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08-100743grry or 4A O 0�_ 00 7----3 Federal WOFrCEIVED PERMIT 393164 SF MF CO L PL DE EN FP COMMUNITY DE VELOPMENT SERVICES 333750+AVENUE50UFN MOX S V?_ CEIVED ByPEDRRALWAY.A9B.;.5 200a APPLICATION FVELOPMENT0V0 05.2507.FAa m PryIrn Ilnulu.dllMlrLdCl[IitI1f11t. [QRI The ollow I d6"hdn - an incomplete application will not be accepted. Please pr nt 1[#g.1bly or type. SITEADDPYSS 30915 28 AVE S SUITEMNIT # ASSESSOR'S TAX/PARCEL # 7984400040� _ _ - _ LOT SIZE (Sf) LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) (AIlach upnrofe Papalar LruOutU Irgal deseAPMnn! PROJECT• • TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING )t MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING CI FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlul RemovelReplace Gas Water Heater -- PROJECT NAME (Nome of Business or owner Last Name] PEOPLE•• • _ TrAlWRY PHONE PROPERTY OWNER SIMMONS, JAMIE { (20j)778-67-04 MAII INC2 AnnREss CTr1. 87YITC, ZIP 13423 11 AVE MARYSVILLE, WA 98271 G4JU6 iwul $ CONTRACTOR COMPMY NAME Apmimifr NAME FAST WATER HEATER COMPANY Carol Randall omtF s PHONE ( 800-f54-8955 011i.1No ADDRESS Crl'Y. SCATS. ZIP 12601 132ND AVE NE KIRKLAND, WA 98034 CELL PHONE ( ] - V CH Y OF FP.nFRAL WAY DUSiNCSS LICENSE NUMB" R WniA71ON DATE VAX NUMBER ( 425-$14-951-6 19-87-000047-00-BL 12/31/08 CONTRACPOWS itSRIsrRATIOR HUMAER F"MATION DATE IiMAn.AD!]RM FASTWW H948BC 1 /4/2010 12:00:OOAN APPLICANT I,:uJM i '.,`"'G I- - FAST WATER HEATER COI ( 800-454-8956 31SNI iNC] AflpCtESS CnY, STATE, ZIP CELL PHONE 12601 132ND AVE NE KIRKLAND, WA 98034 j PEIAMOH9HlP in PROJECT FAXHUMflER ❑ Architect ❑ Tenant ❑ Agent ❑ Other ( 425414-9516 PROJECT CONTACT LENDER NAME PerJtCW I9.27.095: lender information is required Vprcdect value exceeds $6.000 MM ING ADDIMSS CITY, STATE. ZIP PHONE ll ( 7 EXISTING USE PROPOSED USE _, C} EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ { SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO WATER SERVICE PROVIDER ❑ LAKEHAVEN (3 HIGH LINE ❑ TACOMA ❑ PRIVATE {WELL) SEWER SERVICE pROVIDER CI LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE {SEPTIC] AREA. BASEMENT FLRST SECOND THIRD i1DDlT TONAL FLOORS (DESCRI) DECK {p COVERED OR ❑ UN( GARAGE © CARPORT 0 NUMBER OF FLOORS PROPOSED FXISTING PROPOSED TOTAL. R� �. Sol FT. SIFT_. 7nrN- rcrnr.ry[L7rillO Rr 7Cinw17+nrfrird fly Tomr gr '+NEW HOMES ONLY'• NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ Indicate number of each type of fixture to be instnUed or relocated as part of this project. Do not include existing f fixtures to rema(n. Value of Mechanical Work (A COPY OP BID OR ESTIMATE MUST BE INCLUDED WITH APPLICA" 10N) ATING COOLERS GAS PIPE OUTLETS WOODSTOVU- BB 13B HANDLING UNITS EVAPOR85 FANS 1 GAS WA'Ti;RI•[GllTERS WSC (Descr}be) BOILERS FIREPLACE INSERTS HOODS (comme fig COMPRESSORS FURNACES RANGES DUCTS �^ GAS LOG SETS REFRIG. SYSTEMS s LAVS (samroamslnk+l URINALS MISC (Describe) BATHTUBS w7bb/Shvmrcnmbol VACUUM BREAM, DISHWASHERS RAINWATER SYST DRINIUNG FOUNTAINS SHOWERS WATER CLOSM, (NuoU ELECTRIC WATER HEATERS Sli'M WASHING MACHINES HOSE BIBBS SUMPS I certU2i under penalty gfperjury that X am the propsriy owner or authorized agent of the PrOPerty amner. I cerWy that to the best of my knowledge, cart the der pe salty suPudued to support 4r this permit Application is true and carrect. X certVV that I wilt comply with aft applicable city gFederal Way regulations pertaining to the work authorized by the issuance of a permit. X anderstantt that ilia tssaaacc of this pera¢It does not remove the owner's responsibllityfbr compliance with local, segte, orfederal laws regulating construction or eaulronm.ental laws. X further agree to hold harmless the City of ];Vderal Way as to any soanmi(icluding includin the undersigned, and flied so exPOMM and nays' aes the cull, but a le investigation and dgfense qr such clalloq, which mail be made by any P where such claim arises out of the reliance qr the city, including its a laera and employees, upon the accuracy +if the igarmation supplied to the city as a part qr this application. ATE 2/14108 SIGNATURE: pronerty Owner and/or Authorized Agent ❑ NEW o ADDITION BUILDING SHELL ONLY? ZONING DESIGNATION NEW ADDRESS REgUIRED? PLATTED LOT? a ALTERATION o REPAIR a TENANT Im PRO'(TEXENT a YES a NO BASIC PLAN? ❑ YES o NO CHANGE OF USE? o YES ❑ NO a YES ❑ NO UP%SEPA/SU? a YES a NO o YES a NO DEMO PERMIT REQMREI)? ❑ YES o NO Bulletin k190 --January 1; 2008 Page 2 of 4 MHandoutswennit Application