05-102173 •
A 1
• 4
City of Federal Way Mechanical Permit #: 05 - 102173 - 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) 835-305C
Project Name: WALLACE
imp Lit
Project Address: 30520 OTISW (,oszo-41e Pt-S w) Parcel Number: 178880 0630
Project Description: Replace gas hot water tank.
Owner Applicant Contractor
James B Wallace James B Wallace James B Wallace
516 SW LANGSTON PL 516 SW LANGSTON PL 516 SW LANGSTON PL
RENTON WA RENTON WA RENTON WA
98055-2218 98055-2218
Mechanical Valuation 300 Over the Counter Permit Yes
PERMIT EXPIRES November 5,2005.
Permit issued on May 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 Fede y.
Owner or age t: B- tr—)J1164 Date: 0` l 05
t A
A THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-102173-00-ME
Owner: JAMES B WALLACE
Address: 30520 6TH PL SW
FEDERAL WAY, WA 98023-3972
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 fbf Date .cfi?../Qf-
«At. RECEIVED o iii- / 0 ( 73
Federal Way PERMIT
COMARIATYDEVELOPMENT SERVICES MAY 0 9 SF MF COO L PL DE EN FP
3332E D AVENUE A771•POBOX9718 �°?PLICATION
FEDERAL WAY,WA 98063-9718 TD
253-835-2607.FAX 253-635-2609 /
tuww.eii offederalway.com CITY QF FeOdf3NL WAY -
@UILDINQ DEPT.
The ollowi • is re• ired in ormation-an inco •fete a••lication will not be acce•ted. Please •tint in in or
• PROPERTY INFORMATION
SITE ADDRESS 3O`oio 0:b AL' 5jA)
UITE/UNIT#
ASSESSOR'S TAX/PARCEL# - _ _ LOT SIZE(sj7
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) 6C4 1.1/7'Y? 14.4/e
(Attach separate page for l legal description)
' ■ 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 onlu)
‘29r4C3 tic f 490/ae c 4's IA-k`lir/ /,/e'kr7t-r
PROJECT NAME(Name of Business or Owner Last Name)
• PEOPLE INFORMATION
PROPERTY NAME meqq_ PRIMARY PHONE
OWNER \Jowes rJ -/�_()/rC.. ( 4 ) g75› �/'$ 7
MAILING ADDRESS CITY STATE,ZIP
f55CO5/6 S IA/ LgASSsary PL gee Nto,✓ t i V ,5,5-
CONTRACTOR
NTRACTOR COMPN� APPLICANT NAME -
OFF[CE PHONE
MAILI ADDR SS CITY,STATE,ZIP CELL PHONE
( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
-B L / I ( )
CONTRACTOR'S REGISTRATION NUMBER(coPy of card required with each application) EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
.,P1e-S L /kce .— ? ( ) -
MAILING ADDRESS CITY,STATE,ZIP - CELL PHONE
S/6 S�A ssf.,t. �� , e,(,7 tJ LI/i49r1Lf 1 20‘ ) oF - •5'Y7
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect o Tenant 0 Agent o Other(Describe) IAA/14,W (/L5Q) //? - 206[/
CONTACT NAME ,— PRIMARY PHONE E-MAIL ADDRESS 7
) l^ cJ4 dace (za 16/ ' -3-3/7
LENDER :?;_ ,7,1 •! "•,fl- e7.,Y.7 :r./`tvwF"f"rf,CAiir :t,17, n NAME
;;•flit.--'“Jf n"•"ij"-i4,,;•.4% ,->,'<4.<,:nt;C ", 't.,.Xi11f
MAILING ADDRESS CITY,STATE,ZIP
IN DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? a YES 0 NO ' • SUP• SION SYSTEM PROPOSED/REQUIRED? ❑YES ❑ NO
WATER SERVICE PROVIDER a LAKEHAVE• ❑ HIGHLINE a TACOMA a PRIVATE(WELL)
SEWER SERVICE PROVIDER a .N• t N a HIGHLINE a 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 0
NUMBER OF FLOORS ° PROPOSED Toru 't TOT �i DV, sr 1 4s eh.sr
•
•
"NEW HOMES ONLY`• NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of ea • ..a of - to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECKLNICAL
Value of Mechanical W.,k $
•
AIR HANDLING • 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
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS - •SETS(Toilet) MISC(Describe)
DISHWASHERS _ SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS „ - RAINWATER SYST
WASHING MACHINES U' .. HOSE BIBBS
LAVS(Bathroom Sinks) VACUUM BRE -• ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the information furnished by me is true and correct to the ••- f 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 & viDATE
(Signature) (Title)
RELATIONSHIP PROJECT o Owner o Agent o Contractor ❑ Architect ❑ Other
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Bulletin#100-January 7,2005 Page 2 of 4 k\Handouts\Pcrmit Application