04-103627 A mmofl♦edeeWay
Community Development Services Mechanical Permit #:04 - 103627 - 00 - ME
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: LEWIS
Project Address: 176 S 361ST p) Parcel Number: 113780 0290
Project Description: Remove/replace gas water heater.
Owner Applicant Contractor
MICHAEL LEWIS FAST WATER HEATER COMPANY FAST WATER HEATER COMPANY
202 S 361ST PL 12601 132ND AVE NE 12601 132ND AVE NE
FEDERAL WAY WA 98003 KIRKLAND WA 98034 KIRKLAND WA 98034
(425)814-8381
Mechanical Valuation 449 Over the Counter Permit Yes
PERMIT EXPIRES March 8,2005.
Permit issued on September 9,2004
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. C�
Owner or agent: See Application Date: (�cj— ( ' C) Li
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THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection'Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04-103627-00-ME
Owner: MICHAEL LEWIS
Address: 176 S 361ST PL
FEDERAL WAY, WA 98003-8620
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 B4Date
F Way PERMIT 2,1,572 ECEIVED BY SF MF CO O EL PL DE EN FP
'sea tr err AY pEVELOPMENTAr-r-LAC.A.TION
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r r R war,WA 1>60634728?E9.66'-ISAFAX253'661' BSEP 0 9 20
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The oiler • is .tared in ormation--an incom•tete a••lacation will not be acce•ted. Please • at to•1bl (an tniq or . ,
PROPERTY INFORMATION
SITE ADDRESS I , ' I : e A : A n : 1 1 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL I 3 0 0 �. LOT SIZE (sj)
LEGAL DESCRIPTION (e.g.Anne Estates, Lot 1)
fAtto.hr pope F,.4..04 Iepoi dex,.peonj _.._
PROJECT INFORMATION
TYPE OF PERMIT CI BUILDING O PLUMBING XMECHANICAL
❑ DEMOLITION 0 ELECTRICAL 0 ENGINEERING CI FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
Remove/Replace Gas Water Heater
PROJECT NAME(Name of Business or Owner Last Name)
PE DI'IX I CA I K))
PROPERTY NAME PRIMARY PHONE
OWNER LEWIS.MICHAEL (2531661-6151
MAIUNG ADDRESS CITY.STATE,ZIP
202 S 361 PL _., FEDERAL WAY,WA 98003
CONTRACTOR COMPANY NAME APPUCANI NAME OFFICE PHONE
FAST WATER HEATER COMPANY (425)814-3124
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
12601 132ND AYE NE JfatKLAND.WA 98034
CITY OF FEDERAL WAY BUSINESS UCENSE NUMBER EXPIRATION DATE PAX NUMBER
-8 7---0 -0-0- 0-4_7_ A- s L 425 814-9516
CONTRACTORS REGISTRATION NUMBER jeopy•I card re.alrsd with each application) EXPIRATION DATE
EASTWIICO52DE 02/16/2005
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
MAIUNG ADDRESS CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect ❑Tenant 0 Agent !7 Other(Describe)
CONTACT NAME _ - PRIMARY PHONE E-MAIC.ADDRESS
LENDER _Per RCW 29.27.095: Lender irlfoiataon is3 t_ NAME
revelled if project vatue exceedi$5;400 '•WAILING ADDRESS CITY,STATE,ZIP
DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $$449 00
�PRINKLERED BUILDING? 0 YES O NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES C7 NO
. Y
WATER SERVICE PROVIDER a LAKEHAVEN O HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER O LAKEHAVEN 0 HIGIILINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
f�fEMENT
FIRST
SECOND -
THIRD
FOURTH — -
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?) ��—
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL uxunaa TOTAL PROaos&D TOTAL=STING*so raorooea
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ �-
FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing futures to remain.
AMC/LAN/CAL
Value of Mechanical Work $ •
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS aamiet WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES X GAS WATER HEATERS
DUCTS OAS PIPE OUTLETS
PLUMBING
BATHTUBS I.,Tu►/tSMwrC.m,) SHOWERS WATER CLOSETS(-kaki) _ MISC(Dracribe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS •
LAVS Malr.00 surr.l VACUUM BREAKERS ELECTRIC WATER HEATERS 3r
D s ' • i . a i
I cortij"y under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and further, that I
•
ant authorised 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 information supplied to the city as a part of
this application.
NAME/TITLE Permit Mgr DATE 09/08/2004
(Signature) (Tick) — ;
RELATIONSHIP TO PROJECT U Owner h Agent X Contractor 0 Architect ❑ Other _ 1
FOR OFFICE USE.ONLY
o NEW a ADDITION o ALTERATION a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES a NO BASIC PLAN? o YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES o NO UP/SEPA/SU? a YES a NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? a YES a NO
Bulletin M 100-March 30,2004 Page 2 of 4 - k\handouts-Revised ennit Application