03-102888f t
w
City Federal Way
Community Development Services Plumbing Permit #: 03 -102888 - 00 - PL
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050
Project Name: BORGSTROM
Project Address: 31415 3RD S Parcel Number: 794300 0140
Project Description: Remove and replace electric water heater.
Owner
Applicant
Contractor
Stephen Borgstrom & Susan Borgstrom
FAST WATER HEATER COMPANY
FAST WATER HEATER COMPANY
31415 3RD PL S
12601 132ND AVE NE
12601 132ND AVE NE
FEDERAL WAY WA
KIRKLAND WA 98034
KIRKLAND WA 98034
98003-5231
(425)814-8381
Plumbing Fixtures
Q ....:
Water Heaters 1
PERMIT EXPIRES January 11, 2004.
Permit issued on July 15, 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.
Owner or agent: Ra. 0iDate:-7#b!!5—
!!5—&
A kation
11
eL
CONSTRUCTION PERMIT APPLICAMN
CITY OF C0VVUN RECEIVED BY i CAMON NUMBER:
- -
�IYDEI/ELOPijiENTDEPARTMFNT -
Federal WayJUL 10 2003- - - - -
P t i ti ON NUMBER.
**The following is required information — Piease print (in ink) or type"
018572
Blease note: Electrical, Fin: Prevention Systenu and EAgin ring permits may require a separate application,
PROPERTYINFORMATION
SITE CRESS, 31415 3 PL S, FEDERAL WAY, WA 98003 ASSESSOR'S* TAX/PARCEt #: 7943000140
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACK SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
rM OF PRC3ECT (TWs application): a OWLDING XPLUMSING 0 MECHANICAL 0 DEMOLITION
a ELECtRICAL a ENGINEERING D F=IRE PREVENTION SYSTEM
PR03ECi DESCRIPTION (Provide detailed description): Remove/Replace Electric Water Heater
PROJECT NAME: BQFQSIB M. STEPHEN
- - ---------------
PR03ECT INFORMATION
PROPERTYOWNMI MME [AA?SIME :.
BORGSTROM, STEPHEN (253)40-2628 -
.___.._T,..._____...�
MA1. nG AVORM (SrRM7 AWRIM. CM. STAn, ZIP):
31415 3 PL S FEDERAL WAY, WA 98003
NAME: FAST WATER HEATER COMPANY
{(425)$14-3124-
MAILING ADMESS (SM*T AbMS'S; , STALTE.
EWVMG PKINE:
12601 132ND AVE NE KIRKLAND, WA 98034
crrYOF amara. WAY BUSDOZ 13CEIdE NPOM
PAit
87 - 000047 00
— — — —
( 425 ) 814-951.6
rt
CONI n dN MMUR,
VO"AnO+ teen:
(cgrh arse r,tdj FASTWHC052DF
02/16/2065
MAI'JM AWRESS (SMETAISMMMY, SWM, '): VANING PHONE
MA"GO00 TO e*a, FAX NUMSM
c3 ARC H TELT o TENANT 0 OTHER( DESCRIBE):
CONTACT PERSON FOR THIS PROJECT: o PROPfATY OWNER o APPLICANT R CONTRACTOR
MrXISTH USE* EXISTING BUILDING ASSESSED/AP'PRA SEO VALUATION
PROPOS USE: PROPOSED VALUATION FOR IMPROVEMENTS: i$ $339.00
SPRINKLERED BUILDING? a YES a NO FIRE SUPPRESSION SYSTEM PROPOSEDIREQUIR ED: to YES a NO
WATER SERVICE PROVIDER: o LAAKEHiAVEN a NIG LINE a TArC014A In PRIVATE (WELL)
SEWER SERVICE PROVIDER: o LAKEHAtIEN 0 HIGHUNE a PRIVATE (SEi>TI.C)
**Nt-W RESIDENTIALCON5TRUCTION ONLY**
NUMBER OF BEDROOMS: _
_ ESTIMATED SELLING PRIG:
PROJECTFLOOR AREAS
KO -011
TI?i`Ai
EXISTING SQ. FT.
PR9–m
BASEMENT
ORt
S CORD—
THIRD
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
_..._........ _..... _ _ __.
.
.......... _......... .._._...-.--.... .
W
..
iaci MANY FttClRS7
TOTAL:.
Indicate number of each tylie of fixture
MECHANICAL
Alit HANDLING UNIT(S)
EVAPORATIVE COOLER(S)
GAS LOGS)
REFRIG. SYSTEM(S)
"Q(S)
FANS)
HOOD(S)
_ WOODSTOYE(S)
SOILER(S)
FIREPLACE INSERT(S)
RANGE(S)
MISC. 4
COM,PRESSOR(S)
FURNACE(S)
DUCT(S)
GAS PIPE OUTLET(S)
HEAT SOURCE:
a ELECTRIC 0 GAS
PLUMBING
BATHTUB(S)
LAVATORY(S)
URINAL(S)
1 WATER HEATER(S)
DISHWASHER(S)
RAIN WATER SYS.
VACUUM BREAKER(S)
ELECTRIC t -j CAS
DRINKING FOUNTAINS)SHOWER(S)
WASH MACHINE OUTLET
GAS PIPE OUTLET(S)
SINK(S)
WATER CLOSET(S)
MISC. ( _)
IINTERCEPTOR(S)
SUMP(S)
DISCLAIMER/SIGNATURE ALC'.
I am" undw penalty of perjury that the Information furnished by me Is true and torr Lt to the best of my knowledge, and
further, duit I am audwirized. by the owner of the above premises to perform the work for which the permit application is made. I
further agree to hold harmless the Cky of Federal Way as to any cialm (including casts, expo and eyes" fees incurred in the
Investigation and dense of suds claim; which may be made by any person, including the undersigrad, and flied against the City of
Federal Way, but only where such claim arises out of the reliance of the city, including Its officers and employees, upon the accuracy
of the Information supplied to the city as a part of this application.
NAME/TITLE: �'`=-�' Permit MQr MATE 07/08/2003
C OMMUN i'Y DEVaOI"ENT SUMES * 33530 FIRST WAY SOUTH * PO BOX 9716 • FEDERAL WAY, WA 96063-971$ * 253-661-4000 *FAX: 253461-4129
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