03-100113r
City of Federal Way
Cunununity Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Mechanical Permit #:03 - 100113 - 00 - ME
Inspection request line: 253.835.3050
Project Name: ROBERSON �J'/
Project Address: 32350 10TH19 Parcel Number: 150240 0315
Project Description: Gas hot water heater changeout in existing residence.
Owner
Applicant
Contractor
William G & Renae K Roberson
FAST WATER HEATER COMPANY
FAST WATER HEATER COMPANY
32350 10TH AVE S
12601 132ND AVE NE
12601 132ND AVE NE
FEDERAL WAY WA 98003-5925
KIRKLAND WA 98034
KIRKLAND WA 98034
(425) 814-8381
Mechanical Valuation..........................................449 Over the Counter Permit ...................................... Yes
PERMIT EXPIRES July 8, 2003, IF NO WORK IS STARTED.
Permit issued on January 9, 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. Application on
Q
Owner or agent: See AppllDate: �� (✓
eG
I
RECEUED BY
aM�ur - COMMUNITY i�,� (" ,;=NiT Drn.
TION
JAN 0 9)(i0:APPLICATION ------- -----
-The following is required information - Please print (in ink) or type•• 017219
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY .
MATION
SITE ADDRESS: 32350 10 AVE S, FEDERAL WAY, WA 98003
ASSESSOR'S TWPARCEL #: 1502400315
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ® MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
Remove/Replace Gas Water Heater
PROJ ECT NAME: ROBERSON, RENAE
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
■ PEOPLE INFORMATION
NAME: DAYTIME PHONE:
ROBERSON,RENAE
(253)946-4646
MAILING ADDRESS (STREET ADDRESS, CITY, STATE, IIP):
32350 10 AVE S FEDERAL WAY, WA 98003
NAME:
DAYTIME PHONE:
FAST WATER HEATER COMPANY
(425)814-3124
MAILING ADDRESS (STREET ADDRESS, CITY, STATE. IIP):
EVENING PHONE:
12601 132ND AVE NE
KIRKLAND WA 98034
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
19-87000047-00-bl
425 814-9516
OONTRACTORS REGISTRATION NUMBER:
EXPIRATION DATE:
(copy of card required) FASTVMC052DF
02/16/2003
NAME:
DAYTIME PHONE:
I MAILING ADDRESS (STREET ADDRESS, CITY, STATE, IIP): I EVENING PHONE:
j<Street> <City> <Zin>
C) ARCHITECT
RELATIONSHIP OTENANT ❑OTHER (DESCRIBE): I FAX NUMBER: I
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT M CONTRACTOR#
INFORMATION0 DETAILED BUILDING
EXISTING USE: EXISTING BUILDING ASSESSEDIAPPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ $449.00
SPRINKLED BUILDING? ❑ YES I> NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑HIGHLINE ❑TACOMA El PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑HIGHLINE ❑ PRIVATE (SEPTIC)
Wa 716
*NEW RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS'
ESTIMATED SELLING PRICE: $
❑ NEW ❑ ADDITION
❑ ALTERATION ❑ REPAIR
FLOOR AREAS
CENSUS CODE:
LOT SIZE:
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES
BASEMENT
SECrM TOWNSHIP RANGE
NEWADDRESSREQUIRED?
YES ❑ NO ❑
PLATTED LOT? ❑ YES ❑ NO
I CHANGE OF USE? ❑ YES
QINO
0
FIRST
0
SECOND
0
THIRD
0
FOURTH
0
OTHER FLOORS (DESCRIBE)
0
DECK
0
ARA E
HOW MANY FLOORS?
0
TOTAL:
0 0
0 -771
FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S)
EVAPORATIVE COOLERS) GAS LOG(S)
REFRIG. SYSTEM(S)
BBQ(S)
FAN(S) HOODS)
WOODSTOVE(S)
BOILERS)
FIREPLACE INSERT(S) RANGE(S)
MISC. ( )
COMPRESSOR(S)
FURNACE(S)
DUCT(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑
ELECTRIC ❑ G AS
PLUMBING
BATHTUB(S) LAVATORY(S) URINALS) 1 WATER HEATER(S)
DISHWASHERS) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC t] GAS
DRINKING FOUNTAINS; SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) WATER CLOSET(S) MISC.
INTERCEPTORS) SUMP(S)
DISCLAIMER/
I certify under penalty of perjury that the information furnished by me Is true and correct to the best of my knowledge,and
'urther, that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I
�urther agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fee incurred in the
nvestigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the City of
ederal Way, but only where such claim arises out of the reliance of the city, Including Its officers and employees, upon the accuracy
)f the Information suoolled to the citv as a nart of this application.
NAME/TITLE.''') '' Permit Mgr DATE: 01/07/2003
❑ PROPERLY OWNER ❑ APPLICANT ZI CONTRACTOR
FOR OFFICE USE ONLY:
,
❑ NEW ❑ ADDITION
❑ ALTERATION ❑ REPAIR
❑ TENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
BUILDING SHELLONLY?
❑ YES ❑ ISD
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES
ONO
SECrM TOWNSHIP RANGE
NEWADDRESSREQUIRED?
YES ❑ NO ❑
PLATTED LOT? ❑ YES ❑ NO
I CHANGE OF USE? ❑ YES
QINO