01-102839City of Federal Way CommunityDevelopment Services Plumbing Permit #: 01 - 102839 - 00 - PL
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: SAMPSON
SON '1(
Project Address: S 317TH Unit202 Parcel Number: 154180 0940
Project Description: PL - Replace electric hot water tank.
Owner Applicant Contractor
Cynthia Sampson FAST WATER HEATER COMPANY FAST WATER HEATER COMPANY
2506 S 317TH ST #202 FAST WATER HEATER COMPANY FAST WATER HEATER COMPANY
FEDERAL WAY WA 12601 132ND AVE NE 12601 132ND AVE NE
98003-5027 KIRKLAND WA 98034 (425) 814-8381
Plumbing Fixtures
Descri tion Quanti Description
Quantity Descri tion Quanti
Water Heaters 1
PERMIT EXPIRES January 16, 2002, IF NO WORK IS STARTED.
Permit issued on July 20, 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- - t° Date: —d- D
/� ` (it WI I � • -t—' � v�,G. l U lam. � o - 3 � o / G. c�.J
CONSTRUCTION PERMIT APPLICATION
APPLICATION NUMBERLO-1-4 q L - -
APPLICATION NUMBER:_ -
-The following'is require(! information - Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
SITE ADDRESS: 2506 S 317TH ST 202
■ PROPERTY INFORMATION '
ASSESSOR'S TAX/PARCEL #: 1541800940
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
,■ PROJECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ® PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
Remove/replace electric water heater
PROJECT
PROPERTYOWNER:
CONTRACTOR:
APPLICANT:
■ PEOPLE INFORMATION
NAME: DAYTIME PHONE:
Cynthia Sampson 12539417894
MAILING ADDRESS (STREET ADDRESS, CITY, STATE, ZIP):
2506 S 317th St #202 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
WP98034
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
19-87000047-00-bl
CONTRACTORS REGISTRATION NUMBER:
EXPIRATION DATE:
(copy of card required)
NAME:
DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS, CITY, STATE, ZIP): EVENING PHONE:
<Street> <Cit > ST <Zi >
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑TENANT ❑ OTHER (DESCRIBE):
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTORS j
E DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ 349.00
SPRINKLED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑HIGHLINE ❑TACOMA ❑PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
R40 7/6
**NEW RESIDENTIAL CONSTRUCTION ONLY** v
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 UNIT(S) EVAPORATIVE COOLERS) 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 ❑ G AS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) 1 WATER HEATER(S)
DISHWASHERS) RAIN WATER SYS. VACUUM BREAKER(S) is ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) WATER CLOSET(S) MISC. ( )
INTERCEPTOR(S) SUMP(S)
BLOCKDISCLAIMER/ 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' 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 sypplied to the city as a part o this appli tion.
j f 07/16/2001
1' NAME/TITLE: ���' ' DATE:
❑ PROPERLYOWNER ❑ APPLICANT CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION
❑ ALTERATION ❑ REPAIR
❑ TENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
BUILDING SHELL ONLY?
❑ YES ❑ ND
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES
i NO
SECTION TOWNSH P RANGE
NEWADDRESSREQUIRED?
YES ❑ NO ❑
PLATTED LOT? ❑ YES ❑ ND
CHANGE OF USE? ❑YES
❑NO