08-103887City of Federal Way
Community Development Services Mechanical Permit-,,. 08 -103887 -00 -ME
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835.2669 Inspection Request Line: (253) 835-3050
Project Name: VANWOERDEN
Project Address: 917 S 295TH PL
Parcel Number: 515180 0050
Project Description: Replace/relocate gas water heater
Owner
Applicant
Contractor
DIRK VANWOERDEN
KARL EMIG
EVERLAST PLUMBING LLC
917 S 295TH PL
EVERLAST PLUMBING LLC
EVERLPL955PJ (10/16/09)
FEDERAL WAY WA
402 RAILROAD AVE S
402 RAILROAD AVE S
98003-3715
KENT WA 98032
KENT WA 98032
Additional Permit Information
Mechanical Valuation............................................3000 Is this an Online or O.T.C. application? ................ Yes
Mechanical Fixtures
Gas Piping....... ......... 1 Hot Water Tank ............................. 1
PERMIT EXPIRES Tuesday, February 10, 2009
Permit Issued on Thursday, August 14, 2008
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 a in accordance with the laws, rules and regulations of the State of Washington
and City of Federal Way.
Owner or
Date:
THIS CARD IS TO REMAIN ON-SITE
CITY OF k.ommunity Developnitnt Inspection Record
Federal WayIVR INSPECTION REQUEST PHONE # (253) 835 3050
PERMIT #: 08 -103887 -00 -ME
Owner: DIRK VANWOERDEN
Address: 917 S 295TH PL
FEDERAL WAY, WA 98003-3715
This card is part of your required inspection documents. Scheduled inspections maybe failed if this card is not on-site. b N T LOSS 1
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.
❑ Mechanical Rough -in (4165)
Approved
By Date
❑ Gas Piping (4125)
Approved to release test
t. By Date
❑ Final - Mechanical (4065)
Approved
By Date
L�L
For inspector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
CITY b� ��J� �W
Fi�dera ay 14 ZV% PERMIT
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33325 SM AVENUE SWATH • &7 80X 9718���A� L I C AT I N
FEASRAL WAY. WA 98Q63.9718
25,435-2,07• FAX 259 3
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MAILING ADDRESS
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CITY, STATE, ZIP
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E-MAIL ADDRESS
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The fallowing is required ir4formation -an incomplete application will not be accepted. Please print legibly (in in/) or type.
PROPERTY•- •
SITE ADDRESS _2
) -7 S• SUITE/UNIT #
ASSESSOR'S TAX/PARCEL #
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ,a PLUMBING ❑ MECHANICAL
LOT SIZE (sj)
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRWTION (Provide detailed description of work included on this permit only)
PROJECT NAME (Name of Business or Owner Last Name) _1IC
PROPERTY
OWNER
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAME
PRIMARY PHONE
t co
(Z53 )13
MAILING ADDRESS
of '"
CITY, STATE, ZIP
'w
E-MAIL ADDRESS
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�I a
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
jEwe d G lu
CITY, STATE, ZIP
(Z';3) Lsl - 19ez�
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
�I a
b Z
-
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
( )
CONTRACTOR'S RROISTRATION NUMBER
EXPIRATION DATE
E-MAIL ADDRESS
C vir' L P L_ Cl S"; -Q
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
( ) -
NAME PRIMARY PHONE E-MAIL ADDRESS
?-Zfy- 5-L
NAME
Per RCW 19.27.095.
Lender Wornwtion is required i(profect value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
EXISTING ASSESSED/APPRAISED VALUE
PROPOSED USE
VALUE OF PROPOSED WORK $
SPRINKLERED 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)
f PROJECT FLOOR AREAS
AREA DESCRIPTION
EXISTING
SQ. FT.
PROPOSED
SQ. FT.
TOTAL
SQ. FT.
BASEMENT
_ ��� GAS WATER HEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
FIRST
COMPRESSORS
FURNACES
RANGES
SECOND
GAS LOG SETS
REFRIG. SYSTEMS
o YES o NO
THIRD
o YES
a NO
PLATTED LOT?
ADDITIONAL FLOORS (DESCRIBE)
DEMO PERMIT REQUIRED?
o YES
a NO
DECK (❑ COVERED OR ❑ UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
=91150
PROPOSED
TOT.u.
TOMA+. EXMrRro sr
roru.PROPOSED er
2WAL Sr
"REW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECBAMCAL
Value of Mechanical Work .$
(ACOP OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS PIPE OUTLETS WOODSTOVES
BBQS
FANS
_ ��� GAS WATER HEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
HOODS pommard4
COMPRESSORS
FURNACES
RANGES
DUCTS
GAS LOG SETS
REFRIG. SYSTEMS
PLUMBING
BATHTUBS (or7Lb/Shower Combo)
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
LAVS (eaftwm shdo URINALS MISC (Describe)
RAINWATER SYST VACUUM BREAKERS
SHOWERS WATER CLOSETS gouay
SINKS WASHING MACHINES
SUMPS
I esrtifg under penalty of perjury that I am the property owner or authorised agent qj the property owner. I cerft that to the best of my
knowledge, the information submitted in support of this permit application is true and correct. I eertft that I will comply with all applicable
City of Federal Way regulations pertaining to the work authorised by the issuance of a permit. I understand that the issuance of this permit
does not remove the owner's responsibility for compliance with local, state, or federal laws regulating construction or environmental laws.
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 elainq, which may be made by any person, Including the undersigned, and filed against the city, but only
reliance of the city, including its officers and employees, upon the accuracy of the Information supplied to
where such claim arises out oft
the city as apart of this applJo6tion,
SIGN
Authorised Agent
1
o NEW o ADDITION
0
o ALTERATION
a REPAIR o- TENANT IMPROVEMENT
BUILDING SHELL ONLY?
o YES o NO
BASIC PLAN?
a YES
a NO
ZONING DESIGNATION
CHANGE OF USE?
o YES
o NO
NEW ADDRESS REQUIRED?
o YES o NO
UP/SEPA/SU?
o YES
a NO
PLATTED LOT?
a YES a NO
DEMO PERMIT REQUIRED?
o YES
a NO
Bulletin #100 — January 1, 2008 Page 2 of 4 k\Handouts\Pemiit Application