04-100623—
City of Federal Way
Co.:nnunity Development Services
33530 1`t Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Mechanical Permit #:04 -100623 - 00 - ME
Inspection request line: 253.835.3050
Project Name: SOULE p
Project Address: 31017 11TH SW Parcel Number: 525980 0070
Project Description: Replace gas hot water tank.
Owner
Applicant
Contractor
Sandra J Soule
WASHINGTON WATER HEATERS INC
WASHINGTON WATER HEATERS INC
31017 11 TH PL SW
8714 59TH DR NE
8714 59TH DR NE
FEDERAL WAY WA
MARYSVILLE WA 98270
MARYSVILLE WA 98270
98023-4535
(360)653-6429
Mechanical Valuation..........................................500 Over the Counter Permit ...................................... Yes
PERIVHT EXPIRES August 21, 2004.
Permit issued on February 23, 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:Date:
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335.10 FIRST NAT SOUTH - PO BCX 5716
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federal Way PERMIT APPLICATION'` B 2 3 20��'��'�„��S��:Zy
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The follnu/tno is reautred information - an incomplete app8eatton will not be accepted. Please print legibly ltn ink) or type.
SITE ADDRESS: �1 O Y-7 �\ �' &Lkvj O-ZJ-X _`gOZ� SUITE/APT N
ASSESSOR'S TAX/PARCEL t: Z q Q - C) U =1 Q SQUARE FOOTAGE OF LOT:
LEOAL DESCRIPTION (eg. Acme Estates, Lot I )
(Attach separate page for lengthy legal d-criptian)
TYPE OF FERBSIT (This applicatlout c BUILDING ❑ PLv3ml ItG `1 [ECHANICAL c DEMOLITION
C ELECTRICAL ❑ ENGINEERING m FIRE PREVENTION SYSTEM
PROJECT DESCRIPTIO][ I�nouicie detailed description of uerk Included on this permit nn&1t.
PROJECT HAMS (Name D Business/ Owner Last Namd:
PROPERTYPRIMARY PHONE:
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OWNER: q �7
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ADDRESS
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CONTRACTOM NAME. I.VArnn7 rrwc rnvna.
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MAILINGADDRE' (el XEb:1A1IDRESf* CIT', STATE, ZIP�� CELLPHONE:
1161 k -i 5 `N1 1'' Oc- N"(-- me �i 1
FEDt� L WOAY 6l Sl "E E NUMBER:— / 7EXP�RATIQNZ EO A � �� ) FR �� - LOO
CGN'(RAC:11)" REGISCRAfION NUMBER: ] y�- _ 33'gF.X✓P[RATI Q�
(copy of tori requtrad with oaaL appHoatkm V:,,' ` `J �� •� j� (� O
LENDER:
ar Fraprl VYu - 66.00%
APPLICANT:
NAME: fDAY^.IME PHONE•.
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MA1LI"C1�17DItSS:: (STR&E: ADDRESS;!:
— —NATE, Z2P ------ ---
1tAME; OFFICE PHONE:
MANINf A -)DRESS (STREF.TADDREjS)• C1C1', 5 9'T°Z. ZIP EVENING PHONE:
( )
RRLATIGNSHIP TG PROJECT` FAX NUMBER:
O Architect ❑ Termat o Other (D--bej ( )
CONTACT PERSON FOR THIS PROJECT: Li Property Owndi a contractor ❑ Applicant R•MAIL ADDRESS:
DFTAITFD • ••MAT10I
EXISTINr, USE: PROPOSED USE:
EXISMG ASSESSED/APPRAISED VALUE *---VALUE OF PROPOSED WORK:
SPRINhLERED BUILDING? C YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSEDIREQUIRE:D?, c YES O NO
WATER SERVICE PR0V DSR: ❑ LAKEHAVEN t7 HIGHLINE u TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: 0 LAREHAVEN G HIGHLIffs o PRIVATE (SEPTIC)
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I certOV gender penalty Qf perjury that the irtform at{or.,/i,:rseished bg vra r is true and corrract to the batt of mW
kno lodge, and jkerthor, that ! arra authorbed '-Jthe owne gf'the abwa premiacs to parftmm tU caorh for whloh tho pemdt
appRcatlon to made. f furti.rr agree to hold harwt&"s the CV.q q' pedera,t Way as to any cltednt (trticlsadln,$ caste, exp#nsas, aAd
attorneys' fees tnaurred to the lraraestigation a --d d,dim.YC of suO,. etuiny, ultdch mag be made by any pea son, inebading the
vivtdw-signed, *Ad Jtled against the City -q nderaal Why, but s:rtly where such chtfis arises out of the reilance of the city,
including its nfiewra Jrlcv enspta;M0$, tkpon tele ncrurctcy 4f the ietfotrruttlar, mippNed to the cuW as a p alt apptteation_
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