04-100429City of Federal Way
Community Development Services
33530 Ist Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: VALDEZ
Project Address: 2405 SW 325TH 5r
Project Description: Gas to gas water heater replacement
Mechanical Permit #:04 -100429 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 638660 0200
Owner
Applicant
Contractor
Benjamin M Valdez
ACTION WATER HEATERS ONLY INC
ACTION WATER HEATERS ONLY INC
510 STEVENS AVE SW #Q102
12704 NE 124TH ST SUITE 43
12704 NE 124TH ST SUITE 43
RENTON WA
KIRKLAND WA 98034
KIRKLAND WA 98034
98055-1889
1
1 (425) 820-8848
Mechanical Valuation..........................................1787.40 Over the Counter Permit...................................... Yes
PERMIT EXPIRES August 4, 2004.
Permit issued on February 6, 2004
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: �G roN
Mechanical rough -in:
FINAL MECHANICAL: CiCJ
Date
v4
Nate
` Core RECEIVED gy CONSTRUCTION PERM ITAPP TI N ���`
�BEVELOPMENTDEPgR7MEN7 f / v
'CITY OF PLICATION NUMBER: - _ - _
Federal Way FEf3 0 6 2004 APPUCATION NUMBER: - _
PPLICATION NUMBER: - — — - — _
**The following is required information - Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY•. •
�[
SITE ADDRESS: a 1 y 5 L,-) 3: 5- ASSESSOR'S TAX/PARCEL *:.6 ✓
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROJECT•• •
TYPE OF PROJECT (This application): ❑ BUILDING [+PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
Cr (-4 -1" a (f P[- %A C 'L i
PROJECT
■ PROJECT INFORMATION
PROPERTY OWNER:
CONTRACTOR:
NAME: ^' DAYTIME PHONE;
e� rte► vnr�J V r9 C_(� ( S el S�' / 7
MAILING ADDRESS (STREET ADDRESS; CITY, `STATE, ZIP): CC
NAME:
DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
EV NING PHONE:
N 140 , ZZ
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:FAX
NUMBER:
�-S) M, -
CONTRACTOR'S REGISTRATION NUMBER:
►v S
EXPIRATION DATE:
l l
(copy of cera required) C
.iv—
>>
— —
APPLICANT: NAME:
-fi NL ri
MAHM ADDRESS (STREET ADDRESS; CIT
y
❑ ARCHITECT ❑ TENANT ❑ OTHER(
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER
EXISTING USE:
PROPOSED USE:
6-n' r✓
EVENING PHONE:
FAX NUMBER:
❑ APPLICANT
EXISTING BUILDING ASSESSED/APPRAISED VALUATION -�•
PROPOSED VALUATION FOR IMPROVEMENTS: $ I r� I 0
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: #
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
FIRST
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO
CHANGE OF USE? ❑ YES ❑ NO
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNITS) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILERS) FIREPLACE INSERTS) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
fJ1L1ML ) G Le
BATHTUB(S) LAVATORY(S) URINAL(S) WATERH TER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) 11 ELECTRIC VGAS
DRINKING FOUNTAINS) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) WATER CLOSET(S) MISC. ( )
INTERCEPTOR(S) SUM P(S)
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' 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 where sudtoalm arises out of the reliance of the city, Including its officers and employees, upon the accuracy
of the information supplied to the ity as a partof this `applica�ti n.
NAME/TITLE: DATE -0,
❑ PROPERTY O -p-APALICANT CONTRACTOR ��
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO
CHANGE OF USE? ❑ YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 253-661-4129
www.cityoffederalway.com