03-105031Y ^
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City of Federal Way
KELLY VANSCIVER
Mechanical Permit #: 03 -105031 00 - ME
Community Development Services
30020 3RD AVE S
-
33530 1st Way S
FEDERAL WAY WA 98003
KIRKLAND WA 98034
Federal Way, WA 98003-6210
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Ph: 253.661.4000 Fax: 253.661.4129
Inspection request line: 253.835.3050
Project Name: VANSCIVER
Project Address: 30020 3RD I AVC 5
Project Description: Replace gas hot water tank.
Parcel Number: 692860 0480
Owner
Applicant
Contractor
KELLY VANSCIVER
FAST WATER HEATER COMPANY
FAST WATER HEATER COMPANY
30020 3RD AVE S
12601 132ND AVE NE
12601 132ND AVE NE
FEDERAL WAY WA 98003
KIRKLAND WA 98034
KIRKLAND WA 98034
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(425)814-8381
Mechanical Valuation..........................................449 Over the Counter Permit...................................... Yes
PERMIT EXPIRES May 5, 2004.
Permit issued on November 7, 2003
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 tion Date: l � % — 0JL
3
5 � D 1,0 V - F
00
RECEIVED
CONSTRUCTION PERMIT APPLICATION
CITY OF - - - - -------
OPUCA7110N NUMBER: t>3 ! 0ILI"
NOV 0 7 2003
Federal Way Ck&N NUMBER:
CITY OF FEDERAL WAY POLICAMN NUMBER:
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P
BUILDING DEPT, Z
**The following is required information —Please Print (in ink) or type*" 019285
Ptease note; Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY INFORMATION
SITE ADDRESS. 30020 3 AVE S, FEDERAL WAY, WA 98003 ASSESSOR'S TAX/PARCEL #. 6928600480
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROXECT INFORMATION
TYPE OF PR03ECT (This application): n BUILDING 11 PLUMBING X MECHANICAL u DEMOLITION
n ELECTRICAL a ENGINEERING ri FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): Remove/Replace Gas Water Heater
............ . . .
PROPERTY OWNER:
'AORUALTOiltol
APPLICANT:
VANSCIVER, KELLY
PROSECT INFORMATION
'SWIL, ZIP):
DANT ME PHOW:
((253)29-3352-
1 30020 3 AVE S FEDERAL WAY, WA 98003 1
CIVYSTAW, ItPj: EVILAING PHONE--
01 -A-50INSKIi-rd PPWECI: FAY "KW
n ARCHITECT n TENANT 0 OTHER( DESCRIBE):...
CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER o APPLICANT CONTRACTOR
PR03ECT INFORMATION
.................
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS; $--.$449.00
SPRINKLERED BUILDING? r. YES n NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: u YES o NO
WATER SERVICE PROVIDER- oLAKEHAVEN nHIGHLINE a TACOMA a PRIVATE (WELL)
SEWER SERVICE PROVIDER: o LAKtHAVEN n HIGHUNE n PRIVATE (SEPTIC)
. ............................ -", " ................ ........ .. . .. ...... .
*NEW RESIDENTIAL CONSTRUCTION ON LY -
NUMBER OF BEDROOMS.
ESTIMATED SELLING PRICE:
-- - - - -----
PR03ECT FLOOR AREAS
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODVOVE(S)
BOILERS) FIREPLACE INSERT(S) RANGE(S) MISC.
COMPRESSOR(S) FURNACE(S)
DUCT($) GAS PIPE:OtMET(S) HEAT SOURCE:0 ELECTRIC U GAS
PLUMBING
BATHTUB($) . ..... LAVATORY(S) URINAL(S) 1 WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS.X
VACUUM BREAKER(S) ELECTRIC GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH 14ACHINE OUTLET'
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) v x misc.
INTERCEPTOR(S) SUMP(S)
DISCLAIMER /SIGNATURE ALC
I ceeft undw penalty of perjury that the information furnished by me Is true and carrxlxt 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, experts", and attorneys' fees incurred in the
investigation and defense of such claim), which may be made try any person, Including the undersigned, and filed against the City of
Federal Way, but only where such claim arises out of the reliance of the city, including Its officers and employees, upon the accuracy
of the information supplied to the city as a part of this application.
NAMEITITLE-
Pennit Mgr DATE-. 11/05/2003
m PROPERTY OWNER o APPLICANT N CONTRACTOR
commuNrTy oeveL"Eptr svkvicu - 33530 FIRST WAY SOVRI - PO BOX 9718 * FEDL-RAL WAY, WA 98063-9'718 - 253-"1-4000 - FAX: 253-661-4129
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