05-104839 City of Federal Way Mechanical Permit #: 05 - 104839 - OQ- ME
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
I
Ph:(253)835-7000 Fax:(253)835-2609 nspection request line: (253) 835-3050
Project Name: WESTMORE p i&
Project Address: 34424 27TH'W Parcel Number: 502945 0040
Project Description: Replace gas water heater
Owner Applicant Contractor
Steven G Westmore &Elizabeth S Westmore ACTION WATER HEATERS ONLY INC ACTION WATER HEATERS ONLY INC
34424 27TH AVE SW 12704 NE 124TH ST SUITE 43 12704 NE 124TH ST SUITE 43
FEDERAL WAY WA KIRKLAND WA 98034 KIRKLAND WA 98034
98023-3074 (425)820-8848
Mechanical Valuation. 1262 Over the Counter Permit Yes
PERMIT EXPIRES March 20,2006.
Permit issued on September 21,2005
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: vs?ti t .h-tenn Date: Zos-
0?70(A-6
d
r ATHIS CARD IS TO REMAIN ON-SITE
CITY OF''1.../ Community Development Inspection Record
Federal Way JVR INSPECTION REQUEST PHONE # (253) 835-3050
•
PERMIT#: 05-104839-00-ME
Owner: STEVEN G WESTMORE
Address: 34424 27TH AVE SW
FEDERAL WAY, WA 98023-3074
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 Approved
By Date By Date By Date
COINmoviT RECEivED ey
DEVEOPFedA
�'�- ��ll Y5
Federal Way PERMITSEP
COMMUNITY DEVELOPMENT SERVICES ,j iJ U SF MF C e ME EL PL DE EN FP
3332E AVENUESOUTH•PO BOX 9718
FEDERAL WAY,WA 98063-9718 APPLICATION
. / /
253-835-2607•FAX 253-835-2609
www cttyoffederalway.com
The ollowin, is re'uired in ormation-an incom,fete a'•lication will not be acce'ted. Please 'Tint le•ibl (in ink)or .
344 �J• PROPERTY
�INFORM�ATTION
SITE ADDRESS 2-4- 2 T 4-V _SL i- SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 5 12 9 4 s---- pre 44 er LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates.Lot 1)
(Attach separate page for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING yMECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
PROJECT NAME(Name of Business or Owner Last Name) 14.)ebt'o
11 PEOPLE��1 � INFORMATION -�/t
OWNER
PROPERTY
NAMEPRIMARY PHONE
GLI 2A4 W.et OR-- (2-s3) Q/�44-'2= /- J2-
MAILING ADDRESS CITY TATE,ZIP
34A-2A 21'�=' Awe Sial .c aQ c wet, 4'4°0.13
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
ACTION WATER HEATER ONLY INC KNG--ea. (42c) Lo - {g'
MAiCOMMERCIAL CENThWFIY,STATE,ZIP CELL PHONE
12704 NF 124th ST # 43 ( ) -
CnY OF FFRMAR AN.Stift& EXPIRATION DATE FAX NUMBER
3 / (/2� IR 20-7296
ONZL9S GIS ( Ropy O�d requied with each application) EXP
DATE
/ /
APPLICANT COIrE APPLIC NAME OFFICE PHONE -
MAILING ADDRESS CITY, ATE.ZIP CELL PHONE
/'i?o If uC 240'1 S7#1/3 ((,K ie-1-4 L01 ftSY ( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect ❑Tenant ❑Agent ❑ Other(Describe) ( ) -
CONTACT NAMA 6tEPRIMARY PHONE
VZ-r) y2e) - tdr98' E-MAIL ADDRESS
LENDER Per.RCW 19.27.095: Lender information is NAME
required(f prnject value exceeds$5.000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( ) -
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES ❑ NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)
IIlk
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 ❑ CARPORT❑
EXISTING rRorosFD TOTAL TOM=STING Sr TOTAL FROFOFRD lSF TOTAL 6F
NUMBER OF FLOORS
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL aC
Value of Mechanical Work $ 2 (P
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(Commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS l\`�
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(ronet) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom 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,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. /I
NAME/TITLE DATE /[J 5
(Signature) (Title)
RELATIONSHIP PROJECT ❑ Owner ) gent ❑ Contractor ❑Architect 0 Other
FOR OCR USE ONLY
a NEW a ADDITION a ALTERATION a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES a NO BASIC PLAN? o YES o NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a TES a NO
PLATTED LOT? a TES a NO DEMO PERMIT REQUIRED? a YES a NO
Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application