05-100043 • el a
City of Federal Way Mechanical Permit #: 05 - 100043 - 00 - ME
Community Development Services
P.O.Box 9718
FedeWay,WA -9718
Ph:(253 835-0009 806Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: DE LA PAZ
Project Address: 2033 S 304TH 51' Parcel Number: 053700 0049
Project Description: Replacing existing gas water heater
Owner Applicant Contractor
JOE DE LA PAZ JOE DE LA PAZ JOE DE LA PAZ
2033 S 304TH ST 2033 S 304TH ST 2033 S 304TH ST
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
(425)761-3585
Mechanical Valuation 750 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. '�j t s�
Owner or agent:C2i.. Gam-. e , )" Date: 0 f" 0 —0 S
•
..
.. DI
THIS CAR 'IS TO REMAIN ON-SITE
CITY OF110 s+-111A•.. Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-100043-00-ME
Owner: JOE DE LA PAZ
Address: 2033 S 304TH ST
FEDERAL WAY, WA 98003-4805
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) 0 Gas Piping(4125) ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By P- /4.-
Date 2 //-DS"
RECEIVED - l 06- 43
Federal way PERMIT --
COMMUNfrY DEVELOPMENT SE
RAN 0 o 2005 SF MF Co. L PL DE EN FP
33325 8r"AVENUE SOUTH•PO BOX 9718
FEDERAL WAY,WA 98063-9718 bYPPLI CATION TD253-835-2607•FAX2s3oF FEDERAL / /
I tJUILDING DEPT:
The following is required information-an incomplete ap•lication will not be acce•ted. Please •rint legibly(in ink)or type.
IN PROPERTY INFORMATION•
•
/ II.. //
SITE ADDRESS ?i 2 33 S. 3 0 cf 5 T r'�t' 41 L( L J" * SUITE/UNIT N
ASSESSOR'S TAX/PARCEL# - LOT SIZE(s.0
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal desoippan)
IN PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
4 'Ce c� C3-C.e� _ /vis-Z`- ccj c -1,t.%_• cf)L b
(„6..e....14-- .z„....) - AvAl r..0...
/40-7,-- cc.iiet_
nfeE.CO
PROJECT NAME(Name of Business or Owner Last Name) /O E L"i A-21 1 e oL k A5
, - - • • ■ PEOPLE INFORMATION
PROPERTY NAME C Q PRIMARY PHONE
OWNER €€ D LA / 12— /27EAM ieo C k 7.1 S (42-51 76( -35-Y5--
MAILING ADDRESS CITY,STATE,ZIP
Z �3 3 S _ 3 o`f-`r-4` ST 1.2_,o44,2, O,c 4J.4- . ?& ° 2
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
/JA ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
- - -B L / / ( )
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT NAME
OFFICE PHONE
;12 8P-' 1 14Z ( ) -
MAILING ADDRESSCITY, ATE IP CELL PHONE
2,(473 S 045 cr- ti�� I GJ,- f loa3 (442c176( -- 5JSRELATIONSHIP TO PROJECT - FAX NUMBER
❑ Architect Cl Tenant ❑Agent I 'Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
e.i'fr
LENDER ,;4er ROW 19.27 095. ender information is: NAME
required f.project-value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP
•' - - ■ DETAILED BUILDING INFORMATION
r
EXISTING USE PROPOSED USE
• EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PRPPOSED WORK $ n l c V
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑ NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER a LAKEHAVEN o HIGHLINE ❑PRIVATE(SEPTIC)
•
• . . PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. 'TOTAL
BASEMENT
—
-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 $
= _ ,- - - :� .. _-. . - - - '_ _, : -� -_-,: __ =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 $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
• BBQS FANS HOODS(commermat) W OO DSTO V ES
BOILERS FIREPLACE INSERTS RANGES M1SC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
•
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(Tao MISC(Describe)
DISHWASHERS SINKS _ DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(siuuoom sinks) 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,tt
am authorized by the owner of the above premises to perform the work for which the permit application is made. I further agree to
harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred in the investigation and deft.
such claim), which may be made by any person,including the undersigned,and filed against the City of Federal Way,but only where such c1N:
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 oj
this application. ^ c
NAME/TITLE T`//J•r'N DATE O/'-'0 6 --- OJ
. (A41.turd (Title)
RELATIONSHIP TO PRO 1% 0 Owner 0 Agent 0 tractor o Architect 0 Other
,FOR OFFICE USE ONLY
o NEW o ADDITION a ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? a YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? o YES a NO UP/SEPA/SU? a YES a NO
PLATTED LOT? o YES a NO DEMO PERMIT REQUIRED? a YES a NO
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Bulletin 11100-March 30,2004 _ Page 2 of 4 k\Handouts-Revised\Permit Application