04-102319. a
City ueWay
Communitynity Development Services Mechanical Permit #: 04 - 102319 - 00 - ME
33530 1 st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129 b /� 0 2 Inspection request line: 253.835.3050
(J � _J
Project Name: JOHNSON
Project Address: 31416 8TH St PVe S Parcel Number: 858800 0165
Project Description: Install a gas pool heater.
Owner
Applicant
Contractor
Travis Johnson & Rose Johnson
Rose Johnson
Rose Johnson
31416 8TH AVE S
31416 8TH AVE S
31416 8TH AVE S
FEDERAL WAY WA
FEDERAL WAY WA
FEDERAL WAY WA
98003-5302
1 98003-5302
Mechanical Valuation..........................................1647 Over the Counter Permit ...................................... Yes
PERMIT EXPIRES December 7, 2004.
Permit issued on June 10, 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: ,/ Date: &7 _
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04 -102319 -00 -ME
Owner: Rose Johnson
Address: 31416 8TH AVE S
FEDERAL WAY, WA 98003-5302
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 G C^-) Date(,. r
ar.• of )
h .
FederalWay�rF-J''ERMIT
COMMUNITY DEVELOPMENT SERVICES
33530 FIRST WAY SOUTH • PO BOX 97b& y , I
2EDERALWS,WA98 FAX 6971kt '4 4 - 'APPLICATION
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Theollowin re %4 t orrnatioil art inco
g' is uir- q j` rnplete application urili not be
SITE ADDRESS
ASSESSOR'S TAX/PARCEL # -
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
SF MF CO (kE)�-L PL DE EN FP
[D I I
ted. Please print legibly (in inkl or tune-
SUITE/UNIT # /—
LOT SIZE (sj)
(Attach—para[e page for legthy legal d—ip6—)
PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING A MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onitl)
PROJECT NAME (Name of Business or Owner Last Name) , /Q t,4 S
PEOPLEINFORMATION
PROPERTY
NAME PRIMARY PHONE
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
Ti�wl Mase vt 4�
APPLICANT NAMES
�i�c'5e
(2s3 )Z�
-��gp.
MAILING ADDRESS
CITY, STATE, )ZIP
WO FS6v
MATLING
CITY, STATE, ZIP
CELLPHONE
COMPANY NAMEAPPLICANT
NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELLPHONE
PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
— — — — — — — B
EXPIRATION DATE
L
FAX NUMBER
cru 1993@,�tSh•Corv�
CONTRACTOR'S REGISTRATION NUMBER (copy of card required with each application(
EXPIRATION DATE
COMPANY NAME
APPLICANT NAMES
�i�c'5e
OFFICE PHONE
%T�vl s o it N rvvl,
( A3 ) 59
MATLING
CITY, STATE, ZIP
CELLPHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect X Tenant ❑ Agent
NAMEPRIMARY
PHONE
E-MAIL ADDRESS
r V/, -Q U ✓ so ,�
3 72
cru 1993@,�tSh•Corv�
Per RCW 19.27.095. Lender information is
NAME
required if project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
[ DETAILED BUILDING INFORMATION
EXISTING USE _51Aale- Ind A&. PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE VALUE OF PROPOSED WORK $ 2-0
SPRINKLERED BUILDING? ❑ YES )VNO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED? ❑ YES "-Q NO
WATER SERVICE PROVIDER -k LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER LAKEHAVEN ❑ HIGHLINE o PRIVATE (SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
SUMPS
WASHING MACHINES
URINALS
FIRST
VACUUM BREAKERS
BASIC PLAN?
o YES
SECOND
ZONING DESIGNATION
CHANGE OF USE?
THIRD
o NO
NEW ADDRESS REQUIRED? o YES o NO
UP/SEPA/SU?
FOURTH
❑ NO
PLATTED LOT? ❑ YES o NO
DEMO PERMIT REQUIRED?
ADDITIONAL FLOORS (DESCRIBE)
o NO
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS?
TOTAL EX1STDiG
TOTAL PROPOSED
TOTAL rMST7RG AND PROPOSED
—NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MEClANATCAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS
BBQS FANS
BOILERS FIREPLACE INSERTS
COMPRESSORS FURNACES
DUCTS GAS PIPE OUTLETS
BATHTUBS (-TDn/Sh.—C—ho)
SHOWERS
DISHWASHERS
SINKS
GAS PIPE OUTLETS
SUMPS
WASHING MACHINES
URINALS
LAVS(13athr—sinks)
VACUUM BREAKERS
GAS LOGS
HOODS (C—crc,aq
RANGES
GAS WATER HEATERS
WATER CLOSETS (-r.iieq
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
RELATIONSHIP TO PROJECT
0
J (Title)
Owner ❑ Agent ❑ Contractor ❑ Architect ❑
DATE
FOR OFFICE USE ONLY
o NEW o ADDITION
o ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑ YES o NO
BASIC PLAN?
o YES
o NO
ZONING DESIGNATION
CHANGE OF USE?
o YES
o NO
NEW ADDRESS REQUIRED? o YES o NO
UP/SEPA/SU?
o YES
❑ NO
PLATTED LOT? ❑ YES o NO
DEMO PERMIT REQUIRED?
o YES
o NO
Bulletin 4 100 — March 30, 2004 Page 2 of 4 k\I-landouts — Revised\Pennit Application