92-101927CITY OF FEDERAL WAY
33530 First Way South
Federal Way, WA 98003
661-4000
MECHANICALPERMIT PERMIT NO.: BLD92-23§7
BUILDING INSPECTION - 661-4140 ISSUED: 11/04/92
BY: KC
SITE ADDRESS: 34604 28TH PL SAP
PARCEL NO.: 011460-0150
PROJECT DESCRIPTION; HVAC e INSTALL GAS HOT WATER HEATER
OWNER CONTRACTOR
SUSAN DUTTON AMERICAN HEATING SERVICE, INC.
34604 28TH PL SW 7517 PORTLAND AVE.
FEDERAL WAY WA 98023 TACOMA WA 98404
-6991 847-8399
AMERIHS083M5
FUEL TYPES.:GAS
GAS PIPING.: 0 ft
FURN<100K..: 0
GAS NWT..... I
CONV BURNER: 0
BBO........ : 0
GAS DRYER..: 0
RANGE....... 0
GAS LOGS...: 0
Water Line OK
L,AS PIPING OK
FANS..........: 0
HOOD..........: 0
DUCT WORK.....: 0
WOOD STOVES...: 0
FURN>100K.....: 0
MISC.. •0
AIR HANOLING UNITS
.4=10,000 CFM: 0
a 10,000 CFM: 0
I CERTIFY THAT THE INFORMA
OWNER OR AGENT
6Ld meth 07/01/92
BY
LENDER
BOILERSICOMPRESSORS FEES:
0-3 HP......: 0 MEC PRMT ISSUANCE... S 20.00
3-15 HP.....: 0 MEC APPLIANCE FEES.* S 6.50
15-30 HP....: 0
30-50 HP....: 0
5+ HP.. 0
FUEL TANKS ---------
ABOVEGROUND: 0
UNDERGROUND.: 0 TOTAL FEES S 26.50
INSPECTION RECORD
Mechanical Inspection Notes;
Date By
--t: -
l
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORk ISrSTARTED. C!�
AE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLI CITY OF FEDERAL �f PS f M� r L B MET.
DATE ��
�;rU'n[V ❑ mr r Per i # ET -- -2-- '5s.
���llfKi�'rDEVELC?iJ:Ett'� p�P,,l�i1N1� �Z
CITY OF FEDERAL WAY 7
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME: L,
OWNER ��`►' r�� c+rt
OWNER'S ADDRESS "
DESCRIBE J08 VIS 6 /K I' 46
THE PROPERTY IS OWNED BY: SINGLEIMARRIEO
BOX 2 CONTRACTOR'S NAME MLRIQA lrA-0&36 :INCONTRACTOR'S REG. mil' 7 I J�.h�S
FFCY " Wawa.. "
CONTRACTOR'S ADDRESS �� c��Qr� � _ { � CITY � PHONE
EXPIRATION DATE 7- S C1 3
—OR—
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS ANO SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON PHONE
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER �� I
LEGAL DESCRIPTION
If necessary, please submit a separate page with the legal description.}
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Exist! ng/Pro posed) 1ST FLOOR I 2ND FLOOR i
3130 FLOOR lJ BASEMENT _ J DECK l_ GARAGE— I
BOX 8 SINGLE FAMILY [ } NEW CONSTRUCTION
} MULTIFAMILY (NO. OF UNITS = } } EXISTING STRUCTURE
[ j COMMERCIAVINOUSTRIAL TOTAL AREA OF PROPERTY SO FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES -- BASIC FEE $
NO. WATERCLOSETS
GAS PIPING, FEET
BATHTUBS
NO. FURNACE, ELEC. GA5
$
SHOWERS
GAS HOT WATER HEATER
$
LAVATORI E5
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
$
ORINKING FOUNTAINS
COMMERCIAL HOOO
$ —
SUMPS, SPRINKLER VACUUM BREAKERS
OTHER
$
BRAINS
$
OTHER
$
TOTAL FIXTURES
$
TOTAL MECHANICAL FEE
$
RTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME ISTRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APPLICATION IS
E. I FURTHER AGREE TO SAVE HARMLESSTHE CITYOF FEDERAL WAY ASTO ANY CLAIM (INCLUDING COSTS, EXPENSES, AND ATTORNEYS'
INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM), WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
:1LED AGAINSTTHE CITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES DUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
ERS AND EMPLOYEES, UPON THE ACCURACY OFtTHE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.