04-102716City of Federal Way
Com,nu„ity Development Services Mechanical Permit #: 04 - 102716 - 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: ALEXANDER
Project Address: 3844 SW 339TH 54' Parcel Number: 921151 0800
Project Description: Remove/replace gas water heater
Owner
Applicant
Contractor
Harriet Arlene Alexander
FAST WATER HEATER COMPANY
FAST WATER HEATER COMPANY
3844 SW 339TH ST
12601 132ND AVE NE
12601 132ND AVE NE
KIRKLAND WA 98034
KIRKLAND WA 98034
(425)814-8381
Mechanical Valuation..........................................449 Over the Counter Permit ...................................... Yes
PERMIT EXPIRES January 4, 2005.
Permit issued on July 8, 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: Snp, PPe k 6 _ Date: —7 p�lp
THIS CARD IS ro REMAIN ON-SITE,
C1W of Community Development Inspection Record
Federal way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04 -102716 -00 -ME
Owner: HARRIET ARLENE ALEXANDER
Address: 3844 SW 339TH ST
FEDERAL WAY, WA 98023-2973
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 Elate By lir Date
Fey= ra Way
COMMUAM DFS. VELOPMENT SERVICES
335183 FIRST WAY SOUTH • PO BOX 9718
FEDERAL WAY, WA 98063.9718
253-6614115• FAX 2536614129
unuw. dhioftederdtaau.mm
The following is reauin
! o -_0TERMIT
"_- 1,1CATI0N
P 1.
_._
- an incomplete application will not be
SITEADDRESS 3844 SW 339th St
ASSESSOR'S TAX/PARCEL # 9 21 1 51 0 8 0 0
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
SF MF C EL PL DE EN FP
D
ited. Please print legibly (in inkJ or tune.
SUITE/UNIT If
LOT SIZE (sj)
lAuach separate page for lengthy Iegd desoipii-q
PROJECT• •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING v MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only)
Remove/replace qas water heater
PROJECT NAME (Name of Business or Owner Last Name) Alexander
PEOPLE1 • •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
EXISTING USE
NAME PRIMARY PHONE
Alexander Harret (Arlpntzl
9604
MAILING ADDRESS CITY, STATE, ZIP
3844 SW 339th St Federal Way WA 98023
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
Fast Water Heater
CITY, STATE, ZIP
(425)814-3124
MAILING ADDRESS
12601 112 Avtm NP.
CITY, STATE, ZIP
Kirkla 980-44
CELLPHONE
1 -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
FAX NUMBER
1- 9_-8- Z - Q. 0- 0_0_4-7 _ - B L 12/31 /94
(425)814-9516
CONTRACTOR'S REGISTRATION NUMBER (copy of cud required with each application) EXPIRATION DATE
FASTWHC052DF 2 /16 / 05
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
/CELL PHONE
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe)
FAX NUMBER
NAME
PRIMARY PHONE
E-MAIL ADDRESS
Per RCW 19.27.095: Lender {nfonnation is,`t;
reglitr ,d {f project value eXceeds $5,000
NAME
MAWNG ADDRESS
CITY, STATE, ZIP
EXISTING ASSESSED/APPRAISED VALUE $
PROPOSED USE
VALUE OF PROPOSED WORK $ 4491.00
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE ❑ PRIVATE (SEPTIC)
► PROJECT FLOOR AREAS
AREA DESCRIPTION
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BA EMENT
o NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IMPROVEMENT
FIRST
BUILDING SHELL ONLY? o YES o NO
BASIC PLAN?
o YES
SECOND
ZONING DESIGNATION
CHANGE OF USE?
THIRD
o NO
NEW ADDRESS REQUIRED? ❑ YES o NO
UP/SEPA/SU?
FOURTH
o NO
PLATTED LOT? ❑ YES o NO
DEMO PERMIT REQUIRED?
ADDITIONAL FLOORS (DESCRIBE)
❑ NO
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS?
TOTAL EXISTING
TOTAL PROPOSED
TOTAL=STING AND PROPOSED
`"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
Value of Mechanical Work
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
PLUMBING
BATHTUBS (or Tuh/Sho—Combo)
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINES
LAV$ (Bathroom sinks)
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS PIPE OUTLETS
SHOWERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
GAS LOGS
HOODS (commemial)
RANGES
/ GAS WATER HEATERS
WATER CLOSETS [roan)
DRINKING FOUNTAINS
RAINWATER SYST
HOSE BIBBS
ELECTRIC WATER HEATERS
REFRIG. SYSTEMS
WOODSTOVES
MISC (Describe)
MISC (Describe)
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 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.
NAME/TITLE ti- /'yZ-1"
(Signature)
RELATIONSHIP TO PROJECT ❑
❑ Agent
❑ Architect ' ❑ Other
FOR OFFICE USE ONLY':';,
o NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO
BASIC PLAN?
o YES
o NO
ZONING DESIGNATION
CHANGE OF USE?
o YES
o NO
NEW ADDRESS REQUIRED? ❑ YES o NO
UP/SEPA/SU?
o YES
o NO
PLATTED LOT? ❑ YES o NO
DEMO PERMIT REQUIRED?
o YES
❑ NO
Bulletin #100 – March 30, 2004 Page 2 of 4 k\Handouts – Revised\Permit Application