05-105544 4114.44,• City of Federal Way Mechanical Permit #: 05 - 105544 - 00 - ME
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
1 Ph:(255)835-7000 Fax:(253)835-2609
Inspection request line: (253) 835-3050
(Project Name: ELLIS
Project Address: 34827 14T11,t! {?� Parcel Number: 542242 0340
Project Description: Remove/replace gas water heater
Owner Applicant Contractor
Shirley A Gillard &Ellis Charles Gillard FAST WATER HEATER COMPANY FAST WATER HEATER COMPANY
34827 14TH PL SW 12601 132ND AVE NE 12601 132ND AVE NE
FEDERAL WAY WA KIRKLAND WA 98034 KIRKLAND WA 98034
98023-7021 ' (425)814-8381
Mechanical Valuation 1101 Over the Counter Permit Yes
PERMIT EXPIRES April 30,2006.
Permit issued on November 1,2005
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: See Application Date: ( �
5
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( 1/
THIS CARD IS TO REMAIN ON-SITE •
CITY OF A Community Development Inspection Record .
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-105544-00-ME
Owner: SHIRLEY A GILLARD
Address: 34827 14TH PL SW
FEDERAL WAY, WA 98023-7021
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 Bye-7Date//..?z .
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PROP.CRTY ISTORMAT/ON
SITS.ADDI?r-ss 34827 14.PL SW,FEDERAL.AYA.Y,WA_ B023.--- . .-- . ,..- SUITE/UNIT e
A,fssFnscpivs TA.x./pArreEL • 5422420340 _ ___ - - - I OT SIZE i . • -
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PRO411=ZIWORMATiON:
TYPE OF PERMIT t t MID-DING ' t PLUMPANG XMECHANICAL
t t DEMOLITION ...I P.LECTRICAI CI ENGINEERING t' FIRE PRIWENTIoN F,1 sTl'M
I•RoJECT OF!SCRIPTION (Pr e.t11.10 Ch,101i4 t.b."!4or1pt.t+)F1 of t4 POP* el leititied 1,.14:VP'st f err!,(.f ptlki
Rernovc/Renlace Gas Water Heater
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OWSF,R ELLIS.CHARLESI (2531376-0551
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FAST WATER HEATER COMPANY (4251814-3124
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' DISCLAIMER/SIQNA t • :'BLOCK -
I certify under penalty of perjury that the Information furnisher!by me Is tri.e and correct to the heat of My knowledge, ant!Jr.rthrr;• tlicst r
arri areath,,,lied by rhe owner of the abose premise, to perform the work for witch the pettnit alrpli:cation I. made. I twilit(' tiVec (Ulurhl
h ttr raless the City of Federal Way as to any ae laf'rt(including Costs, rx!*rnsos, al d at torncys'fees incurred tri the in aerttrirattnn and defi'n'e of
'curl,rlerh,),w1iic,,may be rncrdr by any person, Ixt Itl(firt((the undersigned, Chid['fa against tli@ Ctty of federal[Yash bat or[I'y where such!•✓[int
arises out of the reliance of the city. Olt:hiding its offie*r's anti.•rrtjrluyerl„ upon Il r accuracy of the I rlror•uitrtrurt aerlrptlecf to Or rrr,1 ua a bort of
t,fs appl(crrturn.
NAME/TITLE -'` .c'�_%-' �_ .P('rmit Mgr I1a'l t'. 10/27/2005
RELATIONSIHI'TO PROJECT ;i i lit!„" 1 t A ;1-i11 X t „tilt.!,tnY .+idol• ` hilt-
FOR OFFI t• USE ONLY
) PtC W ADDITION r 1 ALTE31ATIOFI RFTAI‘, s:TENANT IMPROVEMENT .
uuti.r)INCi SHELL,ONLY? I 1 Yr,S NO BASIL)PIAN? ,YES NO
ZONING DESIGNATION CFIA'irrl •
r OF USE? I• YES . NO
NEW ADDRESS REQUIRED? t I YFS :- NO UP/`BPA/SU? : Y1ntS •. NIT
1'LAT'I'It;I) 1 • NO
-_— ,_ 1'YEN I
N() J - ,QUIRED? YES '• NO_. . , Ut;DA")PERMIT ill" .--- --
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