05-100049 ter
a ► , -
City of Federal Way Mechanical Permit #: 05 - 100049 - 00 - ME
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-30513
Project Name: LARPENTEUR
Project Address: 4929 SW 327TH PL Parcel Number: 873219 0730
Project Description: Gas to gas water heater changeout
Owner Applicant Contractor
Andrew J Larpenteur &Norma L Larpenteur OLYMPIC WATER HEATER,INC OLYMPIC WATER HEATER,INC
4929 SW 327TH PL PO BOX 7862 PO BOX 7862
FEDERAL WAY WA TACOMA WA 98406 TACOMA WA 98406
98023-1923 (253)627-2727
Mechanical Valuation 550 Over the Counter Permit Yes
PERMIT EXPIRES July 5,2005.
Permit issued on January 6,2005
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: 4' !�`��Yr>.e� Date: //6 /OS
1 Ia.' (i9 1,Q, k ' ircl \-Litifk
FINALED
0
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-100049-00-ME
Owner: ANDREW J LARPENTEUR
Address: 4929 SW 327TH PL
FEDERAL WAY, WA 98023-1923
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) gr Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date Date Z����
n
0
o
CU ,,, �" 105 - f O C
049
. Federal WayRECEIVED PERMI�' — — —
COMMUNITY DEVELOPMENT SERVICES SF MF CO ME L PL DE EN FP
33325 8TM AVENUE SOUTH•PO BOX 9718
FEDERAL WAY,WA 98063-9718 JAN 0 6 21l�' PP L I C A T I O N irD
253-835-2607-FAX 253-835-2609
/ /
wws,ahlofederalwaq con,
The following is SEM._: Y. , IA
__ • u} t� incomplete ap•lication will not be accepted. Please .rant legibly(in ink)or type.
• PROPERTY INFORMATION
SITE ADDRESS 4 6/02\CI 6."W '3 a 7 p 1,___ SUITE/UNIT M
ASSESSOR'S TAX/PARCEL# - - LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal desenphon)
- IN PROJECT INFORMATION -
r
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provided tailed de.scr9otion of work included on this permit onitt)
PROJECT NAME(Name of Business or Owner Last Name) La r f i°i4 j-----
- • PEOPLE INFORMATION
PROPERTY NAM
wwllPRIMARY PHONE
OWNER (�' q rpe([ 74:e4.4 ✓ IRS3) 8TS8- S%/.1-
MAILING ADDRESS CITY CITY STAT ,ZIP
'-/ %9- i svi &III' R__. -re deer-, /Q-7� ! , i-/ 9P%4
CONTRACTOR COMPANY NAME
APPLICANT NA�`JJarrlcs T OFFICE PHONE
4149-4Yj44l �✓ yj4_ East ckfA. , A5.9 ba
y a-7a 7MA rAd�sG
CITY,STATE,ZIP CELL PHONE
P J. 13o x -79 2- 7 r,ai /j,g- ( ) -
ECITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
/ / ( )
B L
CONTRACTORS REGISTRATION NUMBER(copy of card required with each applications EXPIRATION DATE
/ /
APPLICANT COMPANY NAME ` APPLICANT NAME , r •
OFFICE PHONE
O1 mal c_ G. (2.4e-v 3�✓) 2»(, »u
Jov ' S .- Diac 4inp.,. kSJ 4?7 74)-7
MAIL�NG ADDRESS CITY,STATE,ZIP CELL PHONE
p. (9 , B o5( -7s4,. . -- '7,-4 c^o.i-1 a i e:i./ra tea'y 0 4 ) -
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect a Tenant 0 Agent ❑ Other(Describe) ( ) -
CONTACT NAME J PRIMARY PHONE
,4-n ( / ✓ E-MAIL ADDRESS
LENDER Per RCW 19.27.095: Lender information is NAME
required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP
.■ DETAILED BUILDING INFORMATION - - • - -
EXISTING USE PROPOSED USE
• EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ ,ASO. ,.0-`
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE a TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
g /D % Th 2o �,.7-ms '5
PROJECT FLOOR AREAS . . • •
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL ,
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
—
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
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 $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG SYSTEMS
BBQS FANS HOODS(CommeraoI) W OODSTOV ES
BOILERS FIREPLACE INSERTS / RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLE,IS
PLUMBING
BATHTUBS or Tub/Shower Combo) SHOWERS WATER CLOSETS(ronk) - MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sulks) VACUUM BREAKERS ELECTRIC WATER HEATERS
_-_ >> _--: -'_ DISCLAIMER/SIGNATUREBLOCK- --- ------- _-...__ -- .-- :_-::-•
1 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 authorized 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 9,..„/„...,,
ge.---ii,„,d,---,-,z-x_ DATE /% /47�(Signature) (Tltk)
RELATIONSHIP TO PROJECT o Owner ❑ Agent ontractor ❑ Architect ❑ Other
( FOR OFFICE USE ONLY
a NEW a ADDITION ❑ALTERATION a REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES ❑NO BASIC PLAN? ❑YES a NO
ZONING DESIGNATION CHANGE OF USE? o YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? o YES a NO
PLATTED LOT? a YES o NO DEMO PERMIT REQUIRED? o YES ❑NO
Bulletin 4100–March 30,2004 , – Page 2 of 4 k\Handouts–Revised\Permit Application