04-103990 AF+ J . ate•
City ot Federal Way '
CominimityDevelopment Services
Mechanical Permit #: 04 - 103990 - 00 - ME
P.O.Box Ct718
Federal Wiry,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-305C
Project Name: MATLICK/Wei
Project Address: 32622 6TH'SW Parcel Number: 926491 0010
Project Description: Remove/replace GAS water heater
Owner Applicant Contractor
David I Matlick &Elizabeth A Matlick FAST WATER HEATER COMPANY FAST WATER HEATER COMPANY
32622 6TH AVE SW 12601 132ND AVE NE 12601 132ND AVE NE
FEDERAL WAY WA KIRKLAND WA 98034 KIRKLAND WA 98034
98023-5623 (425)814-8381
Mechanical Valuation 449 Over the Counter Permit Yes
PERMIT EXPIRES March 29,2005.
Permit issued on September 30,2004
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. f
Owner or agent: L GL��ptc- 4-t1 dl�- Date: /c�7 (e)`f
' 0 Yv
THIS CARD IS TO REMAIN ON-SITE d * "4.
CITY of Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-103990-00-ME
Owner: DAVID I MATLICK
Address: 32622 6TH AVE SW
FEDERAL WAY, WA 98023-5623
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) ❑
By Gas Piping(4125) 13 Final-Mechanical(4065)
By
Approved Approved to release test Approvedr
By Date Date /� Date /0J'7101
to
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, r i Way RECEIVED PERMIT
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7530 FIRST Eir Scorn•PO BOX 97111
MORAL 1S7AX5 ;,S3 1FX253 � SEP3APPLICATION D
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':"fue ollo • is •ui a;• `( 1,• 'I -.4 irtco rete a• •lication will not be acce•ted. Please • nt le•1hZ
...tit-E:•" ': -+-= N.n trucJ or
PROPER • 1' • •it t• •
SITE ADDRESS 32624 AVE.CWS FFI)FRAI.WAV,WA Q8073 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL t ....,92649,10410_ _ — - _—. _ —. ` LOT SIZE(sn
LEGAL DESCRIPTION (e.g.Acme Estates, Lot 1)
Mr..w sgrawsug pawl«+e.yd+y legal desoip►on(
PROJECT INFORMATION
PE OF PERMIT Cl BUILDING ci PLUMBING XMECHA2iICAL
❑ DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
I
I-I OJECT DESCRIPTION(Provide detailed description of work included on this permit only)
Remove/ReDlace Gas Water Heater
1
1
PROJECT NAME(Name of Business or Owner Last Name)
IIIi
PEI'',Fri 1 IJP 7 4 riA1'1'71 Y.4 v
PROPERTY NAME PRIMARY PHONE
OWNER MATLICK.ELIZABETH (2531874-9380 j
MAIUNG ADDRESS CITY,STATE,ZIP --,
3222 6 AVE SW FEDERAL WAY,WA _98023
pQNTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
4.1
i, FAST WATER HEATER COMPANY (4251814-3124
I. AI
MLING ADDRESS CITY.STATE,ZIP CELL PHONE
I 12601 132ND AVE NE KIRKLAND WA 98034
CITY OF FEDERAL WAY BUSINESS UCENSE NUMBER EXPIRATION DATE FAX NUMBER
-8 7---0 -0-0- 0-4-7— _0 .0- B L 425 814-9516 H
CONTRACTOR'S REGISTRATION NUMBER loopy tot arid required•it1 eaeD applicctioaj EXPIRATION DATE I
EASTW_HC052DE 02/16/2005 - i
APPLICANT COMPANY NAME APPUCANT NAME OFFICE PHONE
S
MAILING i Or •' ' 1 CITY.STATE,ZIPI
CELL.PHONE ,t.
( RELATIONSHIP-TO PROJECT FAX NUMBER Al
I:1 Architect a Tenant a Agent a Other(Describe)
CONTACT NAME __ _.. PRIMARY PHONE E-MAIL ADDRESS
i
LENDER per R +4 I:W 19.27.095: Loader 1nj/ort•iattoit is 't_ NAME '�
�
'rogulf�Ject maws excoodi$5,000"--.
MAILING ADDRESS CITY,STATE,ZIP ii
.t J
• at :ii4a$•J: t1 • i' ad • 'I I • k
EXISTING USE PROPOSED USE i
EXISTING ASSESSED/APPRAISED VALUE $ i OF PROPOSED WORK $ $449 nn
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES a NO f
WATER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE a TACOMA a PRIVATE(WELL) "
SEWER SERVICE PROVIDER a LAKEHAVEN D HIGHLINE 0 PRIVATE(SEPTIC) i•
.M^.
.• PROJECT FLOOR AREAS 4.
......• AREA DESCRIPTION - EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL .,
BASEMENT
I
FIRST '
SECOND
THIRD -- ""—
FOURTH {
ADDITIONAL FLOORS(DESCRIBE) --- - j,
DECK(COVERED?) --
is
' GARAGE/CARPORT
HOW MANY FLOORS? TOTAL=VIRG TOTAL PROPOSLD TOTAL Lloerwo AND morocco
i••NEWHOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ �!
FIXTURES
Indicate number of each type of future to be installed or relocated as part of this project. Do not include existing futures to remain. i
!MECHANIC-AL i:
Value of Mechanical Work $
MR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODSterwrru.tl WOODSTOVES ,
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES X. GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING '
BATHTUBS(.r Tub/Shower Combo) SHOWERS WATER CLOSETS(1 j __, MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS i+
LAVS isms.&Wei VACUUM BREAKERS ELECTRIC WATER HEATERS
�
AIMER/SIGNATURE BLOCK '`
DISCL
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 I"
arises out of the reliance of the city,including its officers and employees,upon the accuracy of the information supplied to the as a part of'
this application. city1
NAME/TITLE .�-0 --> e00"'" _ Permit Mar DATE 09/28/2004 L L.
ISiVnaturc) (Tide)
RELATIONSHIP TO PROJECT a Owner 0 Agent Xi Contractor 0 Architect n Other _ jai,
FOR OFFICE USE.ONLY '.
o NEW a ADDITION a ALTERATION o REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES o NO BASIC PLAN? a YES o NO
ZONING DESIGNATION CHANGE OF USE? a YES o NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? _ o YES a NO _i'
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? __._ u YES a NO
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Bulletin#100-March 30,2004 Page 2 of 4 kV landouls-Revised\Pennit Application ;` 1