04-102820City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: ALLCORN VN
Project Address: 33419 28TWSW
Project Description: Remove/replace GAS water heater
Mechanical Permit #:04 -102820 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 010060 0820
Owner
Applicant
Contractor
William C Allcom & Evelyn L Allcorn
FAST WATER HEATER COMPANY
FAST WATER HEATER COMPANY
33419 28TH PL SW
12601 132ND AVE NE
12601 132ND AVE NE
FEDERAL WAY WA
KIRKLAND WA 98034
KIRKLAND WA 98034
98023-2744
(425)814-8381
Mechanical Valuation..........................................449 Over the Counter Permit...................................... Yes
PERMIT EXPIRES January 12, 2005.
Permit issued on July 16, 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.
See Ai
r rlicaton
Owner or agent: Date: � 1P
FINALED
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04 -102820 -00 -ME
Owner: WILLIAM C ALLCORN
Address: 33419 28TH PL SW
FEDERAL WAY, WA 98023-2744
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 Datefl4r__C�
Dates;--eq
REC
IVED BY
cr rc. � COMMUNITY DE EI- PMEENTT DEPARTMENT
Federal Way PERMIT
i y
COMMUM7Y DEVELOPMENT SERVICES _i .,I ti„ r � _004 SF MF CO ME EL PL DE EN FP
33530 FIRST WAY SOUTH • PO BOX 9718
RAL WAY, WA 98063-9718
25FEDE(5 FAX 25366/4129 APPLICATION
w
ww. dl uolTede ral wa u. oom U
The following is required information -an incomplete application wUI not be accepted. Please print iegibiy (in ink) or tune.
SITE ADDRESS 3-3419 28th PI SW SUITE/UNIT #
ASSESSOR'S TAX/PARCEL # 0100600820 _- LOT SIZE (sj)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach separate page for lengthy legal d—ipuon)
PROJECT• •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING iXMECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlul
Remove/replace gas water heater
PROJECT NAME (Name of Business or Owner Last Name) Allcorn
PEOPLE• •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
EXISTING USE
NAME PRIMARY PHONE
Evelyn & William Allcorn 1(253)874-0-677
MAILING ADDRESS CITY, STATE, ZIP
33419 28th P1 SW iFederal Wav WA 98023
COMPANY NAME -
APPLICANT NAME
OFFICE PHONE
Fast Water Heater
CITY, STATE, ZIP
(425)814-3124
MAILING ADDRESS
12601 13 Avp- NF.
CITY, STATE, ZIP
Ki rkl and 8034
CELLPHONE
( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
FAX NUMBER
L 9_-1 Z -Q (L 0_0_4-7 _ - B L 12/ 31 / 94
(425 )814-9516
CONTRACTORS REGISTRATION NUMBER (copy of card required with each application) EXPIRATION DATE
FASTWHC052DF 2 /16 / 05
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELLPHONE
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe)
FAX NUMBER
( ) -
NAME
PRIMARY PHONE
E-MAIL ADDRESS
Per RCW 19.27.095: Lender-14formation is : `
required if project i,alue exceeds aS 0007
NAME
MAILING ADDRESS
CITY, STATE, ZIP
EXISTING ASSESSED/APPRAISED VALUE $_
SPRINKLERED BUILDING? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN
SEWER SERVICE PROVIDER 11 LAKEHAVEN
PROPOSED USE
VALUE OF PROPOSED WORK 6 4 4 9 0 0
FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED? ❑ YES ❑ NO
❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ HIGHLINE 0 PRIVATE (SEPTIC)
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 o NO
BASIC PLAN?
o YES
SECOND
ZONING DESIGNATION
CHANGE OF USE?
THIRD
o NO
NEW ADDRESS REQUIRED? o
YES o NO
FOURTH
o YES
o NO
PLATTED LOT? o YES o NO
ADDITIONAL FLOORS (DESCRIBE)
❑ YES
o NO
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS?
TOTAL EMSTING
TOTAL PROPOSED
TOTAL CASTING AND PROPOSED
—NEWHOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of furture 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 Tub/Sho—Combo)
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINES
LU
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS PIPE OUTLETS
SHOWERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
GAS LOGS
HOODS )commo«i q
RANGES
GAS WATER HEATERS
WATER CLOSETS rroaeq
DRINKING FOUNTAINS
RAINWATER SYST
HOSE BIBBS
ELECTRIC WATER HEATERS
REFRIG. SYSTEMS
WOODSTOVES
MISC (Describe)
MISC (Describe)
I,eertify 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
(Signature)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent
❑ Contractor ❑ 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
❑ NO
ZONING DESIGNATION
CHANGE OF USE?
o YES
o NO
NEW ADDRESS REQUIRED? o
YES o NO
UP/SEPA/SU?
o YES
o NO
PLATTED LOT? o YES o NO
DEMO PERMIT REQUIRED?
❑ YES
o NO
Bulletin #100 — March 30, 2004 Page 2 of 4 k\Handouts — Revised\Permit Application