05-102435 T
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City of Federal Way Mechanical Permit #: 05 - 11:„L.:•41*
024<_5 -.00 -705E°
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection reques (253� 8
Project Name: HAHN
Project Address: 30121 23RD'S e1 N •er: 042
1049
jo
Project Description: Gas to gas water heater changeout
Owner Applicant for
Eugen A Hahn PERMIT GROUP,THE*LINDA THORNQ b WASHI •N EN R VICES CO
0
444\
30121 23RD AVE S PO BOX 2034 •ORNDYKE
FEDERAL WAY WA KIRKLANR, A 98083 ATTLE WA 981
::i:: aIuation
(206)850 wer the C ermit Yes
C11411
' I 'IRES Nove a 005.
'tis don May27,
I hereb �`it the . info :t `i is caArr-. d that the construction on the above and
the • ,_s �e use`s .e in ac• ce with the laws,rules and regulations of the State of Washington and
Of I ;t <l Way- ..
-r • t. . aq '11
/ � cdeiscraib_edlp,roperty
r�
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-102435-00-ME
Owner: EUGEN A HAHN
Address: 30121 23RD AVE S
FEDERAL WAY, WA 98003-4254
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) ❑ Final-Mechanical(4065)
Approved Approved to release test T v Aa Approved
By Date By Date By -59 Date G..9,0 S
MAY-24-2005 08:26 FROM: TO:12538352609 P.
cmr of��,
OF - IC 4 35
Federal Way RECEIVE�'ERM IT
COMMUNITY WAY SOUTH
T PO SERVICES
SF MF CO �L PL DE EN FP
33530 FIRST WAY SOV1N•lb BOX 97!11
FEDERAL WAY,WA 98063-97189M ..i 2 AQP L I C AT I O N r°
253.6614115•FAX 253.6614129ytagjAAtioffssic '� / /
The ollowin• is re•u y.. A I, ,•^,_fia4iki btIo •lete a••Ucation will not be.acce•ted. Please •rant le
•ibl in inky or • .
�J PROPERTY INFORMATION
.`3
SITE ADDRESS a l Z ) Z3 rJ 4c/`.C- ` r
SUITE/UNIT M
ASSESSOR'S TAX/PARCEL M vcLzi -q -
? _q — LOT SIZE(sn
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach sepa•a1e page/a 1c,gew legal d«alpionl
PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING o PLUMBING
HANICAL
0 DEMOLITION O ELECTRICAL ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
gas 1I °C1 I' 01 .. - 1 % - rlifri rly d
-41
Pk)R Q—
'# -0
I
PROJECT NAME(Name of Business or Owner Last Name) < h Y1
PEOPLE INFORMATION
PROPERTY MANA
PRIMARY PHONE
/QCl )(LL -7770
MAIADRESS 444-
� CITY,STATE,ZIP' Ja,l ►
me 0 Cd' c.<J a(POO
CONTRACTOR COMPANY NAME APPLICANT NAME
UVf__ t n qday, � +�9Y Sail( OFFICE PHONE62
MAILING ADDRES y ,��_`QI ��-
2SDa ` r1 ,rr�(C� - Aug c� ,fiett-� fig. [.otesl49 ;ELL PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBERt 1
' U?_ /O 4, T V-Oct,- PIRATION DA/1'E FAX NUMBER -
CONTRACTORS REGISTRATION NUMBER copy of card required with each application]
Lt hi+S L.I 1�� f+ Q1r� O EXPIRATION DATE
�( [ .J ( 1 Cl / Z / oC
APPLICANT COMPANY NAME APPLICANT ME
�- e ?-r G�,r � �N 71i r OFFICE PHONE
MAILING ADDRESS t �J CITY,STATE,ZIP ��� CE PHONE
�o RISK" �3� eL caA Desen ( 2f) 77,0- 374P-9'
RELATIONSHIP TO PROJECT
O Architect 0 Tenant O Agent 0 Other(Describe FAX NUMBER
( )
CONTACT e. NAME/ iF�.! PRI ARY PHONE �/
'�r�-_� L/.i O� / Le0r/2" (jet i ( f) 77 -3 0 E-MAIL ADDRESS
`'
LENDER ���'LJ ! / 'C
Per ROW 19..27.09$: Lender tifP
almoh2c1...' NAME
required'�f project value
exceeds.$5,000:`
MAILING ADDRESS CITY,STATE,ZIP
DETAILED BUILDING INFORMATION
EXISTING USE
PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE
VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? O YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/R-QUIR,EDP 0 YES 0 NO
WATER SERVICE PROVIDER O LAKEHAVEN O HIGHLINE ❑ TACOMA
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ PCIVATE(WELL)
O HIGHLINE 0 PRIVATE(SEPTIC)
MAY-23-2005 14:38 FROM: TO:12538352609 P.2
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEM ENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS zasruo I rRorosw TOTAL t y' '•,fi ao 4r ay+ { ft gTstx'. r
"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.
MECFIANICAL
Value of Mechanical Work $ �� 1
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
PLUMBING
BATHTUBS(or7ub/sbooarCombo) SHOWERS WATER CLOSETS genet) e_ 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.
NAME/TITLE C/ Jnn C -Q ^dI / V
DATE
r
(Signature) `Title)RELATIONSHIP TO PROJECT 0 Owner o
ent a Contractor 0 Architect 0 Other
a h g?u b + s
) T ewtY ) e to� i f Y' loZ l v , r * 66 y}/
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Bulletin 4100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application