02-104382City of Federal Way Mechanical Permit #: 02 - 104382 - 00 - ME
Communit} Development Services
33530 1st Way S
Federal Wa•:. WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050
Project Name: MEDINA �JPi
Project Address: 31026 26TH S Parcel Number: 798440 0145
Project Description: MEC - Remove/replace gas water heater
Owner
Applicant
Contractor
FELICISIMO & ARSENIA MEDINA
FAST WATER HEATER COMPANY
FAST WATER HEATER COMPANY
31026 26TH AVE S
12601 132ND AVE NE
12601 132ND AVE NE
FEDERAL WAY WA 98003
KIRKLAND WA 98034
KIRKLAND WA 98034
(425) 814-8381
I--*-- -
L4&/ �44--5-r
AA z
Mechanical Valuation. �......................................449 Over the Counter Permit...................................... Yes
PERMIT EXPIRES April 5, 2003, IF NO WORK IS STARTED.
Permit issued on October 7, 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: See Application Date: U d
RECEIVED BY APPLICATION NUMBER• — O
COMMUNITY DEVELOPMENT DEPARTME — _ _ — — — — — —
OCT U ? 2002 MB -------_
"The following is required information - Please print (in ink) or type— 762996
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY INFORMATION
SITE ADDRESS: 31026 26 AVE S, FEDERAL WAY, WA 98003
ASSESSOR'S TWPARCEL #: 7984400145
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: MEDINA, MARICEL
PROPERTYOWNER:
CONTRACTOR:
APPLICANT:
■ PEOPLE INFORMATION
NAME•MEDINA, MARICEL DAYTIME PHONE:
_ (253)941-1015
MAILING ADDRESS (STREET ADDRESS, CITY, STATE, ZIP):
31026 26 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
QTY 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 C3 OTHER DESCRIBE
E-MAIL ADDRESS
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT M CONTRACTO
INFORMATIONE DETAILED BUILDING
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: ❑ LAKEHAVEN ❑HIGHLINE ❑TACOMA L3 PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑HIGHLINE ❑ PRIVATE (SEPTIC)
W lib
**NEW RESIDENTIAL CON
NUMBER OF -BEDROOMS' ESTIMATED• SELLING PRICE:
FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
❑ ALTERATION O REPAIR
❑ TENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
a
FIRST
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES
CTIO
SE( TIDN TOWNSHIP RANGE
NEW ADDRESS REQUIRED?
YES ❑ NO ❑
0
SECOND
LINO
0
THIRD
0
FOURTH
0
OTHER FLOORS (DESCRIBE)
0
DECK
0
ARA E
HOW MANY FLOORS?
0
TOTAL:
0
0
0
AIR HANDLING UNIT(S)
BBQ(S)
BOILERS)
COMPRESSOR(S)
DUCT(S)
FIXTURES
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEMS)
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACE INSERT(S) RANGE(S) MISC. ( )
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ G AS
PLUMBING
BATHTUB(S) LAVATORY(S) URINALS) 1 WATER HEATER(S)
DISHWASHERS) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC GAS
DRINKING FOUNTAINS) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC. ( )
INTERCEPTORS) SUMP(S)
DISCLAIMER/
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowiedge,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 suoolied to the city a_a nart of this application.
NAME/TITLE.''"~r ''` = " Permit Mgr DATE:
10/02/2002
❑ PROPERLY OWNER ❑ APPLICANT ZICONTRACTOR
FOR OFFICE USE ONLY:
O NBN ❑ ADDITION
❑ ALTERATION O REPAIR
❑ TENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
BUILDING SHELL ONLY?
❑ YES ❑ ND
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES
CTIO
SE( TIDN TOWNSHIP RANGE
NEW ADDRESS REQUIRED?
YES ❑ NO ❑
PLATTED LOT? ❑ YES ❑ N?
I CHANGE OF USE? ❑ YES
LINO