03-105194City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
(A to
Plumbing Permit #:03 -105194 - 00 - PL
Project Name: LIFE CARE CENTER OF FEDERAL WAY
Project Address: 1045 S 308TH
Project Description: Remove/replace ELECTRIC water heater
Inspection request line: 253.835.3050
Parcel Number: 082104 9042
Owner
Applicant
Contractor
FEDERAL WY CONVALESCENT C
FAST WATER HEATER COMPANY
FAST WATER HEATER COMPANY
PO Box 723548
12601 132ND AVE NE
12601 132ND AVE NE
KIRKLAND WA 98034
KIRKLAND WA 98034
PO Box 723548 !Atlanta, GA 31139-0548
\
(425) 814-8381
Plumbing Fixtures
Description Quanti Description Quantity I Description Quantity
Water Heaters 1
PERMIT EXPIRES May 18, 2004.
Permit issued on November 20, 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 accordancewith the laws, rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: See " r licati
` 'tj�nj
on Date:
Plumbing rough -in:
Water line:
FINAL PLUMBING: CJ
Date
Date
Date
CITY OF REED By AIRIVENT
Mt7Y T)FVEMPhAENT IDF-P
Fwe- d e ra I wIN
alt I
Nov 2 0 2003
AilAPPUI�X N--NUM'BER'
**The following Is required Information - Please pint (in ink) at type" 019393
please note.* Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
i E PROPERTY INFORMATION
SITE ADDRESS: 1045 S 308 ST, FEDERAL WAY, WA 98003 ASSESSORS, TAX/PARCEL #: 0821049042
LEGAL DESCRIPTION OF SUB3ECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY).
I N PROJECT INFORMATION
TYPE OF PROJECT (TWs application): a BUILDING XPLUMSING 0 MECHANICAL a DEMOLITION
a ELECTRICAL 0 ENGINEERWO is FIRE PREVENTION SYSTEM!
PR03ECT DESCRIPTION (Provide detailed description)- Remove/Replace Electric Water Heater
PROJECT NAME: LIEE CAEL CENIER OF FED WAY
PR03ECT INFORMATION
PROPERTY OWNM- Kw- DAYRME WHOW, -------
LIFE CARE CENTER OF FED WAY ((25 )9
3 A6-2273
PWUNG (STREU ADMX%; CM. STAIL ZIP):
1045 S 308 ST FEDERAL WAY, WA 98003
APPLICANT:
MM FAST WATER HEATER COMPANY
Wnme P*�
((425)414-3124-
(STW-Cr AnIMM QTV, STAn. ZIP),-
EVEFMG PHOW;
12601 132ND AVE NE KIRKLAND, WA 98034
aty (w mom WAY most Lilik topem, -
. Mx Mhow.,
87 - 000047 00
(425 ) 814-951.6
CONTRAM" AEGMTRAT'IM
WWI" PAM
(,W" of card eV i) FASTWHC052DF
02/16/2065
Dkenw PN o"E:
MAULING ADDRESS (STREET ADCAM CUT, STAIX, UO):
EVE - N1 I NG P"Oftf-,
RRA,nonw TO "Aa.
FAY "MR -
a ARCH11TECt o TENANT 0 OTHER DESCRIBE):_
E -PAIL AD9R1155c
THIS PR03ECT, u PROPERTY OWNER o APPLICANT' CONTRACTOR
PIRMECT TISIMPMATTr
EKISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION ........................
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS; $339.00
SPRINKLERED BUILDING? 13 YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/MUIRED- a YES a NO
WATER SERVICE PROWDER., o LAKEHAVEN n HIGHLINE (3 TAC0141 a PRIVATE (WELL)
SEWER SERVICE PROVIDER: c3AKEHAVEN o HIGHLINE a PRIVATE (SEPTIC)
4 /1
t4tc�
k�/03
Indicate number of each type: of fixtures
MECHANICAL
AIR HANDLING UNITS) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG, SYSTFM(S)
... BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
80rLER(S) FIREPLACE MERT(S) RANGE(S) MESE. ( y
COMPRESSOR(S) FURRACE(S)
DUCT(S) GAS PIPE OUTLET(S) NEAT SOURCE: ra EtECTRIC :r GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) 1 WATER HEATER(S)
DISHWASHER(S) RAINWATER SYS. VACUUM BREAKER(S) ELECTRIC r::x OAS
DRINKING FC NTAIN(S) SHOWERS) _ _. WASH MACHINE OUTLET
GABS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) misc. ( }
INTERCEPTOR(S) SUMP(S)
WSCLAIMER/SIGNATURE RLC
I certify r< penafty of poury, ttunt the Information furnished by me is true and Correct to the best of my knowledge, and
further, that I am authorized by tiro awrw of the above premises to perform the work for which the permit application is tirade. I
further agree to hotel harmless the CR.y of Federal Way as to any dairn (including casts, expense*, and attorneys' fees Incurred in the
Investigation and defense of. daim), which may be made by any person, including the underrslgaa4 and filed against the City of
Fedoras Wary, but onty where such claim arises out of tine reliance of the city, induding its officers and employees, upon the accuracy
of the information supplied to the city as a part of this action.
NAME/TITLE: ' =- Pernut Mpr
DATE: 11/19/2003
GCiB mumrry Qr YI�Y.rJPf+n3 w SERVm • 33M FIRST WAY SWM + PO WA 9718 • FeDMXL WAY, WA 9W34718 • ZSI-01-40W • FAX 253.661 re1 t4