06-100071City of Federal Way
Community Development Services Mechanical Permit #• 06 -100071 -00 -ME
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (253) 835-3050
Project Name: NULL
Project Address: 31415 11TH PL SW
Project Description: Gas water heater replacement
Parcel Number: 556050 0210
Owner
Applicant
Contractor
WILLIAM D NULL
LINDA THORNQUIST
WASHINGTON ENERGY SERVICES CO
CHARLEEN M NULL
PERMIT GROUP, THE
WASHIES9710B (9/2/06)
31415 11TH PL SW
PO BOX 2034
2800 THORNDYKE AVE W
FEDERAL WAY WA
KIRKLAND WA 98083
SEATTLE WA 98199
98023-4543
Additional Permit Information
Mechanical Valuation............................................650 Over the Counter Permit? ...................................... Yes
Plumbing Fixtures
Water leas ................................ 1
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 ccordance with the laws, rules and regulations of the State of Washington
nd the Ci of Federal Way.
Owner or agent: Date: fholc'�e-
V
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record'
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 06 -100071 -00 -ME
Owner: WILLIAM D NULL
Address: 31415 11 TH PL SW
FEDERAL WAY, WA 98023-4543
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD.
Inspections are listed as close to sequential order as possible (read left to right, top to bottom). Please schedule inspections as appropriate. Work must not
be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections
are logged on the back of this card.
❑ Mechanical Rough -in (4165) ❑ Gas Piping (4125) ❑ Final - Mechanical (4065)
Approved Approved to release test Approved
By Date By Date By Date /
PPr-
JAN-6-2006 11:18 FROM"PI°fIT'v_U 4257756315
�411�„� . JAN 0 6 2006
Federal Way �'ERMIT
CDMMUNl7YDEVEWPMEMSERVJc(;� �TY OF FEDERAL W
1 JJJ258- AVENUE SOUM-PO, BOX 971a BUILDING DFEDP
?SJ-d�WAY. WA 607 PAX 25J 5-2609 ' PLICATION
ynuueolvo/fcderofway. oom
The following is required information - an incomplete application will not be
SITE ADDRESS �1 l 7-k
ASSESSOR'S TAX/PARCEL # 4 & 15
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
TO:12538352609
P.2
0
OFFICE PHONE
?— - ��
Sr, MF C. ME
EL PL DE EN FP
CELL PHONE
CITY OF FEDERAL WAY BUSINESS ICE NUMBER EXPIRATION DATE
Zo-0 3- l'Z3 / /
:,pied.. Please print legibly (in ink) or tuve.
SUITE/UNIT #
LOT SIZE (sn 1—
(An-* rryarataOope/w k9W d—W6.4
'• M •
TYPE OF PERMIT O BUILDING O PLUMBING W MECHANICAL
❑ DEMOLITION O ELECTRICAL O ENGINEERING O FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this Permit onlyl
PROJECT NAME (Name of Business or Owner Last Name) IV U / l
PEOPLEt •- •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
NT5u f l A ( PRIMARY PHONE
7,4? ?-
N ,� /�f(v / ` \C
MAI IN O ADDRESS CITY STATfi, ZIP
t JITI'' ofCcs �e O w / wt
COVCANY
NAMEAPPLICANT
92W
NAME
1
OFFICE PHONE
?— - ��
�M%ILL1LNG ADDR S
L4 Ac-
CITY, STATE 1P - /�.1�'
CELL PHONE
CITY OF FEDERAL WAY BUSINESS ICE NUMBER EXPIRATION DATE
Zo-0 3- l'Z3 / /
FAX NUMBER
-
CPNT�RACTORS�REEG( t�NU BER (coP7 of d regalred with each appLcatloul ` EXPIRATION DATE
ANY NA
NAME
A LICANT A
rO CEEPHONE
CITY, STATE, ZIP
t
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�T[
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omy
-
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect O Tenant O Agent O Other (Des- be)
( -
CONTACT NAM PRIIAARY PHONE E-MAILADDRESS
r&y t,(k (M 7T
ENDER , a
P rRCWf`192�OJ�`#LenderirSjormaHonii+
NAME
HairePd �(roJecu Da(ue �caeds +5 000'
MAILING ADDRESS
CITY, STATE, ZIP
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED W RK $
SPRINKLERED BUILDING? O YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ UIRED? O NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ SIGHLINE O TACOMA O PRIVATE (WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE (SEPTIC)
FOURTH
ADDITIONAL FLOORS (DESCRIBE)
DECK (COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS?
,.NFw NnMES ONLY•` NUMBER OF
TOTAL pD5T0G
TED
PROPOSLD
TOTAL LRSTMG AXD
as part of this project. Do not include existing fixtures to remain
Indicate number of each type of fixture to
be installed or relocated
o NEW o ADDITION
o ALTERATION
o REPAIR
BUILDING SHELL ONLY?
MECHANICAL
BAS
ZONING DESIGNATION
Value of Mechanical Work $ t
NEW ADDRESS REQUIRED? o YES o NO
UP/
PLATTED LOT? o YES o NO
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS LOGS
REFRIG. SYSTEMS
WOODSTOVES
BBQS
FANS
HOODS ico�<ray)
RAN GES
MISC (Describe)
BOILERS
FIREPLACE INSERTS
Z GAS WATER HEATERS
COMPRESSORS
FURNACES
DUCTS
GAS PIPE OUTLETS
pLUMBING
SHOWERS
WATER CLOSETS Roneq
MISC (Describe)
BATHTUBS (orTub/Sh—Combo)
DRINKING FOUNTAINS
DISHWASHERS
D
SINKS
RAINWATER SYST
GAS PIPE OUTLETS
SUMPS
HOSE BIBBS
WASHING MACHINES
URINALS
ELECTRIC WATER HEATERS
LAVS saD,room sintcs
VACUUM BREAKERS
d correct to the best of my knowledge, and further, that I
I certify under penalty of perjury that the inrormation furnished by me is true an
am authorized by the owner of the above premises to perform the work for which the perntieteapncurartied insthe investigation andrdefertseoof
harmless the City of Federai Way as to any claim (including costs, expenses, and attorney f
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 information supplied to the city as apart of
this application. /
DATE
NAME/TITLE (Titicl
(Signatures �, 7Aent
RELATIONSHIP TO PROJECT d Owner o Contractor b.Architect ❑Other
FOR OFFICE USE ONLY
oTENANTIMPROVEMENT
IC PLAN? o YES o NO
o NEW o ADDITION
o ALTERATION
o REPAIR
BUILDING SHELL ONLY?
o YES o NO .'
BAS
ZONING DESIGNATION
CRA
NEW ADDRESS REQUIRED? o YES o NO
UP/
PLATTED LOT? o YES o NO
DEM
Bulletin # 100 — March 30, 2004 — Page 2 of 4
k\Handouts — Revised\Permit Application
GE OF USE> a YES
-. a NO
SEPA/SU?. o YES
ONO
O PERMIT REQUIRED? o YES
o NO
Bulletin # 100 — March 30, 2004 — Page 2 of 4
k\Handouts — Revised\Permit Application