05-103266 City of Federal Way Mechanical Permit #: 05 - 103266 - 00 - ME
Community Development Services
P 0 Box 9718 •
Federal Way,WA 98063-9718 •
Ph (253)835-7000 Fax (253)835-2609 • Inspection request line: (253) 835-3050
Project Name: FAY pJL
Project Address: 32812 12TH'SW Parcel Number: 926494 1010
Project Description: New gas hot water heater
Owner Applicant Contractor
Michael W Fay &Maureen K Fay Maureen K Fay Maureen K Fay
32812 12TH AVE SW 32812 12TH AVE SW 32812 12TH AVE SW
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
98023-5203 98023-5203
Mechanical Valuation 939 Over the Counter Permit Yes
PERMIT EXPIRES January 3,2006.
Permit issued on July 7,2005
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 Fed- Way. �f
Owner or agent: / Date: / 7_0 �
THIS CARD IS TO REMAIN ON-SITE
CITY OF rW'RlimilWor Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-103266-00-ME
Owner: MICHAEL W FAY
Address: 32812 12TH AVE SW
FEDERAL WAY, WA 98023-5203
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 of 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 ByG Date/Z2S—G
1
a�,.f A RECEIVED .
Federal Way 05-- __/ ._.)...
c0MMUNnYDBYELOPMEWrSERV J 0 7 2005PERMIT SF MF C EL PL DE EN FP
3J31sDRLWA, A7FD 'pLICATI0N
FEDERAL WAY,WA 91063-9711 iro
sss4s5-sTfr*Fe xils3 ti1%, OF FEDERAL / I
vww.atuolrederalwa.���BUILDING DEPT, 1
The ollowi • is -• fined in ormation-an i •fete • ••Iication will not be acce•ted. Please •rint k•ibl n or
`/ /� 11`1 PROPERTY INFORMATION `,, f�
RITE ADDRESS g�d io2-- / A ye Tr C�7 1 V4 /A- SUITE/UNIT It
ASSESSOR'S TAX/PARCEL# - .UiL3
LOT SIZE(s,)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page far iengthylegal derafpoay
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 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)
r p/a e. -a.�/,,i he/ tr.21'C/ t _ - , • .
PROJECT NAME(Name of Business or Owner Last Name) I. / -
NI PEOPLE INFORMATION
PROPERTY NAME c IC1
IPRIMARY PHONE
OWNER //air / /toree,) FATEZP )O3 g-'- p
S��MAIUNO ADDRESS
3./OZ 102-/71/41/4 5W 1 Fc,d&' /
wa, W4-. ,9'. 3
CONTRACTOR COMPANY NAME APPLICANT NAME
OFFICE PHONE
0
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
(CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER FAX B _
_ EXPIRATION DATE - FAX NUMBER
. / / ( ) _
_BL
CONTRACTOR'S REGISTRATION NUMBER(copy of earl retnlead with each appLLeatieN EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT��LlNAAMMEOFFICE PHONE
MAILING ADDRESS CI1Y`1 STATE.ZIP Fai CELL PHONE
51imG as a6t ✓e- ( ) _
RELATIONSHIP TO PROJECT
FAX NUMBER
CIArchitect ❑Tenant ❑Agent a Other(Describe)
0 0-112 e-K1 ( _
CONTACT NAME PRI -t Y PHONE E-MAIL ADDRESS
LENDER ._
.• F,;.1' r,4,,e r (frk.li:,i : <, NAME
IIPIPF
e.
NO AD'.: • -mow- CITY,STATE,ZIP
■ DETAILED BUILDING INFORMATION
EXISTING USE _ PROPOS '
EXIS G ASSESSED/APPRAIS-• VALUE $ UE OF PROPOSED WO-. $
SPRINKL D BUILDING? a YES a NO FIRE ,. t •PRESSION SYSTEM PROPOSED/REQUIRED r. a e r
WATER SER PRO A ER ❑LAKEHAVEN a HIGHLINE ❑TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑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 0 CARPORT
NUMB t. LOORS raw= I PROPOSED
"NEW HOMES ONLY* NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each ,- • • -• • • be installed • r-.,cated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mecha I Work $ %51. 49 t"
•
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(C.mmerel.i) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
• COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(mks MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS - SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE MBA
LAVS(Bathroomsiolq VACUUM BREAKERS � 94114-WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
•
I certify under penalty of perjury that the •rmation 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 C , )
i� Y .(� �j/N/ DATE 7- 7-
(Signature)
-(Signature) (Title)
RELATIONSHIP TO PROJECT ❑ Owner 0 A: ❑ Contractor 0 Architect 0 Other
,1 L)t P(c)t( bt t Ytit.` t, i r: rY rl
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Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application