06-106401 City of Federal Way Plumbing Permit #: 06-106401-00-Pi_
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253)835-3050
Project Name: HARTMAN
Project Address: 36625 9TH AVE SW Parcel Number: 302104 9143
Project Description: Replace existing electric hot water tank with new electric hot water tank.
Owner Applicant Contractor
DAVID HARTMAN DAVID HARTMAN DAVID HARTMAN
36625 9TH AVE SW 36625 9TH AVE SW 36625 9TH AVE SW
FEDERAL WAY WA 98023 FEDERAL WAY WA 98023 FEDERAL WAY WA 98023
Plumbing Fixtures
Water Heaters 1
PERMIT EXPIRES Friday, December 19, 2008
Permit Issued on Wednesday, December 20, 2006
I hereby certify that the above information is correct and that the construction on the above described property and
the of uncy 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 Cs, 'd Date: / Z( Q. 7o &
yy vv
THIS CARD IS TO REMAIN ON-SITE - h
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 06-106401-00-PL
Owner: DAVID HARTMAN
Address: 36625 9TH AVE SW
FEDERAL WAY, WA 98023-7230
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 Plumbing Groundwork(4190) ❑ Rough Plumbing(4230) ❑ Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date By Date By Date
0 Final-Plumbing(4075)
Approved n
By ate /Q t 5,rY
CITY OF ""�a�.✓ RirCED ' ./
Federal Way PF,RVIIT w ' �� G � -
COMMUNITY DEVELOPMENT SERVICESflEC 2 U 2OO(- SF MF CO ME EL,6111111E EN FP
33325 8TH
FEDERAL
NUE WAY,WA
PO BOX 9718 �L I C A T I 0 __
FEDERAL WAY,WA 98063-9718 . ,_ TD
253-835-2607.FAX 253-835-2�y.��OF FE L �1`www.cittioffederalwau.com DEPT.
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink) or type.
• .. ■ PROPERTY INFORMATION •• '
LSITE ADDRESS 3 ` qrN ht,k S H/ Lii , -I SUITE/UNIT #
ASSESSOR'S TAX/PARCEL # ? LI Z / J C - 9 / 41 J LOT SIZE (sf)
LEGAL DESCRIPTION (e.g.Acme Estates, Lot 1)
(Attach separate page for lengthy legal description)
■ PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING I? PLUMBING ❑ MECHANICAL
.1] DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only)
ft di,4 I.A i•-.1 fiYY,_. J f •—_ 1 2- 5/1. .L.- i. j i • i✓✓(4,4, L{..e'„,1 ipi, w/ s o y/i i.'-.
f -'-�, r o .v l-- / l� / '
PROJECT NAME(Name of Business or Owner Last Name) 144# 4— ..✓\ .
■ PEOPLE INFORMATION
s,3t
PROPERTY NAMEPRIMARY PHONE
OWNER DAV.:cj /4 A t2.(rt,A,,J (6 7y) 11 q u
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
3 C 6 Lf Cr3 /2 i J ./ f(16 A,kl S-.i '16 �1
CONTRACTOR COMPANY/��) NAME APPLICANT NAME OFFICE PHONE
M7CILING ADDRESS CITY,STATE,ZIP - CELL PHONE .
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER • '
( ) -
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
COPY of card required t,
with each application I V
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADDRESS • - CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT - FAX NUMB ER
❑ Architect 0 Tenant 0 Agent 0 Other ( )
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT `- w 1"v' () -
LENDER NAME )fRCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
\ i 1 _
.. - . •• ■ DETAILED BUILDING INFORMATION l I .
EXISTING USE •ROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ �� VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES 0 NO�FI OPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑ NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
( 2`-r 7
■ PROJECT FLOOR AREAS ,
AREA DES • PTI•N EXISTI G PROPOSED TOTAL
SQ. FT. •. FT. SQ. FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑ COVERED OR ❑UNCOVERED?)
GARAGE ❑ CARPORT ❑
EXISTING PROPOS l TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
NUMBER OF FLOORS
**NEW HOMES ONLY** NUMBER OF BED ROOMS ESTIMAT- D 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.
MECHANICAL
Value of Mechanical Work $ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
• AIR HANDLING UNITS EVAPORATIV "OOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS ANS GAS WATER HEATERS MISC(Describe)
BOILERS _ '' PLACE INSERTS HOODS(commerdaq
COMPRESSORS FUR •CES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
_ BATHTUBS(or Tub/Shower Combo) LAVS(eathroom sink.) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(roue)
1 ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS •
SIGNATURE
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. � I I
NAME/TITLE p 19 -� DATE / 2-(.2-`'A F
(Signature) (Title)
RELATIONSHIP TO PROJECT .et-owner ❑ Agent 0 Contractor ❑ Architect 0 Other
1
•.cs� 4
?. ®R °..z. s'
❑NEW ❑ADDITION ❑ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES o NO BASIC PLAN? o YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES ❑NO UP/SEPA/SU? ❑YES ❑NO
PLATTED LOT? ❑YES o NO DEMO PERMIT REQUIRED? ❑YES ❑NO
J
Bulletin#100—January 1,2006 Page 2 of 4 k\Handouts\Permit Application