01-102873 City of Federal Way Mechanical Permit #:01 - 102873 - 00 - ME
Community Development Services
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: PODUCH
Project Address: 30216 28TH S Parcel Number: 798380 0180
Project Description: HVAC-Replacing gas water heater
Owner Applicant Contractor
Julia B Poduch FAST WATER HEATER COMPANY FAST WATER HEATER COMPANY
33310 18TH LN S#G304 FAST WATER HEATER COMPANY FAST WATER HEATER COMPANY
FEDERAL WAY WA 12601 132ND AVE NE 12601 132ND AVE NE
98003-8909 KIRKLAND WA 98034 (425)814-8381
Mechanical Valuation 1163 Over the Counter Permit Yes
PERMIT EXPIRES January 19,2002,IF NO WORK IS STARTED.
Permit issued on July 23,2001
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.
Owner or agent: 211U_ (,L tZlk Date: 71Z3/0
Mechanical rough-in: Date:
W1—
Gas pipe: Date: /
FINAL MECHANICAL: Date: S /6 I
--e RECEIVED BY ,
crr.or �"�IUMUNRYnFVFLOPMENTDEPA CONSTRUCTION PERMIT APPLICATION '
\>\> FEY11101111111111111 APPLICATION NUMBER: I - 0 id 3- Q !
RECEIVED BY — — _
r•nAofgn,INirry 1-1 \/FE OPMENT DEPARTMEN1PLICATION NUMBER: - -
APPLICATION NUMBER: - -
JUL 2 3 2001
**The following is required information—Please print(in ink)or type**
Please note: Electrical, Fire Prevention Systems and En tig permits may require a separate application.
,�*;,.,y:z ...••ria%
- • - ■ PROPERTY INFORMATION - - - -
SITE ADDRESS: 502- I(0 Z Sl L N ASSESSOR'S TAX/PARCEL #:.1-3 g3 .5S O V A % Q
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
y: . - • ■ PROJECT INFORMATION : - . . _ .
TYPE OF PROJECT(This application): ❑ BUILDING A • BING MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed des
iption):11 ii
1 lt� G-.'s wat-w 1CeaLt.--
PROJECT NAME: PO d/A,014)
- - ■ PEOPLE NFORMATION
PROPERTY OWNER: NAME:
A ,\' ,�/ DAYTIME PHONE:
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): l 1
t o o '�
30 2 i (4, 2 s `r''` C..�-tee. 5 -f--e� Q�� i
CONTRACTOR: NAME:
( - Tv 0 a e` - Oti ( DA ME PHONE:
Ln1 ea -e44- IF) gZv - Si 48ri
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
12-toLtOt (2L{ S%A- X13v, \..,..d ?Rs(I (4M1 (cI
Zo - 884 -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
1 � - q ¶ t 0 4 a - k (`1Z --) &?o -7B) Co I
CONTRACTOR'S REGISTRATION NUMBER:
4 EXPIRATION DATE: i
(copy of card required) C- � az 0 -} 0 'i 5 P _ '- / („ / oz
APPLICANT: NAME: DAYTIME PHONE: I
�(tA-�-- iNt e ,I ( ) �Sz a -- 8 8tia
MAKING ODRESS STR�ADDRESS;ClSTATE,ZIP): EVENING PHONE:
C TI 11// `J S/70 .8-6-qk I
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT CIOTHER(DESCRIBE): ) 7()�7 --rc /-
/ C I
E-MAIL ADDRESS: -
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT,CONTRACTOR
- - - _ -■ DETAILED BUILDING INFORMA
TION - - .- --
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
I PROPOSED USE: PROPOSED VALUATION \\ .Q 2 '
FOR IMPROVEMENTS: $
\i\( SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO ,
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
MI6 .
•
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
•-PRO]ECT FLOOR AREAS _
FLOOR EXISTING SQ. FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
= ='FiXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC. ( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HE ER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
_` :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 whet such CI -m arises out of the reliance of the city,including its officers and employees, upon the accuracy
of the informati suppli-y9to t • ' as a part of this application.
I i
NAME/TITLE: DATE: r6 I Z l 0 (
❑ PROPERTY OWNER q�APPLICANT ❑ CONTRACTOR /
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO
COrvaurlrry nrvrl nrrarrrr`,ER`:ICE`•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDFRAl WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129