05-100339 •
City of Fedora!Way Mechanical Permit #: 05 - 100339 - 00 - ME
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
4
Project Name: KAUER
Project Address: 122 S 296TH P1 Parcel Number: 718300 0030
Project Description: Gas to gas water heater changeout
Owner Applicant Contractor
Sheila R Kauer WASHINGTON ENERGY SERVICES CO WASHINGTON ENERGY SERVICES CO
122 S 296TH PL 2800 THORNDYKE AVE W 2800 THORNDYKE AVE W
FEDERAL WAY WA SEATTLE WA 98199 SEATTLE WA 98199
98003-3626 (206)282-4700
Mechanical Valuation 600 Over the Counter Permit... Yes
PERMIT EXPIRES July 25,2005.
Permit issued on January 26,2005
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:
• THIS CARD IS TO REMAIN ON-SITS'
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-100339-00-ME
Owner: SHEILA R KAUER
Address: 122 S 296TH PL
FEDERAL WAY, WA 98003-3626
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.
0 Mechanical Rough-in (4165) 0 Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved /�
By Date By Date By `C, Date 9jZo/ar
JAN-26-2005 09:41 FROM: TO:12538352609 4P.7
y
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.. O S - 1 U 0 :- =3 q .
Federal Way PERMIT SF MF C•0 EL PL DE EN FP
WMMJMTY DEVELOPMENT SERVICES
J3715 D AMAX An/•PO 971 "" APP LI CATI 0 N — :d
FEDERAL WAY,WA 5343S.26O / /
451.235.2607•FAX 2534354609
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The olio • is re• fired information-an Inco •Tete a••Motion will not be acce•ted. Please •rint le•Wbi in ink)or
Q • PROPERTY INFORMATION
_
SITE ADDRESS 1 ZZ S 2 ` & p SUITE/UNIT I
ASSESSOR'S TAX/PARCEL 1 1 C - V �J LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
PAM,.a6wwtrpaorfv knorhyIgaIlescsImic)
• _• ■ PROJECT INFORMATION
TYPE OF PERMIT CI BUILDING 0 PLUMBING MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on"this
�permit only) a
cittli 1-b 94J tria2i-er-it
efiah
PROJECT NAME(Name of Business or Owner Last Name) k,CL)-P--r-
„
.. • • ili PEOPLE INFORMATION
PROPERTY NAM�i.��� /� PRIMARY PHONE
OWNERJ` rl/ `- U6- �J / 0 5-J ) qC -- arettbfr
!
MAILING L2ADDRESS
J 241 ' 41 p1 T•.E.IIE. GL-i• ever. c7 W L ��Q�..
CONTRACTOR COMPANYNAME APPUCAN NAME ` OFFICE PHONE .
0 �1't k (/ rl G�4_ (204)2)2 -117a0
MAILINO ADDRC STATE (LL PHONE
ea -f/ �� cu` -
CITY OF FEDERAL WAY BUSINESS UCEN N �AB R EXPIRATION DATE FAX NUMBER
2C)- 07-ldc127 L
-B L / / ( ) -
. TO AE I l of ayR tesaIre6 wItL u
asci,appLtloa) XPIRATION DATE
JJ JC a 7// / Z /Or
APPLICANT COMPANY NAMEAPP CANT NAME OFFICE PHONE
L-i vi.ck _ APP
7'7 0 3 2S-, ( 1 -
MAIUNO ADDRESS CI STATE,ZIP CELL PHONE
( ) - -
RELATIONSHIP TO PROJECT • FAX NUMBER
O Architect 0 Tenant Agent O Other(Describe) ( ) -
CONTACT NAME V 1- a- PaINJVILEBONE - (epi EMAIL ADDRESS
LENDER so.`r.ij •aW, '.2 p, ;G'iyi i fo.ntatlo` is �' NAME
• ,re: l p.t «,`f :`..°, `,:.
.w $5,9¢sor s_
MAILING ADDRESS CITY,STATE.ZIP
• - ■ DETAILED BUILDING INFORMATION •
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUII,DING? O YES O NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES t] NO
. WATER SERVICE PROVIDER O LAKEHAVEN 0 BIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER O LAKEHAVEN a HIGHLINE O PRIVATE(SEPTIC)
JAN-26-2005 09:41 FROM: TO:12538352609 P.
. PROJECT FLOOR AREAS __
•
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
-
FiRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
TOTAL R
E(5O TOTAL PROPOSED TOTAL DOL(
STO MD PROPOSED
HOW MANY FLOORS?
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECFUMCAL
Value of Mechanical Work $ I
•
EVAPORATIVE COOLERS GAS SAGS REFRIG.SYSTEMS
NR HANDUNO UNITS HOODS(C.omeRiatl WOODSTOVES
BBQS FANS MISC(Describe)
BOILERS FIREPLACE INSERTS , RANGES
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS OAS PIPE OUTLETS
BATHTUBS
PLUMBING WATER CLOSETS Iraq MISC(Describe)
I.ETusiss. rc..b.I SHOWERS
DISHWASHERS SINKS GAS PIPE OUTLETS
DRINKING FOUNTAINS
SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
VACUUM BREAKERS ELECTRIC WATER HEATERS
•
- jt. 7...c..--_ -- _ _ .. - "'DISCLAIMER/SIGNATURBBLOCK -. - . - -- . ` _ _-- - -
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 the filedaagrya'st the ojtCity
e ormdNon FederalW ay,
but
only
lh wher as re asuch
pclaim
of
arises out of the reliance of the city,including its officers and employees,upon
this appllcaHon. /� fr
DATE
NAME/TITLE (Tide)
(Sianaturcl
RELATIONSHIP TO PROJECT 0 Owner O gent 0 Contractor 0 Architect O Other
FOR9pr c.EAYSE QMAT. k
a NEW a ADDITION o ALTERATION a REPAIR tS TENANT IMPROVEMENT
o YES a NO
BUILDINGBUILDINGSHELL ONLY? o YES o NO BASIC PLAN? ,S D NO
ZONING DESIGNATION CHANGE OF USE? . D
YE_NEW ADDRESS REQUIRED? D YES a NO UP/SEPA/SU? o YES o NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? a YES o NO
7o 2 F �r-
Bulletin#100—March 30,2004 — Page 2 of 4 lAhandouts—RevisedWcrmit Application