01-103785City or Federal way Plumbing Permit #: 01 - 103785 - 00 - PL
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: LIFE CARE CENTER
Project Address: 1045 S 308TH 5+ Parcel Number: 082104 9042
Project Description: PLUMB - Remove and replace electric water heater
Owner Applicant Contractor
FEDERAL WY CONVALESCENT C FAST WATER HEATER COMPANY FAST WATER HEATER COMPANY
FAST WATER HEATER COMPANY FAST WATER HEATER COMPANY
12601 132ND AVE NE 12601 132ND AVE NE
KIRKLAND WA 98034 (425) 814-8381
Over the Counter Permit......................................Yes
Plumbing Fixtures
Description Quanti Description IQuantif Description Quantit
Water Heaters 1
PERMIT EXPIRES March 25, 2002, IF NO WORK IS STARTED.
Permit issued on September 26, 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: e (a
Plumbing rough -in:
FINAL MECHANICAL:
Date:
Date:4ZL1_11
Al";
CONSTRUCTION PERMIT APPLICATION
APPLICATION NUMBER` -:>_
t 0 i $� �` APPLICATION NUMBER: — — — — — — — — — —
T llowin required information - Please print (in ink) or type"
Please note: Electrical;' Fire Prevention SysEa�and Engineering permits may require a separate application.
SITE ADDRESS: 1045 S 308th St
ASSESSOR'S TAX/PARCEL #: 0821 0jb042
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): ❑ BUILDING 0 PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
Remove/replace electric water heater
PROJECT NAME: Life Care Center
PROPERTYOWNER:
CONTRACTOR:
APPLICANT:
NAME: DAYTIME PHONE:
Life Care Center of Federal Way 12539462273
MAILING ADDRESS (STREET ADDRESS, CITY, STATE, ZIP).
1045 S 308th St Federal Way WA 98003
NAME: DAYTIME PHONE:
Fast Water Heaters Company (SEA) 14258143124133
MAILING ADDRESS (STREET ADDRESS, CITY, STATE, ZIP): EVENING PHONE:
12601 132nd Ave. N.E. Kirkland WF98034
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
19-87000047-00-bl
CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required)
NAME: I DAYTIME PHONE
MAILING ADDRESS (STREET ADDRESS, CITY, STATE, ZIP): EVENING PHONE:
<Street> <Cit > ST <Zip>
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑TENANT ❑OTHER(DESCRIBE):
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONT
EXISTING USE:
PROPOSED USE -
SPRINKLED BUILDING?
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED VALUATION FOR IMPROVEMENTS: $ 349.00
❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑YES
❑ LAKEHAVEN ❑HIGHLINE ❑TACOMA ❑PRIVATE (WELL)
❑ LAKEHAVEN ❑HIGHLINE ❑ PRIVATE (SEPTIC)
❑ NO
R4U 7/6
*='`NEW RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS' ESTIMATED SELLING PRICE:
FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
0
FIRST
0
SECOND
0
THIRD
0
FOURTH
0
OTHER FLOORS (DESCRIBE)
0
DECK
0
GARAGE
HOW MANY FLOORS?
0
TOTAL:
0
0
0
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNITS)
EVAPORATIVE COOLER(S)
GAS LOG(S)
REFRIG. SYSTEM(S)
BBQ(S)
FAN(S)
HOODS)
WOODSTOVE(S)
BOILER(S)
FIREPLACE INSERT(S)
RANGE(S)
MISC. ( )
COMPRESSOR(S)
FURNACE(S)
DUCT(S)
GAS PIPE OUTLET(S)
HEAT SOURCE: ❑ ELECTRIC ❑ G AS
PLUMBING
BATHTUB(S)
LAVATORY(S)
URINAL(S) 1
WATER HEATER(S)
DISHWASHER(S)
RAIN WATER SYS.
VACUUM BREAKER(S) 0
ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S)
WASH MACHINE OUTLET
GAS PIPE OUTLET(S)
SINK(S)
WATER CLOSET(S)
MISC. ( )
INTERCEPTOR(S)
SUMP(S)
7TSC1 OTMFR/STrNATURF RLC
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' fee 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 suppli o the pity as apart of th' ppl' tion.
NAME/TITLE: 9% DATE:09/21/2001
❑ PROPERLY OWNER AIMPLICANT CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION
❑ ALTERATION ❑ REPAIR
❑ TENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
BUILDING SHELL ONLY?
❑YES ❑ NJ
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES
L NO
SECTJDN TOWNSHIP RANGE
NEW ADDRESS REQUIRED?
YES ❑ NO ❑
PLATTED LOT? ❑ YES ❑ ND
CHANGE OF USE? ❑YES
CVO