93-102183 CITY
F FEDERAL WAY
MIT NO:
335300Firstt Way South MECHANICAL P EI�:M I T PER ISSUED: 09/02/9353
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 03/01/94
ADDRESS:410 SW 322ND ST
NO. : 926490-1350
PROJECT DESCRIPTION:HVAC - INSTALL GAS FURNACE.
= OWNER —CONTRACTOR — LENDER
LEON MADDOX NORTHWEST WATER HEATER
410 SW 322ND ST 8201 DURANGO ST SM
FE L MAY MA 98023 TACOMA, NA WA 98499
814-4105 984-6404
NORTHMH103R2
FUEL TYPES.:GAS FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 1 DUCT MORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 10.00
GAS HMT • 0 MOOD STOVES...: 0 15-30 HP • 0
CONY BURNER: 0 FURN>100K • 0 30-50 HP • 0
BBQ • 0 MISC • 0 5+ HP • 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS
RANGE • 0 <:10,000 CFM: 0 ABOVE GROUND: 0
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
TOTAL FEES $ 30.00
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Inspection Record Mater Line OK Mechanical Inspection Notes:
GAS PIPING OK Date By
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO MORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL MAY REQUIREMENTS MILL BE MET.
OWNER OR AGENT ______ DATE
FILE COPY
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CITY OF FEDERAL WAY MECHANICAL PEIZA4IT PERMIT NO:
09/02/9353
33530 First Way South
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 03/01/94
ADDRE:S S:410 SW 322ND ST
NO. : 926490-1350
PROJECT DESCRIPTION:IIYAC - INSTALL GAS FURNACE.
INNER - ___...._.- - _ -_ ,..._._�___,,...- ___._.,...__._.�... .. �. :_ CONTRACTOR -:- _ _ :--_ ... __ .. _ LENDER
LEON MADDOX NORTHWEST WATER HEATER
410 SW 122ND ST 8201 DURANGO ST SW
FEDERAL NAY NA 98023 TACOMA, NA NA 98499
B75 984-6404
&
FUEL TYPES.:GAS FANS • 0 BOIIERS "-- FEES:
GAS PIPING.: 0 ft ROOD - 4 0-3 HP,F.....: 0- '.,.$17074NItagigkW NEC PRMT ISSUANCE... $ 20.00
FURN(LOOK..: I DUCT WORK 3 15 ,.: 0 �, 0 S. $ 10.00
GAS HIT • 0 WOOD STOVES...: 0 35-30 ,,.: ' a .c Y
CONY BURNER: 0 FURN)i ....: 0 ' 30-50 I(P ...:
880 • 0 MISC HP ' 0 .� 1;51:,:i7.-Cl'ir4i1..'
_.. :: '44,,,,,,,p01,,,,,-,t
GAS DRYER..: 0 AIR HA 114: •
\�, I4 -* I ° d ,Irl. �
RANGE • 0 <:10,r I s ` , ,I ' 1 SIVE: 4 ,
GAS LOGS0 > 10,000 C 1 -, p 4-, , ��
At ° ;* � TOTAL FEES B 30.00
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Inspection Record Nater line OK Mechanical Inspection Notes:
GAS PIPING OK Dat '^Q j' 7
PERMITS EXPIRE TOO DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISED BY ME IS TRUE AND CORRECT TO THE BEST OF NY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT Fig--,,�-% - DATE ._11-?„. .,?_____
FIELD COPY
Per 't ## RL q -d9 s• 3
'' CITY OF FEDERAL WAY XE
BUILDING PERMIT APPLICATION IN;/
— Please Print—
BOX 1 TENANT NAME:
OWNER . SITE LOCATION
OWNER'S ADDRESS I-1C0 , W 3-Q +- CITY N r� . PHONE S'`7'-- /C
DESCRIBE JOB tl.�c� C1 j nn i l l`UY 'CL('
THE PROPERTY IS OWNED BY: SINGLE/MARRIED X. PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME NlLt) l a)Q Un 'HD OQCONTRACTOR'S REG. # I k kT[-ftD f V 3R
_ Card MUST be presented
CONTRACTOR'S ADDRESS O r\c ' 1C O S+SLLCITY I� �0. PHONE Q?Lf
EXPIRATION DATE is01 at 3 U
— OR —
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON � �"��o l/�,C .V O PHONE QS1-I — L1,1-(0g
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST -1 EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER CUC Lic1( (•.�`'�
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIALJINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET t I )C- $
BATHTUBS NO. FURNACE, ELEC. GAS • $
SHOWERS GAS HOT WATER HEATER $
LAVATORIES CONVERSION BURNER $
SINKS BOILER, SIZE BTU $
DISHWASHERS AIR HANDLING UNITS $
ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $
LAUNDRY WASHER OUTLET UNIT HEATERS $
URINALS AIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER $
DRAINS $
OTHER $
TOTAL FIXTURES $
TOTAL MECHANICAL FEE $
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 PERMIT APPLICATION IS
MADE.I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(INCLUDING COSTS,EXPENSES,AND ATTORNEYS'
FEES INCURRED IN 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.
OWNER/AGENT: . / • J./tea,( DATE: •
ANP-008 3/90