02-101754City of Federal Way a
Community Development Services
33530 Ist Way S )J�l
Federal Way, WA 98003-6210
Pb: 253.661.4000 Fax: 253.661.4129 ^
J
Project Name: LOPEZ P i
Project Address: 34617 4TH S
Project Description: PLUM - Replace electric water heater
Plumbing Permit #:02 - 101754 - 00 - PL
Inspection request line: 253.835.3050
Parcel Number: 276230 0110
Owner
Applicant
Contractor
RUTH LOPEZ
ACTION WATER HEATERS ONLY INC
ACTION WATER HEATERS ONLY INC
34617 4TH PL S
12704 NE 124TH ST SUITE 43
12704 NE 124TH ST SUITE 43
FEDERAL WAY WA 98003
KIRKLAND WA 98034
KIRKLAND WA 98034
(425)820-8848
Plumbing Fixtures
I?escrlptio �;, ,;,
Water Heaters 1
PERMIT EXPIRES October 23, 2002, IF NO WORK IS STARTED.
Permit issued on April 26, 2002
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:��/_ L����� Date: 4
�� � LNrrYRECEIVED DEVELOPMENT � CONSTRUCTION PERMIT APPLICATION
�D PARTMENT
uV �y APPLICATION NUMBER:
APR 2 5 2002 APPLICATION NUMBER: _ -
APPLICATION NUMBE , �MUn DEV pP - -
**The roTlli htj is requirggq. information — Please print (in ink) or type** APR 15 2002
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
SITE ADDRESS: :?-A(0 11 —1 `�: P L. S,- ASSESSOR'S TAX/PARCEL #: z
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): l
TYPE OF PROJECT (This application): ❑ BUILDING XPLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): -
PROJECT NAME:
PROPERTY OWNER: NAME-
Lo e�Z
MAIUNG ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
3-L
CONTRACTOR: NAME:
MAIUNG ADDRESS (STREET ADDRESS;. CITY, STA E, ZIP):
QTY OF FEDERAL WAY BUSINESS LICENSE NUMBER: _
APPLICANT:
CONTRACTORS REGISTRATION NUMBER. / (1'-
(COPY Of Card required) • 7' ` l 1 aC-() !
NAME:
A -S �o vc'
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
KtUk11UNSHIP TO PROJECT:
❑ ARCHITECT ❑ TEkANT +OTHER ( DESCRIBE)-
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT
EXISTING USE:
PROPOSED USE:
SPRINKLERED BUILDING?
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
TIME PHONE:
4J
EVENING PHONE:
(
FAX NUMBER:
EXPIRATION DATE:
J / /7/ 621
ff.A0 -%shy
EVENING PHONE:
I FAX NUMBER:
E-MAIL ADDRESS:
CONTRACTOR
EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED VALUATION FOR IMPROVEMENTS LJ/
❑ YES El No FIRE SUPPRESSION SYSTEM PROPOSE ED: ❑ YES ❑
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN ❑ HIGHLINE Q PRIVATE (SEPTIC)�r /
l
-," **NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS:
ti
ESTIMATED SELLING PRICE: $
■ PR03ECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILERS) FIREPLACE INSERTS) RANGE(S) MISC. ( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAINWATER SYS. VACUUM BREAKER(S) ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC. ( )
INTERCEPTORS) SUMP(S)
%TCCI ATMFRICTnNATIIRF RIC,
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 informa 'n supplied to the city as a part of this application. I
NAME/TITLE: DATE: �� l
❑ PROPERTY OWNER ❑ APPLICANT INONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 2S3-661-4000 - FAX: 253.661-4129
www.(itvoffederalway.com