04-103413 '
/
, 1I , ,
City of Federal Way •'
Community Development Services Mechanical Permit #:04 - 103413`- 00 - ML
33530 1st Way S
Federal Way,WA 98003-6210 , U
Ph•253.661.4000 Fax:253.661.4129 9,4(1.6 Inspection request line: 253.835.3050
Project Name: MANDERS
Project Address: 27732 25TH 1 U r $ Parcel Number: 757561 0760
Project Description: Remove and replace gas water heater
Owner Applicant Contractor
Norman M Lustig &ELLEN MANDERS FAST WATER HEATER COMPANY FAST WATER HEATER COMPANY
27732 25TH DR S 12601 132ND AVE NE 12601 132ND AVE NE
FEDERAL WAY WA KIRKLAND WA 98034 KIRKLAND WA 98034
98003-6928 (425)814-8381
Mechanical Valuation 449 Over the Counter Permit Yes
PERMIT EXPIRES February 23,2005.
Permit issued on August 27,2004
I hereby certify that the above inforination 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. j�� ^� �6074.'(Owner or agent: See � Cat Date: � ! — C7
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community te
A velopment Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04-103413-00-ME
Owner: NORMAN M LUSTIG
Address: 27732 25TH DR S
FEDERAL WAY, WA 98003-6928
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 Appr ed
By Date , (By Date By 4 Date
•
Federal' ay NIR IT. a - -L-o___, CiK1s
OUW KENrs VICES RECEIVED BY pAR ....� SF MF C ( )EL PL DE EN FP
Is.
ss�6ul,tws p 1sa� vyajTYDEva0PME1� PLICATION TO
�` AUG25200 / / ...... •--
The ollowi • is •aired in ormatlon--an inco •tete a••Iication will not be acre•ted. Please • nt le•ibt (in ink)or • .
PROPERTY INFORMATION •
S''TE ADDRESS 177l2 DR S,FF,DE.RAI.WAY,WA 08003 _ SUITE/UNIT I
3SESSOR'S TAX/PARCEL# -75756.1076(L- _ - LOT SIZE(sf1
LEGAL DESCRIPTION (e.g.Acme Estates, Lot 1) _
(Attath s�}.awAE gay.fir,4."90,,i1.54 deaatgron}
PROJECT INFORMATION
TYPE OF PERMIT LI BUILDING 0 PLUMBING )(MECHANICAL
❑ DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only)
Remove/ReDlace Gas Water Heater
'PROJECT NAME(Name of Business or Owner Last Name)
PEt'5Pal: [V1.4'1:1M,VI IC r
'':OPERTY NAME PRIMARY PHONE
,)SER MANDERS.ELLEN M (2531946-2152
MAIUNG ADDRESS CITY,STATE,ZIP
27732 25 DR S FEDERAILWAY,WA 98QQ3
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
IC
FAST WATER HEATER COMPANY (4251814-3124
MAILING ADDRESS CITY,STATE,ZIP ' CELL PHONE .�
12601 132ND AVE NE .WA 95034
CITY OP FEDERAL WAY BUSINESS UCENSE NUMBER EXPIRATION DATE PAX NUMBER
-8 7---0 A1-0- 0- 4-7_ -0 A- B L 425 814-9516 ii
CONTRACTOR'S REGISTRATION NUMBER tespy•t earl regalia&with+tacit applicatioaj EXPIRATION DATE
EASTWBCD52DE 02/16/2005
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
I
MAIUNG ADDRESS CITY.STATE,ZIP CELL PtIONE 1
I
,.5 RELATIONSHIP TO PROJECT _ FAX NUMBER 1
to Architect 0 Tenant o Agent ri Other(Describe) r _•,W'
'CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS 77
LENDERPer RCW 19.17.095: Lender iit,(ormatioa iaa k, NAME
ngv.Ii project value exceeds#5;000' •
MAtUNG ADDRESS cITY,STATE,SWP '
sti,. DETAILED BUILDING INFORMATION
EXISTING USE _PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $_ VALUE OF PROPOSED WORK $,4449 00 1
SPRINKLEREI3 BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES t0 NO i+
WATER SERVICE PROVIDER a LAKEHAVEN 0 HIGBLINE 0 TACOMA a PRIVATE(WELL) f
SEWER SERVICE PROVIDER a LAKEHAVEN ci HIGHLINE 0 PRIVATE(SEPTIC)
j
4c
PROJECT FLOOR AREAS .
F't AREA DESCRIPTION EXISTING
SEMENT SQ.FT. PROPOSED SQ.FT. TOTAL '
FIRST
SECOND —
THIRD ��_. .. -----� A
FOURTH -
I ADDITIONAL FLOORS(DESCRIBE) "- — " ` _
DECK(COVERED?) _ "
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL=man TOTALrRO?OszD TOTAL swsrax
O AMP PROroa ii
;17
ONLY" NUMBER OF BEDROOMS .____.. ESTIMATED SELLING PRICE $
FIXTURES '
h
Indicate number of each type of ftxture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL,
Value of Mechanical Work $
MR HANDLING UNITS EVAPORATIVE COOLERS GAS LOOS REFRIG.SYSTEMS '
BBQS FANS HOODS(roomactril WOODSTOV ES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES X GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(KTu►/Rfe.trCombo) SHOWERS WATER CLOSETS trwtti -_ MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS '
f GAS PIPE OUTLETS SUMPS RAINWATER SYST Y
WASHING MACHINES URINALS HOSE BIBBS -,LAVS m.t rs sin of VACUUM BREAKERS ELECTRIC WATER HEATERS x;.
DISCLAIMER/SIGNATURE BLOCK
,
,,, /•, 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
ant authorised by the owner of the above premises to perform the work for which the permit application is made. L 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 4
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 08/24/2004
(Signature) (Title)
RELATIONSHIP TO PROJECT U Owner cl Agent X Contractor cl Architect ❑ Other
•
} FOR OFFICE USE.ONLY
o HEW o ADDITION o ALTERATION a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES o NO BASIC PLAN? a YES o NO '
ZONING DESIGNATION CHANGE OF USE? n YES a NO
NEW ADDRESS REQUIRED? a YES o NO UP/SEPA/SU? o YES a NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? u YES u NO ___/
Its
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Bulletin#100-March 30,2004 Page 2 of 4 —Ay�{ klIiandouts-Revisedll'ennit Application