02-100441City of Federal Way
Applicant
Community Development Services
Wayne W Rockwell
33530 1st Way S
ACTION WATER HEATERS ONLY INC
Federa; Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
/
12704 NE 124TH ST SUITE 43
FEDERAL WAY WA
Project Name:
Project Address:
Project Description:
ROCKWELL
1 f
Plumbing Permit #:02 - 100441 - 00 - PL
Inspection request line: 253.835.3050
31402 28T'H/,SW Parcel Number: 150330 0200 klee&
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Owner
Applicant
Contractor
Wayne W Rockwell
ACTION WATER HEATERS ONLY INC
ACTION WATER HEATERS ONLY INC
31402 28TH PL SW
12704 NE 124TH ST SUITE 43
12704 NE 124TH ST SUITE 43
FEDERAL WAY WA
KIRKLAND WA 98034
KIRKLAND WA 98034
98023-7837
(425)820-8848
Plumbing Fixtures
Descriptlon . - Quanti , ;; Descriptionw W,W Qiantt m k7Descri tion Quantit
Water Heaters 1
PERMIT EXPIRES July 29, 2002, IF NO WORK IS STARTED.
Permit issued on January 30, 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 Citv of Federal Way.
Owner or agent:
Date: Q V
W.or G y CONSTRUCTION PERMIT APPLICATION
• QQ
VV iR�PLIGATION NUMBER: - _ -
PPLICATION NUMBER: - 00
APPLICATION NUMBER: - -
**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.
SITE ADDRESS: / 1 407— ec 50
ASSESSOR'S TAX/PARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): 15 O ! 1 d C' 26 O , e
TRNIFCT TNFARMATTC
TYPE OF PROJECT (This application): ❑ BUILDING PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
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PROJECT DESCRIPTION (Provide detailed description): � c� e V v?
PROJECT NAME:
•I I 1 •4 F•
PROPERTY OWNER: NAM P DAYTIME PHONE:
ai
(L 7 )
MAILING ADDRESS EET ADDRESS; CTT -Y, STATE, ZIP):
L4 0 Z 1 S 60 f2
CONTRACTOR:
APPLICANT:
N ME:
DAYTIME
`PHONE: -7
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MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
2 ;� o A uc k 2 TI--, S 31-1 x. rY V -k �} 0
EVENING PHONE:
( ) Wn-
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CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
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_ _ — _ _ _ _ _ _ — _ _
( (1 �) (i,?U
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CONTRACTOR'S REGISTRATION NUMBER:
_
L. �J lJ C1
EXPIRATION DATE:
/ ,) /
TT
(copy of card required)_
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NAME: DAYTIME PHONE:
( ) I
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
RELATIONSHIP TO PROJECT: i FAX NUMBER:
❑ ARCHITECT ❑ TENANT OTHER ( DESCRIBE): CO -VL -
E -MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT .--O -CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ _
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: It
SPRINKLERED BUILDING? ❑ YES ❑ NO
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
❑ NO
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
BUILDING SHELL ONLY? [DYES ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
FIRST
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO
CHANGE OF USE? ❑ YES ❑ NO
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING UNIT(S)
BBQ(S)
BOILERS)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEMS)
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACE INSERTS) RANGE(S) MISC. ( )
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
LAVATORY(S) URINAL(S) WATER HEATER(S)
RAIN WATER SYS. VACUUM BREAKER(S) ELECTRIC ❑ GAS
SHOWER(S) WASH MACHINE OUTLET
SINKS) WATER CLOSET(S) MISC. ( )
SUMP(S)
'ITSCI_ATMPPIRTGNATURE RLC
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 informatio sup lie to the city as a part of this application. ��``
g../1:�� DATE: / V'
NAM E/TITLE: I-
❑ PROPERTY OWNER ❑ APPLICANT NTRACTOR
We] X&I94Cal *I'Yxirk, IA A
❑ NEW ❑ ADDITION ❑ ALTERATION
❑ REPAIR ❑ TENANTIMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
BUILDING SHELL ONLY? [DYES ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO
CHANGE OF USE? ❑ YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • P.O. BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 253-661-4129