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04-104094 4Ct y of Federal Way Mechanical Permit #: 04 - 104094 - 00 - ME Conununity DeYelopment Services P.O.Box 9718 Federal Way,WA 98063-9718 Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050 Project Name: JACKSON Project Address: 2121 S 277TH pl Parcel Number: 757562 0180 Project Description: Replace gas hot water tank. Owner Applicant Contractor Anthony D Jackson &Monica Jackson FAST WATER HEATER COMPANY FAST WATER HEATER COMPANY 2121 S 277TH PL 12601 132ND AVE NE 12601 132ND AVE NE FEDERAL WAY WA KIRKLAND WA 98034 KIRKLAND WA 98034 98003-6954 (425)814-8381 Mechanical Valuation 449 Over the Counter Permit Yes PERMIT EXPIRES April 4,2005. Permit issued on October 6,2004 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. See Application Owner or agent: on Date: /0 - '7 - U 41 THIS CARD IS TO REMAIN ON-SITE CITY OF Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT #: 04-104094-00-ME Owner: ANTHONY D JACKSON Address: 2121 S 277TH PL FEDERAL WAY, WA 98003-6954 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. ❑ Mechanical Rough-in(4165) ❑ Gas Piping(4125) ❑ Final-Mechanical(4065) Approved Approved to release test Approved By Date By Date By %�. Date /0*' • v c•40 - , libiguNpRECEIVED BY _0_1 — _ . IX . , It1196 Frfederai -i DEVELOPMENT BEMIRE R M I T SF TAF CO 419 ,,L -oPL DE I''..N FPumuiffrrmvu.orhivcrs-Fiwcr.:, ,.. _ _ l;3°FiRsT"rscyr"."."9nOCT 06 ?APPLICATION 1 WAY,WA `111041 v7la PO 44,1-4 115..F.4.11.253401 4121 iri..) ,,, ..............,./ ... I kmiartilifetAkiNIV CV2., The oflowtn i-s re.tared in orrnation-an tncom tete a •lication will not be acce•ted. Please •rint le!(big(in in or t PROPERTY INFORMATION SITE ADDRESS 2121 S 277 PL,,FEDERAL WAY,WA 48(101 _ -- --- SUITE/UNIT / ASSESSOR'S TAX/PARCEL * 75756201.80 z, - - - -- -- - LOT SIZE LEGAL DESCRIPTION (c(1 el<11.i.E.,i(itcs, bit 1) kl' ., — - _ -- ,.., {Attu,4,k 1,.1,14.0.t y.wc fut torto.,10 Ai Loyd air 016 al 10..1 . PROJECT INFORMATION TYPE OF PERMIT LI BUILDING t'l PLUMBING XMECHANICAL il DEMOLITION t.) ELECTRICAL n ENGINEERING Ci FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Thoerde detailed descnp(ion of work included on!los perfnit only) Remove/ReialaceGas Water Heater _„ PROJECT NAME (Name of flusuows or Owner Lost Name) .„„.... _ PE4 T:TE VrE'XIMAVII U PROPERTY NANtr, PRNACtY PI(ON r ' ' - OWNER JACKSON.ANTHONY (2531946-4611 IMAII.Th(i At q IRE-S.N CIET,STATE.ZIP 2121 S 277 PL , FEDERALWAY,..WA, 98003_ ... . CONTRACTOR COMPANY NAME APPLICANT NAME (ii-lia iiibut: - - FAST WATER HEATER COMPANY - (425814-3124 ..-.4Alf.hi-.7,1)oiii 4,,if ,STATE,ZIP CEU.PHONE 12601 L32NIRKLAND...WA_ 98034. .. . CITY OE I.EBEFUO,WAY BUSINESS UCENSE NUMBelt EXPIRATION DATE EAX NUMBER - -87 -_0 -0 -0.. 0- 4-.7— _0 0Th L 425 814-9516 ( - )iik1:.:4..SiWIIT)T1 iiiiitiinir V0.--iiZi;(1.revitat;4;itia ci WiiaTial-----" ---- Exii ui 61'4 rim F, FASTWHC052DF 02/16/2005 _ .. APPLICANT coNArve riAmt.; - — APPLICANT NAI,4 ' ----- - ----—61-'11CL 11“INk- -, . P-A-11.1Nii AliBRE-SS--- CITY,STATE.Eli . -- t..ELL 14-16i717 Ni',...;,11iti:V,I'ii 6 ri5FEC FA Y NUMBF le I I Ar(hitert (I Tenant f'I Agent r ()the! (Describe) _..,..:-_- CoNT A("i' i....41..— --- PKIMARy PtIONe -'' - I P-MAII,A14,11.1-,,,,S -- -- - — : .I -------- -'-- , -- ,— , ,.... . ' ' . LENDER Per RCW'19.27.095: Lender information is'. • NAME - required if project value exceeds$5,000' ^ mAttlt4,3 Anbc-TETs cl-ri,'KATE,ISIA DETAILED BUILDING INFORMATION _ EXISTING USEPROPOSED USE _ EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ $449.00 . „ „ • SPR1NKLERED BUILDING? LI YES I I NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRE!)? t i YES ) NO WATER SERVICE PROVIDER n LAKEHAVEN LI HIGIILINE II TACOMA o PRIVATE(WELL) , SEWER SERVICE PROVIDER n LAKEHAVEN ti IIIGILLINE ii PRIVATE(SEPTIC! _ ..... _ • PROJECT FLOOR AREAS AREA DESCRIPTION � EXIS_TING S Q. FT., PROPOSED SQ.FT, BASEMENT TOTAL- FIRST _ SECOND -_ __ __ THIRD F()111(1 f t j . ' _ .. ____.._... _ i ADDITIONALFL(>t>I:S(I);;S(_'kffiE) I)I•:('I: (t'OVt;PEI1•P) __ . i GARAGE/CARPORT 0W MANY FL©OR:i? TOTALckistP6 -TOTAL1.10n.5Ll —j roisi.mirt Iimartin LTD Ron, � "NEW HOMES UNI.Y' NUMBEROE OF BEDROOMS_._ __ _... ESTIMATED SELLING !'WC . $ !} FIXTURE'S Indicate number of each tura'of fixture to be installed or rrineated as pan of this project. Do not include existing fixtures to remain. MECHANICAL __... _._ _. __ _ _ _ . _- , Value of AI,'ch,:n:cu? Worii. $__ —_ AU ;IA(()LING UNIT- _ EVAPORNf3VE:C(X)LERS GAS(AXIS ., I?F.F"IZIO SYSTEMS r hi NS FANS — 1(Ol)1)ti,t•,,,,.miprr.a, ,- W'tX)I,STOVES „ BOILERSFIREPLACE INSERTS RANGES T- MISC.(I)ca,:t e) COMI'RESS(>RSFURNACES X GAS WATER HEATERS I 1C:'I`s GAS PIPE OUTLETS PryrrMrlrNc (( op Tuhw fsrr.r cc^.,Frot -__— SHOWERS WATER(:U)SETS t-,,.,.• _ ',MSc;I1:••ccnir,F PI PWA`IHER* SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMP RAINWATER SYST WAS))INO MAC'FHINESURINAI a IIOSE mons IAV:-.,«t.ctuw..8,,,k1- _^ 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 mads 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 �-:.::l,` ,T :- :.. - .Permit Mgr _ DATE 10105512004 .._ — RELATIONSHIP TO PROJECT :i Owner ii Al;cut X Contrzu for :: Arrhutr(t LI Otht•,r _._ _. FOR OFFICE USE ONLY l o NEW ::ADDITION o ALTERATION REPAIR c TENANT IMPROVEMENT - _ __. BUILDING SHELL ONLY? t t YES o NO BASIC PLAN? u YES r NO i ZONING DESIGNATION CHANGE OF USE? C3 YES r NO 1 NEW ADDRESS REQUIRED? r)YES r, NO UP/SEPA/SU? t:YES t:NO PLATTED LOT? - I i YES ,: NO _ - DEMO PERMIT REQUIRED?_ _ :.YES L.NO - i • I IIultctiit PIG() ht,ucIi 3u.2001 1'11gc 2 of4 k'.Ilan louIts cvia•tl1I'nnull A1p1ica(tPiz