93-101212CITY OF FEDERAL WAY
33530 First Way South
Federal Way, WA 98003
661-4000
MECHANICAL PERMIT
BUILDING INSPECTION - 661-4140
SITE ADDRESS: 32809 26TH AVE SW
PARCEL NO.: 894520-0150
PROJECT DESCRIPTION: HVAC - INSTALL 1 GAS RANGE
OWNER CONTRACTOR
ROBERT CLARK PUYALLUP GAS APPLIANCE INC.
32809 26TH AVE SW P.O. BOX 95
FEDERAL WAY WA 98023 PUYALLUP WA 98371
0709 848-1549
PUYALGA285RI
FUEL TYPES.:GAS
GAS PIPING.: 0
FURN<100K..: 0
GAS HWT....: 0
CONV BURNER: 0
BBQ........: 0
GAS DRYER..: 0
RANGE......: 1
GAS LOGS...: 0
FANS..........: 0
ftHOOD..........: 0
DUCT WORK.....: 0
WOOD STOVES...: 0
FURN>100K.....: 0
MISC..........: 0
AIR HANDLING UNITS
<=10,000 CFM: 0
> 10,000 CFM: 0
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
#AS
ter Line OK Mechanical Inspection
PIPING OKS�O-moi 3 f�� Date----i2�3 By
Notes:
LENDER
q�-
10 l ;q -?e-
PERMIT NO.:
BLD93-0524
ISSUED: 05/19/93
BY: FLF
FEES:
MEC PRMT ISSUANCE... $ 20.00
MEC APPLIANCE FEES.* $ 6.50
TOTAL FEES S 26.50
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THAT THE INFOR TION FURNISHED BY ME IS TRUE AND RRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT �n/�"i/v DATE
bld meth 07/01/92
PLEASE PRINT
jSiTE-1.6C,A*T
9 City of Federal Way 0 %
APPLICATION FOR BUILDING PERMIT
APPLICATION #. 9C.i��
Name (F,M,L)
Address
Tenant of known)
Lot #
Tax#
Building Owner Name
Address
City rState
Zip I Phone
Nature of Work
Name (F,M,L)
City
Address
12 -
City
I State Z� -1zip
%r-,371
Contact Person
Day Phones.
Other Phone
Fax
Il,// 5kov
1
1 ----
I I
Company Name
Address 7
City
State
Zip
Contact Person
Phone
Fax
Contractor's # (card must be presented)
Expiration Date
Verified 0 Yes 0 No
Name
Address
City
State
Zip
Contact Person
Phone
Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
CDO492 V�Wv 41931
C
RUCTURE
n
of
isting Use
City
Proposed Use
State Zip
Phone
includes:
License #
Building
'NKPermit
❑ Plumbing
echan(cal
❑
Other
Type of Work -Residential
❑ Commercial
❑ New
❑ Addition
❑ Remodel
❑ Garage
❑ Num er of Units _
❑ Shed
❑
❑
Deck
Other
Enter 1 st Floor
Area Basement
sq ft
sq ft
2nd Floor
Decks
sq ft 3rd Floor sq ft
sq ft Garage sq ft
Existing Floor Area
Proposed Total Area
3-15 Tons
sq ft
sq ft
Water Availability
❑ Sewer Availability ❑ On -Site Septic System Availability ❑
..Project Valuation
S:
Zoning
Lot Size
Existing Bldg.ValtiiC*in
Name
n
of
Address
City
Zip
State Zip
;....: •. ;:>.. :.; .:::..: ....:.::....::. .
hCHA rI CAI' CQNTRACTOR;'
Contractor Name `Cy ,r� � �
Address
City
State
Zip
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
PLUIVIBING CONTRACTOR �';'`::::'.::'
I MM
Contractor Name
Address
City
State
Zip
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
Water Closets
Sinks
Urinals
Lawn Sprinklers
Bathtubs
Dish Washers
Drinking Fountains
Other
Showers
Electric Water Heaters
Sumps
50+ Tons
Lavatories
Washing Machine
Drains
Totat.Fizue::Count;:'•:':;:;.:.::':;
��cxArvzCai: uNrr covivT:>> . :
Fuel Type (electric/other)
Gas Dryer
Air Handling < = 10,000 CFM
15-30 Tons
Length of Gas Piping
ange
Air Handling > = 10,000 CFM
30-50 Tons
Furn <100K BTUs
Gas Log
Unit Heater
50+ Tons
Furn > 100 BTUs
Fans
Miscellaneous
Fuel Tanks
Gas Hwt
Hood
Boilers
Above Ground
Conv Burner
Duct Work
0-3 Tons
Underground
BBQ's
Wood Stoves
3-15 Tons
Total Unit.Count
DISCLAIMER: 1 certify under penalty of perjury that the information furnished by me is true and correct to the beat 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 au 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 ,including its officers and employees, upon the accuracy of the information supplied to the City as a part of this
application.
Owner/Agent: e:_— '-4-- Date: �� a 7,.?
t ~
CITY OF FEDERAL WAY MECHANICAL PERMIT
33530 First Way South BUILDING INSPECTION - 661-4140
Federal Way, WA 98003
661-4000
SITE ADDRESS: 32809 26TH AVE SW
PARCEL NO.: 894520-0150
PROJECT DESCRIPTION: HVAC - INSTALL 1 GAS RANGE
OWNER CONTRACTOR LENDER
ROBERT CLARK PUYALLUP GAS APPLIANCE INC.
32809 26TH AVE SW P.O. BOX 95
FEDERAL WAY WA 98023 PUYALLUP WA 98371
0709 848-1549
PUYALGA285R1
FUEL TYPES.:GAS
GAS PIPING.: 0 ft
FURN<100K..: 0
GAS HWT....: 0
CONV BURNER: 0
BBQ........: 0
GAS DRYER..: 0
RANGE......: 1
GAS LOGS...: 0
ater Line OK
AS PIPING OK
PERMIT NO.: BLD93-0524
ISSUED: 05/19/93
BY: FLF
FANS..........:
0
BOILERS/COMPRESSORS
FEES:
HOOD..........:
0
0-3 HP......: 0
MEC PRMT ISSUANCE... S 20.00
DUCT WORK.....:
0
3-15 HP.....: 0
MEC APPLIANCE FEES.* $ 6.50
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 S 26.50
INSPECTION RECORD
Mechanical Inspection Notes:
Date By
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
1 CERTIFY THAT THE INFOR71ON FURNISHED BY ME IS TRUE AND ORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT _ �� DATE a2 -d
bld meth 07/01/92