02-105633w
I
Applicant
City of Federal Way
Community Development Services
Rachelle L Coe
Plumbing Permit #:02 - 105633 - 00 - PL
33530 1 st Way S
1003 S 308TH ST UNIT 19
10310 AURORA AVE N
Federal Way, WA 98003-6210
FEDERAL WAY WA 98003-4753
SEATTLE WA 98133
Ph: 253.661.4000 Fax: 253.661.4129
Inspection request line: 253.835.3050
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Project Name: COE
Project Address: 1003 S 308TH Unit19 Parcel Number: 259590 0190
Project Description: Replace electric hot water heater in condominium unit.
Owner
Applicant
Contractor
Rachelle L Coe
QPM INC.
QPM INC.
1003 S 308TH ST UNIT 19
10310 AURORA AVE N
10310 AURORA AVE N
FEDERAL WAY WA 98003-4753
SEATTLE WA 98133
SEATTLE WA 98133
(206) 545-7837
Plumbing Fixtures
Water Heaters — 1
PERMIT EXPIRES June 16, 2003, IF NO WORK IS STARTED.
Permit issued on December 18, 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: Date:
RECEIVED
CONSTRUCTION PERMIT APPLICATION
VV w � DEC 1 8 2002 PPLicAnoN NUMBER: - ! �' �,_� _ �'C, l
CITY OF F PPLICATION NUMBER: - _ _ _ _ _ _ - _ _
BUILDING WAY APPLICATION NUMBER: - -
DEPT, -- ------
"The following is required information - Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY• •
50,
_
NVIM 41 3O J 9 ASSESSOR'S TAX/PARCEL #:�� o- G CL U
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROJECT• •
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TYPE OF PROJECT (This application): ❑ BUILDING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
O-AEZr
JECT DESCRIPTION (Provide detailed description): /? k ,, _C) ld d L� der
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NAME: (20P— /&6;; e"c
OWNER:
NAME: DAYTIME PHONE:
RaCft/le Cam G25-3) 74b -70758
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
/00 3 i32k?%' 5
,64
NAME:
DAYTIME PHONE:
(.51(tL ) 5Z75- - 763 7 -
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
DAYTIME PHONE
z
(,Rte ) 54-Z- - I 3
RELATIONSHIP TO PROJECT:
❑ ARCHITECT ❑ TENANT CR OTHER ( DESCRIBE):
(,;bc)sys-7�3�
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
E-MAIL ADDRESS:
�/33
EVENING PHONE:
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(0?0(-)S4rs - -t,53 T -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
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FAX NUMBER:
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CONTRACTORS REGISTRATIO UMBER:
EXPIRATION DATE:
(copy d mm required) i'h J LV
NAME:
�D q r o, "c,,7
DAYTIME PHONE:
(.51(tL ) 5Z75- - 763 7 -
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
EVENING PHONE:
y t .,I ?*4>
(,Rte ) 54-Z- - I 3
RELATIONSHIP TO PROJECT:
❑ ARCHITECT ❑ TENANT CR OTHER ( DESCRIBE):
FAX NUMBER:
(a 6c- ) SVC- - 72sz
E-MAIL ADDRESS:
'ACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN 11 HIGHLINE 11 PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PR03ECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
AIR HANDLING UNIT(S)
FIRST
GAS LOG(S)
REFRIG. SYSTEM(S)
BBQ(S)
SECOND
HOOD(S)
WOODSTOVE(S)
BOILERS)
THIRD
RANGE(S)
MISC. (, )
COMPRESSOR(S)
FOURTH
DUCT(S)
OTHER FLOORS (DESCRIBE)
HEAT SOURCE: ❑ ELECTRIC
❑ GAS
DECK
BATHTUB(S)
GARAGE
HOW MANY FLOORS?
URINAL(S)
�S)
DISHWASHER(S)
TOTAL:
VACUUM BREAKER(S)
❑ GAS
DRINKING FOUNTAIN(S)
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and
ther, that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I
-ther agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attomeys' fees incurred in the
restigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the City of
decal Way, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy
the information supplied to the city as a part of this application.
ME/TITLE: �C�, DATE: E 7
PROPERTY OWNER ❑ APPLICANT 97CONTRACTOR
aDMMUNTTY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 980639718 • 253-661-4000 • FAX: 253-661-4129
www.ctvofrederalway.com
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)
�S)
DISHWASHER(S)
RAIN WATER SYS.
VACUUM BREAKER(S)
❑ GAS
DRINKING FOUNTAIN(S)
SHOWER(S)
WASH MACHINE OUTLET
GAS PIPE OUTLET(S)
SINK(S)
WATER CLOSET(S)
MISC. ( )
INTERCEPTORS)
SUMP(S)
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and
ther, that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I
-ther agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attomeys' fees incurred in the
restigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the City of
decal Way, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy
the information supplied to the city as a part of this application.
ME/TITLE: �C�, DATE: E 7
PROPERTY OWNER ❑ APPLICANT 97CONTRACTOR
aDMMUNTTY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 980639718 • 253-661-4000 • FAX: 253-661-4129
www.ctvofrederalway.com