05-104583 IC .Co
of Federal Way Mechanical Permit #: 05 - 104583 - 00 - ME
Conarvunity Development Services
PO.Bok9718
Federal Way,WA 98063-9718
Ph:(253)835-'7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: PINAL
•
Project Address: 30835 10TH SW Parcel Number: 024800 0090
Project Description: Replace gas hot water tank.
Owner Applicant Contractor
Sisto M F Pina &Kathy M Pina WASHINGTON ENERGY SERVICES CO WASHINGTON ENERGY SERVICES CO
30835 10TH AVE SW 2800 THORNDYKE AVE W 2800 THORNDYKE AVE W
FEDERAL WAY WA SEATTLE WA 98199 SEATTLE WA 98199
98023-4501 (206)282-4700
Mechanical Valuation 650 Over the Counter Permit Yes
CONDITIONS:
This parcel is located within a Wellhead Protection Area(Capture Zone 10)and must comply with FWCC,Chapter 22,
Article XIV"Critical Areas" and fill out a Hazardous Materials Inventory Statement,if applicable.
PERMIT EXPIRES March 8,2006.
Permit issued on September 9,2005
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 Wa `C�
Owner or agent:/ �� Date: ( C
AO
76 r-
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THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-104583-00-ME
Owner: SISTO M F PINA
Address: 30835 10TH AVE SW
FEDERAL WAY, WA 98023-4501
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) F3 Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By DateByklio} Date 10114 (`
SEP-8-2005 09:33 FROM:PERMIT 4257756315 TO:12538352609 P.3
Feder+`a c 5 - i_ 0 `i 5 3 3
Way
Icomma/errDEVEWPMENTSERVICEs PERMIT SF MF CO DEL PL D EN FP
3,�o �W"Y SOUTH'FAX2 .lb DOX-4129 APPLICATION
FEDERAL WAY,WA 9d069.971d lTD
7S9.66AL WAY,W 759161-II79 I
wWW Ellvr(lederolway.00,
The ollowin• is re•aired in ormation-an taco •tete a. •itcatlon will not be acce ted. Please •Hint to•ibi in in or
PROPERTY INFORMATION
SITE ADDRESS 5.D.T 3 c ,0 l e___ £ SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 0 2 (p. C) O - 0 O L � LOT SIZE(sJ)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach a pa,.i•page for lengthy legal duwtproe) _
PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ArMECHANICAL
0 DEMOLITION O ELECTRICAL 0 ENGINEERING a FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
0 gf ' i - 0' R rge_ra
--' ' V - CO iu. n/<
PROJECT NAME(Name of Business or Owner Last Name) i 1 V
PEOPLE INFORMATION
PROPERTY NAME
PRIMARYPHONEOWNER W ! P I� �. (2s-A gets---2_. ..)
MAILING�A�� /o" / qty STATE,ZIP 3 C4.14
CONTRACTOR COMPANY NAME �� �y saw APPLICANT NAME OFFICE PHONE
(/♦ �
W 1SWI�5 C/ L1 3ti o_1 Y (2.64) 242 - T (W
2/ a MAJLINO DRE�(4 1(-+E. /(t+C 4 CSA�ITY,STATE, IP_ W CELL PHONE( ) -
CITY OF FEDERAL WAY BUSINESS UCENSE NUMBER PIRATION DATE FAX NUMBER '
'.2'6-- 03- /Ot�'27 �'- B L `
/ / ( } _
CONTRACTORS REGISTRATION NUMBER(copy of cud requited with each application) EXPIRATION DATE
LU 4 XII 14•+"'-'::s g71 O a y / Z / CIC
APPLICANT COMPANY NAME APPUCANT ME OFFICE PHONE
i'/•et-e►se A;11- Etrav' i_ir et_ill,6 ( )
MAILING ADDRESS CITY,STATE,ZIP CE41,PHONE
re,eRELATIONSHIP TO PROJECT ���4rA i-2 (i 2U)
FAX NUMBER .. / -7
❑ Architect ❑ Tenant ❑Agent O Other(Descr'ibe) • ( ) �/ O'z51/
CONTACT e. NAME PRI ARY PHONE E-MAIL ADDRESS
-7, is 1.1 � �nausi- ( - ) -- J
LENDS
'PerRCW,Y9.27. l': Lertdertitjori�~aCi n�i`si�..., NAME 7���
- regiai-easfU9proJeceimatieercceecTs:SS,O'00, f
MAILING ADDRESS 'r ; 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 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE ❑ TACOMA. ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKERAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) •
SEP-8-2005 09:34 FROM:PERMIT 4257756315 TO:12538352609 P.4
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 Exisri Xo TOTAL morocco ToTAL curraa 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.
MECFIAMCAL n
Value of Mechanical Work $ (4'5b1
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOOS REFRIG.SYSTEMS
BBQS FANS HOODS(Coraaerciati WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES / GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(et ruefah.eerc.me.i SHOWERS WATER CLOSETS rrous MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVs Ls.m,..a sintc.j �.® VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
I eert(fy 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 (A:2144.16.-Q141.07/1/1,:76 DATE 4949(Q•'
(Signature) Critic)
RELATIONSHIP TO PROJECT 0 Owner Agcnt o Contractor 0 Architect ID Other
°FOR OFFICE USE ONLirt)
41g."4,0,• :r s;
o NEW o ADDITION a ALTERATION o REPAIR n TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? • o YES o NO
ZONING DESIGNATION CHANGE OF USE? a YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES o NO
PLATTED LOT? u YES o NO DEMO PERMIT REQUIRED? n YES o NO
y‘2,r- r Ptic
Bulletin#100-March 30,2004 Page 2 of 4 k\Handouts-Revised\Pcnnit Application