92-102241CITY OF FEDERAL WAY
33530 First Way South
Federal Way, WA 98003
661-4000
MECHANICAL PERMIT
BUILDING INSPECTION - 661-4140
SITE ADDRESS: 34004 23RD AVE SW
PARCEL NO.: 330630-0090
PROJECT DESCRIPTION: INSTALL GAS FURNACE.. GAS HOT WATER HEATER# & GAS PIPING
OWNER
AL BETTS
3400423RD AVE SW
FEDERAL WAY WA 98023
874-6157
F -K TYPES.:GAS
FANS..........: 0
GAS PIPING.:
10 ft
HOOD..........: 0
TURN<100K..:
1
DUCT WORK.....: 0
GAS HWT....:
1
WOOD STOVES...: 0
CONV BURNER:
0
FURN>100K..... : 0
BBQ........:
0
MISC..........: 0
GAS DRYER..:
0
AIR HANDLING UNITS
RANGE......:
0
<=10,000 CFM: 0
GAS LOGS...:
0
> 10,000 CFM: 0
CONTRACTOR
PACIFIC GAS HEATING & AIR INC
11002 34TH AVE S
TACOMA WA 98444
582-5882
PACIFGH110ME
BOILERS/COMPRESSORS
0-3 HP......: 0
3-15 HP.....: 0
15-30 HP....: 0
30-50 HP....: 0
5+ HP. 0
FUEL TANKS ---------
ABOVE GROUND: 0
UNDERGROUND.: 0
INSPECTION RECORD
Water Line OK A Mechanical Inspe tion Notes;
I
PIPING OK Date/-
S yy
LENDER
q�- [ v (
PERMIT NO.: BLD92-2555
ISSUED: 12/16/92
BY: FLF
FEES:
NEC PRMT ISSUANCE... S 20.00
NEC APPLIANCE FEES.* $ 18.50
TOTAL FEES S 38.50
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT
bld mech 07/01/92
DATE
60
T
DEC 15 02
_. mmvW lAL WAY
BOX 1 TENANT NAME:
Permit # O V7 - 2 ,_-�DISSJ
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
OWNER C?_ SITE LOCATION )
OWNER'S ADDRESS ayxn CITY QW_o4.r% u>r>4l
DESCRIBE JOB a a '
THE PROPERTY IS OWNED BY: SINGLE/ ARRIED ✓ OARTNE0SHIP CORPORATION
BOX 2 CONTRACTOR'S NAME
c tJ CONTRACTOR'S REG. # Aae,'
`/ Card MUST be presented
CONTRACTOR'S ADDRESS d 'ip-1 K? c 1 CITY / T9," � �` PHONE
EXPIRATION DATE 4"- V 3/
-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 PHONE _hYJ -. .P' Q
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER dJP /arc' I? Z) 96
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______J_ GARAGE /
BOX 8 ( ) SINGLE FAMILY
( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = )
( ) EXISTING STRUCTURE
( ) COMMERCIAUINDUSTRIAL
TOTAL AREA OF PROPERTY
SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES —
BASIC FEE $
N0. WATERCLOSETS
GAS PIPING, FEET /40
$
BATHTUBS
NO. I 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:
DATE:
ANP -008 3/90
CITY OF FEDERAL WAY
33530 First Way South
Federal Way, WA 98003
661-4000
MECHANICALPERMIT PERMIT NO.: BLD92-2555
BUILDING INSPECTION - 661-4140 ISSUED: 12/16/92
BY: FLF
SITE ADDRESS: 34004 23RD AVE SW
PARCEL NO.: 330630-0090
PROJECT DESCRIPTION: INSTALL GAS FURNACE, GAS HOT WATER HEATER, & GAS PIPING
INER CONTRACTOR LENDER
BETTS PACIFIC GAS HEATING & AIR INC
004 23RD AVE SW 11002 34TH AVE S
FEDERAL WAY WA 98023 TACOMA WA 98444
874-6157 582-5882
PACIFGH110ME
FUEL TYPES.:GAS
GAS PIPING.: 10 ft
FURN<10OK..: 1
GAS HNT....: 1
CONV BURNER: 0
BBQ........: 0
GAS DRYER..: 0
RANGE......: 0
GAS LOGS...: 0
Water Line OK
GAS PIPING OK
FANS..........:
0
BOILERS/COMPRESSORS
FEES:
HOOD..........:
0
0-3 HP......: 0
MEC PRMT ISSUANCE... $ 20.00
DUCT WORK.....:
0
3-15 HP.....: 0
MEC APPLIANCE FEES.* E 18.50
WOOD STOVES...:
0
15-30 HP....: 0
FURN>100K..... :
0
30-50 HP....: 0
MISC..........:
0
5+ HP.......: 0
AIR HANDLING UNITS
FUEL TANKS ---------
<=10,000 CFM:
0
ABOVE GROUND: 0
> 10,000 CFM:
0
UNDERGROUND.: 0
TOTAL FEES E 38.50
INSPECTION RECORD
Mechanical Inspection Notes:
Date By
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT T���J✓ DATE
bld_mech 07/01/92 /