05-105501 -
1 t
City of Federal Way . Mechanical Permit #: 05 - 105501 - 00 :ME
Community Development Services
r P.U.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-305C
Project Name: MURAKAMI
Project Address: 1920 S 289TH Parcel Number: 422300 0300
Project Description: Changeout of gas water heater
Owner Applicant Contractor
David Murakami &Elsie I Murakami WASHINGTON WATER HEATERS WASHINGTON WATER HEATERS
1920 S 289TH ST 32015 56TH AVE S 32015 56TH AVE S
FEDERAL WAY WA AUBURN WA 98001 AUBURN WA 98001
98003-3815 (800)978-8588
Mechanical Valuation 874.92 Over the Counter Permit Yes
PERMIT EXPIRES April 24,2006.
Permit issued on October 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. A /
Owner or agent: See Application Date: II (D
firuA LrO /i /d,G
THIS CARD IS TO REMAIN ON-SITE
CITY of Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-105501-00-ME
Owner: DAVID MURAKAMI
Address: 1920 S 289TH ST
FEDERAL WAY, WA 98003-3815
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 kE/9- Date 5-//,70
RECEIVED BY
t� COMMUNITY DE�IE.OPMFNT I l's PAI;?',"';i
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7.1 r_.--
Federal way Pg+ RM IT
coMMUNflTDEVELOPMENT SERVICES SF MFC M EL PL DE EN FP
33325 d^i AVENUE SOUTH•PO BOX 9J1 d APPLICATION
FEDERAL WAY,WA 98063-9714 TD
253-835.2607•FAX 253-835-2609 �—
• WWI,ni'wilederalaiay coni �- '-^
IIS PROPERTY INFORMATION
SITE ADDRESS l�A0 5 Z59 ' CX-t k , c. / �✓ SUITE/UNIT$
ASSESSOR'S TAX/PARCEL# ( Z- 2 '; 00 - 03 !t
O LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach wParar<Page fa,ktwg U legal deaa+ptbn)
N PROJECT INFORM ATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING g23 CIIANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION description ofoork included on this Hermit only)
L. Jam- O U ) r C 7- Ai ,2 -
PROJECT NAME(Name of Business or Owner Last Name) (17 VOLILevvi
ii PEOPLE INFORM-\TION
PROPERTYN 1 •
PRIMARY PHONE -7� �
OWNER �1-(J I I } L(C e t it/111 (3 ) J / - /7 �
141242MAILING -,s �
ADDRESS ,21 't— . 6 CM,STATE,mg C�l-7 t(/2 9--trcc
•
CONTRACTOR COMPANY NAMEAPPLICANT NAME OFFICE PHONE
4-5Cik, keV- \cul- 1 t 6{-4-ds 6 - . (J0c - --(SZ )' .- 553k
MAILING ADD CITY,STATE, CELL PHONE
2 O 6 5Co4"V , 4u:Oct-C.1 V-lz CO (`-tz5) 1 -`1 t 5 .
crrY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
Th-L. Q-5. .5_ L t a-B_ L /Z 1 ii /Z (QV,-) 3n --NLc5/
CONTRACTORS REGISTRATION NUMBER loopy of card requited with each application) RATION DATE J
IV. -1"�� `� a v .C) l/7 /Uf
APPLICANT C MPANY NAME r �[+ APPLICANT NAME / OFFICE PHONE
WC(5/►'n� (1k4' ,es Gea-Lzir)/� G`'C`t ( )`715 - i5SS'
MAILING AD S C ,STA ,ZIP CELL PHONE
of5 564" t 5 fLcbc4co r L't O6/ (x/25) 357. - S-4
RELATIONSHIP TO PROJECTFAX NUMBER
❑ Architect ❑ Tenant ‘n; ❑ Other(Describe) (`S )375 - 2`/S/
CONTACT Nide_ PRIMARY PHONE _ E-MAIL AD 'r
�u �vk,1 t-i Cts' ( v )`'I- c -`='SSS hoW 't Li ckcC yck-4(
LENDER Per RCW 19.27.095: Lender information is NAME CG
required(rpm/eat value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES ❑ NO
WATER SERVICE PROVIDER 0 LAKEHAVEN a HIGHLINE a TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
•
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE III CARPORT❑
tn
NUMBER OF FLOORS n.,aa tsoros= TOTAL TOTALIXISTaN.aPP TOTMOTOemIf TOTAL IP
"'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 fixtures to remain.
MECHANICAL
Value of Mechanical Work $ '7 l c 1 2-
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG,SYSTEMS
BBQS FANS HOODS icommerr,rl WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES / GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMING
BATHTUBS(or Tub{shower Combo) SHOWERS WATER CLOSETS(rode) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAYS(tt.throomaim* VACUUM BREAKERS ELECTRIC WATER HEATERS
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
am 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. r�
NAME/TITLE CV— DATE /Oy-
(Signatur (Title(
RELATIONSHIP TO PROJECT CIOwner int 0 Contractor 0 Architect ❑ Other
FOR OFFICE USE ONLY
o NEW o ADDITION a ALTERATION o REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES ❑NO BASIC PLAN? o YES o NO
ZONING DESIGNATION • CHANGE OF USE? ❑YES ❑NO
NEW ADDRESS REQUIRED? ❑YES a NO UP/SEPA/SU? ❑YES ❑NO
PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? ❑YES ❑NO
Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application