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04-102359City of Federal Way Community Development Services Mechanical Permit #: 04 -102359 - 00 - ME 33530 1st Way S Federal `Nay, WA 98003-6210 Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050 Project Name: HULTMANp,JO/ Project Address: 32211 2NDISW Parcel Number: 926490 1740 Project Description: Replace gas hot water tank. Owner Applicant Contractor Carl T Hultman & Sharon L Hultman ACTION WATER HEATERS ONLY INC ACTION WATER HEATERS ONLY INC 32211 2ND AVE SW 12704 NE 124TH ST SUITE 43 12704 NE 124TH ST SUITE 43 FEDERAL WAY WA KIRKLAND WA 98034 KIRKLAND WA 98034 98023-5603 (425)820-8848 Mechanical Valuation..........................................1000 Over the Counter Permit ...................................... Yes PERMIT EXPIRES December 11, 2004. Permit issued on June 14, 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: (a ty THIS CARD IS TO REMAIN ON-SITE CITY OF Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT #: 04 -102359 -00 -ME Owner: ACTION WATER HEATERS ONLY INC Address: 32211 2ND AVE SW FEDERAL WAY, WA 98023-5603 This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as possible (read left to right, top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card. ❑ Mechanical Rough -in (4165) ❑ Gas Piping (4125) ❑ Final - Mechanical (4065) Approved Approved to release test Approved By Date By Date By Date Ile CIT OF t,(J,tih%Jl�lvlr O'( 1 z 3 2 `J �_,g fi[ ©F ©/V 8 i�r���Y DEVELOPMENT SERVICES 33530y�1��P:1TH • PO BOX 9718 °! F FEDERAL WAY,' *k :98063-9718 Federal Way PERMIT APPLICATION 253-661-4115-offede lway 1-4129 rUww.cituoffederalw¢u.carn For Office Uw Only: `. f 3 2 _ TD: _ FW File Number: a The following is required information -an incomplete application will not be accepted Please print legibly (in ink) or type. SITE ADDRESSS:��// ASSESSOWS'1`AR)PARCEL #: LEGAL DESCRIPTION (e.g.: Acme Estates, Lot 1) SQUARE FOOTAGE OF LOT: G,4m P (A -S D ( V lttach separate page for lengthy le APT # 6- 01 fir- 1 --1 TYPE OF PERMIT (This application): ? BUILDING ? PLUMBINGMECHANI ?DEMOLITION ? ELECTRICAL ? ENGINEERIN ? FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this permit only: PROJECT NAME (Name of Business/Owner Last Name): ft—v PROPERTY OWNER: CONTRACTOR: j 3'�L LENDER: (If P-poasd VW.., 66,000) APPLICANT: c NAM II PIUMARY g U �"V �" I C J) 3) HONE: _ � _ � i MAILING ADDRESS (STREET ADDRESS;):CITY, STATE, ZIP 2 �O ajj aj� IqLJ� S f D�igtTL W14 E JTG1 COMPANY O FFIFE ONE: 10 nl Bn Gn• MAILING ADDRESS (STREET ADDRESS;): CITY, STATE IP CELL PHO EVENING PHONE: 00(0 Y3P- CITjY OF FEDERAL WAY BUSINESS LICENSE NUMBER: EXPIRATION DATE: F NUMBER: FAX NUMBER: (Za' O � - CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE: f / (co" e6 card requited with each appLeation _ D NAME: DAYTIME PHONE: MAILING ADDRESS (STREET ADDRESS;): CITY, STATE, ZIP NAME: OMP 04 FFI xPHONE:��. Bn Gn• MAILING ADDRESS (STREET ADDRESS): �Q jo �►�,� i a S' 3 C TATE, ZIP i 1cc� � 9Sz3 EVENING PHONE: 00(0 Y3P- 7_D1_153 RELATIONSHIP TO PROJECT: /_ - ? Architect ? Tenant ? Other (Describe): � FAX NUMBER: (Za' O � - I CONTACT PERSON FOR THIS PROJECT: ? Property Owner AContractor ? Applicant I �y "`L'j+""`r (2 /1 c G% ii n r r EXISTING USE: <_ °1,% .-F—n , /4/ PROPOSED USE: J C-0 m L/ EXISTING ASSESSED/APPRAISED VALUE l$ VALUE OF PROPOSED WORK: Ly �L SPRINKLERED BUILDING? ? YES ? NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: ? YES ? NO WATER SERVICE PROVIDER: ? LAKEHAVEF ? HIGHLINE ? TACOMA ? PRIVATE (WELL) / SEWER SERVICE PROVIDER: ? LAKEHAVEN ? HIGHLINE ? PRIVATE (SEPTIC) 0 • AREA DESCRIPTION EXISTING SQ. FT. PROPOSED SQ. FT. TOTAL BASEMENT o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT FIRST BUILDING SHELL ONLY? o YES ❑ NO 3ASIC PLAN? SECOND a NO ZONING DESIGNATION: THIRD o YES o NO NEW ADDRESS REQUIRED? FOURTH UP/SEPA/SU? o YES o NO ADDITIONAL FLOORS (DESCRIBE) c YES o NO DEMO PERMIT REQUIRED? o YES DECK (COVERED?) GARAGE/CARPORT HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL EMSTING AND PROPOSED **NEW HOMES ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ Indicate number of each type of fixture that is to be installed or relocated as part of this project. Do not include existing fixtures to remain. MECHAMCAL /U U Value of Mechanical Work .$ AIR HANDLING UNITS BBQS BOILERS COMPRESSORS DUCTS PLUMBING BATHTUBS (or Tub/Showercombol DISHWASHERS GAS PIPE OUTLETS WASHING MACHINES LAVS (Bata—ta Sink EVAPORATIVE COOLERS FANS FIREPLACE INSERTS FURNACES GAS PIPE OUTLETS SHOWERS SINKS SUMPS URINALS VACUUM BREAKERS GAS LOGS REFRIG. SYSTEMS HOODS (co—iatl WOODSTOVES RANGES MISC (Describe) GAS WATER HEATERS WATER CLOSETS (Toilet) MISC (Describe) DRINKING FOUNTAINS RAINWATER SYS HOSE BIBBS ELECTRIC WATER HEATERS ]iSCLAiMER/SIGNATURE BLC 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 claimf, which may be made by any person, including the undersigned, and f led 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 apart of this application. N l� co (Signature) (Title) - f RELATIONSHIP TO PROJECT: ❑ Property Owner ❑ Applicant contractor ❑ Architect ❑ �,v / FOR OFFICE USE ONLY: o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT BUILDING SHELL ONLY? o YES ❑ NO 3ASIC PLAN? o YES a NO ZONING DESIGNATION: CHANGE OF USE? o YES o NO NEW ADDRESS REQUIRED? o YES ❑ NO UP/SEPA/SU? o YES o NO PLATTED LOT? c YES o NO DEMO PERMIT REQUIRED? o YES ❑ NO Page 2