03-105465City of Federal Way
Community Development Services
33530 1st Way S e
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: CHUBBS C
Project Address: 34640 14TH SW
Project Description: Replace gas hot water tank.
Mechanical Permit #:03 -105465 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 666490 0460
Owner
Applicant
Contractor
Brent Chubbs & Trisha L Chubbs
FAST WATER HEATER COMPANY
FAST WATER HEATER COMPANY
34640 14TH PL SW
12601 132ND AVE NE
12601 132ND AVE NE
FEDERAL WAY WA
KIRKLAND WA 98034
KIRKLAND WA 98034
98023-7038
(425)814-8381
Mechanical Valuation..........................................449 Over the Counter Permit...................................... Yes
PERMIT EXPIRES June 14, 2004.
Permit issued on December 17, 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 A'ppllcat'1on Date: 1-2- -1 7 —0'5
CITY OF COMerirWry RECEIVED 1r3y'
eu_ —1 eral Way
DEC 17 2003
* *The following is required information — Plea" print (in ink) or "* *
Plea" note, Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY INFORMATION
SITE ADDRESS: 34640 14 PL SW, FEDERAL WAY, WA 98023 ASSESSOR'S TAX/PARCEL #: 6664900460 -
LEGAL DESCRIPTION OF SU83ECT PROPERTY (ATTACK SEPARATE DESCRIPTION IF LENGTHY)-
PR03ECT INFORMATION
TYPE OF PR03ECT (TWs application): a BUILDING 0 PLUMBING )0 MECHANICAL. 0 DEMOLITION
a ELECTRICAL o ENGINEERING 0 FIRE PREVENTION SYSTEM
PRO)ECT DESCRIPTION (Provide detailed description): Remove/Replace Gas Water Heater
PROJECT NAME: A
jlwttj.l n.-% ]3RENI
PR03ECT INFORMATION
PROPERTY OWNM-
APPLICANT:
CHUBBS, BRENT
34640 14 PL SW
FEDERAL WAY, WA 98023
1018
DAYTIME PHM:
((253)15-6845-
MALLM XWWSS (SMErADOUSS; afY, STAtf, Z(fl: EMING PHONE
A"TIOR314V TO PRO= FAX "of R:
c3 ARCH rTECT In TENANT 0 OTHER (DESCRIBE]:_
CONTAC' PERSON FOR THIS PROJECT: o PROPERTY OWNER o APPLICANT CONTRACTOR
PROJECT INFORMATION
EXISTING USE. EXISTING BUILDING ASSESSED/APPRAISED VALUATION .. .... . ...... ...
PROPOSED USE., PROPOSED VALUATION FOR IMPROVEMENTS: S $449.00
SPRINKLERED BUILDING? o YES n NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: �i YES NO
WATER SERVICE PROVIDER, o LAXEHAVEN n HIGHLINE OTACOMA El PRIVATE (WELL)
SEWER SERVICE PROVIDER-. o LAKEHAVEN 0 KGHLINE 0 PRIVATE (SEPTIC)
f *Ni:�ir ESIL�ENTIAL C'C�NS'TttUC"ION ONLY* �'
NUMBER OF BEDROOMS ESTIMATED SELLING PRICE: $�
PRO3ECT FLOOR AREAS
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYS'TEM($)
ams) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE`. ra ELECTRIC j GAS
BATHTUS(S)
VISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTOR(S)
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINK(S)
SUMP(S)
URINAL(S)
VACUUM BREAKER(S)
WASH 1 AC;HINEOUTL.E"T
WATER CLOSET(S)
DISCLAIMERISIGNATURE ALC"
WATER HEATER(S)
r) ELECTRIC X GAS
I certify undw penalty of perjury that the rota motion famished by me is true and vombct to the best of my knowledge, and
further, that I am authorized. by the awmew of the above premises to Perform On work for which the permit application is made. I
further agree to hold harmless the City of Fiederal Way as to any dalm (including costs, ex and act m eys' feces incurred in theInvestigation and cense of h daim), which may be made by any person, including they undersigned, and filed against the City of
Federal Way, but ontV where such claim arises out of the: reliance of the city, including its *Mcm and employees, upon the accuracy
of the information supplied to the city as a Part of this ap llmtion.
NAME/TITLE: Permit Mgr. DATE 12/15/2003
COM"U RY R>EVELC"4ENT SERVICES • 33530 FIRST WAY SOV M ■ PO BOX 9718 • FEDERAL WAY, WA 98063.9718.253-661-4= • FAQ[: 253-661-41 Z9