — w _ _
COMMUNITY DEVELOPMENT
� �DD'9EPAR
"The following iswgdirg Lawan - Please print (in ink) or type** 759985
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY •. •
SITE ADDRESS: 30619 11 AVE S, FEDERAL WAY, WA 98003
ASSESSOR'S TAX/PARCEL *: 0919000130
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIMON IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ® MECHANICAL Q DEMOLITION
Q ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
Remove/Replace Gas Water Heater
PROJECT NAME: SMITH, SANDY
PROPERTY OW N ER:
CONTRACTOR:
APPLICANT:
■ PEOPLE INFORMATION
NAME: SMITH, SANDY DAYTIME PHONE:
(253)839-2283
MAILING ADDRESS (STREET ADDRESS, CITY, STATE, ZIP):
30619 11 AVE S FEDERAL WAY, WA 98003
NAME:
DAYTIME PHONE:
FAST WATER HEATER COMPANY
(425)814-3124
MAILING ADDRESS (STREET ADDRESS, CITY, STATE. ZIP):
EVENING PHONE:
12601 132ND AVE NE
KIRKLAND WA 98034
QTY 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> <Ciiy> <Zi >
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑TENANT ❑OTHER (DESCRIBE):
CONTACT PERSON FOR THIS PR03ECT: Q PROPERTY OWNER Q APPLICANT M
DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ $449.00
SPRINKLED BUILDING? Q YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED:OYES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN QHIGHLINE ❑TACOMA ❑PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN QHIGHLINE ❑ PRIVATE (SEPTIC)
W716
**NEV RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS' ESTIMATED SELLING PRICE: $ -
FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED . FT.
TOTAL
BASEMENT
❑ ALTERATION ❑ REPAIR
❑ TENAfNTDWROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
0
FIRST
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES
ENO
SECMN TOWNSHIP RANGE
NEWADDRESSREQUIRED?
YES ❑ NO ❑
0
SECOND
EM
0
THIRD
0
FOURTH
0
OTHER FLOORS (DESCRIBE)
0
DECK
0
URAGE
HOW MANY FLOORS?
0
TOTAL:
0
0
0
FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S)_.._GAS LOG(S) REFRIG. SYSTEMS)
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: Q ELECTRIC Q G AS
PLUMBING
BATHTUB(S) LAVATORY(S) URINALS) I WATER HEATER(S)
DISHWASHERS) RAIN WATER SYS. VACUUM BR§KER(S) ❑ ELECTRIC E] GAS
DRINKING FOUNTAINS) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) WATER CLOSET(S) MISC. (�
INTERCEPTORS) SUMP(S)
BLOCKDISCLAIMER/ SIGNATURE
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
if the Information suool ed to the citv 4s_o oart of this application.
v.-= " �`c c- °;�"`' , Permit Mgr 09/23/2002
NAME/TITLE. " DATE:
❑ PROPERLY OWNER ❑ APPLICANT $I CONTRACTOR
FOR OFFICE USE ONLY;
❑ NEW ❑ ADDITION
❑ ALTERATION ❑ REPAIR
❑ TENAfNTDWROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
BUILDING SHELL ONLY?
❑ YES ❑ N)
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES
ENO
SECMN TOWNSHIP RANGE
NEWADDRESSREQUIRED?
YES ❑ NO ❑
PLATTED LOT? ❑ YES ❑ ND
I CHANGEOFUSE? ❑YES
EM