04-100430City of Federal Way t
Community Development Services Mechanical Permit #:04 - 100430 - 00 - ME
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050
Project Name: YIP
Project Address: 33319 12TH SW
Project Description: Replacement of gas water heater
Parcel Number: 926496 0030
Owner
Applicant
Contractor
Ricky Yip & Fanny Yip
ACTION WATER HEATERS ONLY INC
ACTION WATER HEATERS ONLY INC
33319 12TH AVE SW
12704 NE 124TH ST SUITE 43
12704 NE 124TH ST SUITE 43
FEDERAL WAY WA
KIRKLAND WA 98034
KIRKLAND WA 98034
98023-5301
(425)820-8848
Mechanical Valuation..........................................887.50 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: i Date: �� (,-'(
.3f.0/OV - GOf 1-ee r 11)AJS,
Mechanical rough -in:
Date
FINAL MECHANICAL: ' " r c
Date
t' RECEIVED BY CONSTRUCTION PERMIT APP ICATION
v COMMUNITY DEVELOPMENT DEPARTMENT
CIT PPLICATION NUMBER: - _ _ _ M
Federal Way FEB 0 6 2004 APPLICKRON 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.
'� % .O. O.
SITE ADDRESMATION
S- '�' 161 J /�J — �'i ASSESSOR'S TAX/ PARCEL #:
-------
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): ❑ BUILDING V16MBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
NAME: c DAYTIME PHONE:
r
1FAf�t4(%
MAILING ADDRESS (STREET ADDRESS; CITY, ST IIP):
NAME:
17c -l—" aw
DAYTIME PHONE:
-Skyg
MAILiy[,ADDRESS (STREET ADDRESS; CITY, STATE, IIP): �
EVE(� � �
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CITYOFFEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER:
EXPIRATION DATE:
(copy of card required)
l l
APPLICANT: NAME:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, IIP):
RELATIONSHIP TO PROJECT: c
❑ ARCHITECT ❑ TENANT ❑ OTHER ( DESCRIBE):
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
EXISTING USE:
PROPOSED USE:
EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED VALUATION FOR IMPROVEMENTS:
DAYTIME PHONE:
- XR
EVENING PHONE:
FAX NUMBER: a
E-MAIL ADDRESS:
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
❑ NO
**NEW RESIDFO-TIAL CONSTRUCTION ONLY**
• 11k MBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION
BASIC PIAN? ❑ 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:
AIR HANDLING UNIT(S)
BBQ(S)
BOILER(S)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTOR(S)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEMS)
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACE INSERTS) RANGE(S) MISC. ( )
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
LAVATORY(S) URINAL(S) 1 WATER HEATER(S)
RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC
SHOWER(S) WASH MACHINE OUTLET
SINKS) WATER CLOSET(S) MISC. ( )
SUMP(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 perso, including the undersigned, and filed against the City of
Federal Way, but only where such im arises out of the reliance of the ci , including its officers and employees, upon the accuracy
of the information supplied to thecl as a part of this application. y
NAME/TITLE: DATE: ^ L
❑ PROPERTY OWNEK- ❑ APPLICANT !b 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 PIAN? ❑ 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