06-104167• City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: BUSH
Project Address: 30237 1ST PL S
Mechanical Permit #: 06 -104167 -00 -ME
Project Description: ALT - replacing gas water heater.
Inspection Request Line: (253) 835-3050
Parcel Number: 339180 0101
Owner
Applicant
Contractor
JAMES M BUSH
WASHINGTON CORROSION SRVC INC
WASHINGTON CORROSION SRVC INC
30237 IST PL S
1425 BLAINE AVE NE
WASHICS055KC 5/4/08
FEDERAL WAY WA
RENTON WA 98056-2774
1425 BLAINE AVE NE
98003-4037
RENTON WA 98056-2774
Additional Permit Information
Mechanical Valuation............................................1053.37 Over the Counter Permit? ...................................... Yes
I hereby'c6rtif that a above it^tformation is cor ct and that the conttru bri o the above d scribed property and
the occupancy 4nd the use vA, be in accordance wA the'` nr� tuIds and, ulat' s of the,tate of Wasliir6t6
Owner or agent:
and the City of Federal Way. G�
✓ �. ts� i Date: � (� � � � � G
THIS CARD IS TO REMAIN ON-SITE -
CITY OF Community Development Inspection Record.
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 06 -104167 -00 -ME
Owner: JAMES M BUSH
Address: 30237 1 ST PL S
FEDERAL WAY, WA 98003-4037
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 Q�
By Date By Date By Date
RECEIVED
CITY OF * AUG 17 2006 - Q b
Federal Way p
CONAI UNITY DSVELOPYBM'
OF FEDERAL WAY E RM IT SF MF CO )EL PL DE EN FP
93325d*MAVENUS WA.9•PO�U�LDING D PPLICATION
PMWAL WAY, WA 9d063-9716 .
253-835-4607• PAX 253-835.2609
www.dtuoffedemhony.com
The_followina is required information -an incomplete application udll not be accented. Please print leaibin /in ink! or tune.
SITE ADDRESS /J� 12L SUyN V 1 SUITE/UNIT i
ASSESSOR'S TAX/PARCEL tF _ - LOT SIZE (s])
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
PROJECT•- •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PR OSCRIPTION (Prduide detailed desqwtion of work included on this permit only)
PROJECT NAME (Name of Business or Owner Last Name) R U S
PEOPLE•- •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
N E� PRIM RY III{/ljPj(
o% 1
[LINO ADD � � CgV, STATE, ZIP
COMPANY NAME/�
APPLICANT NAME
/�Il i
(�2� � � �
- ��
OFFICE PHONE
G+" G1 '
&4y 1
'
WNO ADDRESS
( ) -
, STATE, ZIP
/CELL PHONE
-
��
! i+ Go✓U
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
FAX NUMBER
RELATIONSHIP TO PROJECT
FAX NUMBER
--B
B L'
o Agent
❑ Other (Describe)
CONTRACTOR'S R ISTRATION NUMBER (copy of
cord required with "Ch application)
L
EXPIRATION DATE
K /0 Q,
_
A)q
MPANY NAMEAPPLICANT
NAME
OFFICE PHONE
G+" G1 '
&4y 1
'
( ) -
MAILINO ADDRESS
CITY, STATE, ZIP
CELL PHONE'
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect O:Tenant
o Agent
❑ Other (Describe)
EXISTING USE PROPOSED USE '' \\ ?
EXISTING ASSESSED/APPRAISED VALUE $$ VALUE OF PROPOSED WORK I$_ U `�^ J ,
SPRUMERED BUILDING? d YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE 0 PRIVATE (SEPTIC)
AREA DESCRIPTION
EXISTING PROPOSED TOTAL
SQ. FT. SQ. FT. SQ. FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS (DESCRIBE)
DECK (COVERED?)
GARAGE ❑ CARPORT ❑
saserao norwso TorN
NUMBER OF FLOORS
"NEW HOMES ONLY*" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number
Value of Mechanical
AIR HANDLING 1
BBQS
BOILERS
COMPRESSORS
DUCTS
,;
BATHTUBS (.Tnh/5home1--"
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINES
LAVS Ma.. swat
to be installed or relocated as part
not
EVAPORATIVE COOLERS GAS LOGS
FANS HOODS (commeret�q
FIREPLACE INSERTS RANGES
FURNACES GAS WATER HEATERS
OAS PIPE OUTLETS
SHOWERS
SINKS _
SUMPS _
URINALS _
VACUUM BREAKERS
existing f udures to remain.
REFRIG. SYSTEMS
WOODSTOVES
MISC (Deacribe)
WATER CLOSETS (r o q MISC (Describe)
DRINKING FOUNTAINS
RAINWATER SYST
HOSE BIBBS
ELECTRIC WATER HEATERS
I cert(fy under penalty of perjury that the injbrmation furnished by me is true and correct to the best of my knowledge, and further, that I
am authorised 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 lincluding costs, expenses, and attorneys' fees incurred in the investigation and defense of
such clalm/, 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 relianceojt city, including its officers and employees, upon the accuracy of the Wormation supplied to the city as a part of
this application.
NAME/TITLE / DATE Cj i
.(Sign re) (Title)
RELATIONSHIP TO PROJECT 0 Owner O Agent O Contractor D Architect I7 Other
Rnlletin #I iN1 _ TnnnAry i 2006 Pa¢e 2 of 4 Mandouts\Pennit ADDlication