04-103499 City ofFederalWay
Community
Development Services 1VIechanical Permit #:04 - 103499.- 00 - ME
1);(
33530 1st Way S D
Federal Way,WA 98003-6210 vv
Ph:253.661.4000 Fax:253.661 4129 Inspection request line: 253.835.3050
Project Name: MONTGOMERY
Project Address: 27640 26TH A)t. 5 Parcel Number: 757560 0410
Project Description: Replace gas hot water tank.
Owner Applicant Contractor
Harry Montgomery &Lynn Montgomery FAST WATER HEATER COMPANY FAST WATER HEATER COMPANY
28712 18TH AVE S#X202 12601 132ND AVE NE 12601 132ND AVE NE
FEDERAL WAY WA KIRKLAND WA 98034 KIRKLAND WA 98034
98003-2956 (425)814-8381
Mechanical Valuation 449 Over the Counter Permit Yes
PERMIT EXPIRES February 28,2005.
Permit issued on September 1,2004
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.
Owner or agent: See Application Date: 9 - /-64/
THIS CARD IS TO REMAIN ON-SITE ' `
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04-103499-00-ME
Owner: HARRY MONTGOMERY
Address: 27640 26TH AVE S
FEDERAL WAY, WA 98003-6932
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) ❑ Gas Piping(4125) 0 Final-Mechanical (4065)
Approved Approved to release test Approved
By Date By Date By Date
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7s3F Frftst'weAY.mitt•ro� ATI P LI C A'T I O N
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?5.3•661-1115•FAX 253-661.1129 JCf
The aloud • is •uired in orrnation--are Inco •tete a••lication wilt riot be aces•ted. Please • nt le•ibi (In.talc.)or • .
PROPERTY INFORMATION
SITE ADDRESS ,• 1 t , / 1 : _ * _ 1 !. t : I I SUITE/UNIT 1t
ASSESSOR'S TAX/PARCEL _7575600410- - _ LOT SIZE (sf)
LEGAL DESCRIPTION (e.g.Acme Estates, Lot 1)
(Attar# +avdj 1.94 de*a*nfsn}
PROJECT INFORMATION
TYPE OF PERMIT t3 BUILDING ❑ PLUMBING XMECHA.NICAL
❑ DEMOLITION 0 ELECTRICAL 0 ENGINEERING O FIRE PREVENTION SYSTEM
'?OJECT DESCRIPTION(Provide detailed description of work included on this permit only)
Remove/Renlace Gas Water Heater
PROJECT NAME(Name of Business or Owner Last Name)
PEOFIL 1t Ft1 :I..'+l
PROPERTY NAME PRIMARY PHONE
OWNER MONTGOMERY.HARRY _(253)946-1536
MAILING ADDRESS CITY,STATE.ZIP
27640 26 AVE S _,___EE,DERA!.WAY,,WA 98003
CONTRACTOR COMPANY NAME APPUCANT NAME OFFICE PHONE
FAST WATER HEATER COMPANY (425)814-3124
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
1 601 1.2ND AVE NEJ jJ KLANTI,WA 98034
CITY OF FEDERAL WAY BUSINESS UCENSE NUMBER EXPIRATION DATE FAX NUMBER
-8 7---0 -0-0- 0- 4_7— A - s L 425 814-9516
CONTIIACTOWS REGISTRATION NUMBER copy of card required with each epplicatloaj EXPIRATION DATE
EASTWHC052DE 02/16/2005 J
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
MAIUNG ADDRESS CITY.STATE,ZIP CELL.PHONE
RELATIONSHIP TO PROJECT FAX NUMPER�
❑ Architect O Tenant ❑Agent ❑ Other(Describe) _
1
CONTACT {NAME jThK1MARY PHONE E-MAIL ADDRESS
LENDER Per RCW 19.27.095. Lender in{torTrtatio`it ts "t., NAME l
regrciiyd(jproject value exceeds#S;oot
WUUNG ADDRESS CTTY,STATE,ZIP
{r{
DETAILED BUILDING INFORMATION
1
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $_ VALUE OF PROPOSED WORK $ $449 00
SPRINKLERED BUILDING? ❑ YES lJ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? Li YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE t] PRIVATE(SEPTIC)
{ PROJECT FLOOR AREAS
4 AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT.
I BASEMENT TOTAL
FIRST
SECOND
THIRD .... ...__�.__.
FOURTH
ADDITIONAL FLOORS(DESCRIBE) — '""— •
DECK(COVERED?) "� "'—
GARAGE/CARPORT
HOW MANY FLOORS? ioYu sAwsua TOTAL rRorosco Tara t ITTIaARa raoroe= `
___
‘"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
w
- - FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MBCKANICAL
Value of Mechanical Work $ -.
AIR HANDUNG UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS '
BI3QS FANS HOODS 1c. ,,uall WOODSTOVES i;'
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES X GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS t.,Tayst...,comwi SHOWERS WATER CLOSETS(ratty __. ._ MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS inc.... ,, Si,Jkal VACUUM BREAKERS ELECTRIC WATER HEATERS
_ DISCLAIMER/SIGNATURE BLOCK
'. I curt*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. !further agree to hold
harmless the City of Federal Way as to any claim(including costs, expenses, and attorney?fees incurred in the investigation and defense of
i 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.
NAE/TITLE ��"'' _Permit Mur DATE 08/31/2004 .
M '
ISianaturel (Title)
RELATIONSHIP TO PROJECT 0 Owner n Agent X Contractor 0 Architect 0 Other
-
FOR OFFICE USE,ONLY
o NEW a ADDITION a ALTERATION a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES o NO BASIC PLAN? a YES a NO
ZONING DESIGNATION CHANGE OF USE? o YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a YES a NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? u YES a NO
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Bulletin#100—March 30,2004 Page 2 of 4 ___� k\Handouts—Revised\Permit Application