93-1023511]
'.ITY OF FEDERAL WAY MECHANICAL PERMIT
33530 First Way South
?ederal Way, WA 98003 Building Inspection Requests 661-4140
i61-4000
kDDRESS:31505 27TH AVE SW
90.: 150310-0430
?ROJECT DESCRIPTION: HVAC - INSTALL GAS LOG I PIPING.
= OWNRR
PHYLLIS GIBONRY
31505 27TH AVE SW
FEIw WAI WA 98023
927-6999
CONTRACTOR
NORTHWEST WATER HEATER
8201 DURANGO ST SW
TACOKA, WA WA 98499
984-6404
NORTHWH103R2
FUEL TIPKS.:GAS
FANS..........:
0
BOILERSICOKPRESSORS
GAS PIPING.:
40 ft
HOOD..........:
0
0-3 HP......: 0
FURN(1001..:
0
DUCT WORI.....:
0
3-15 HP.....: 0
GAS HiiT....:
0
WOOD STOVES...:
0
15-30 HP....: 0
CONV BURNER:
0
FU11)1001.....:
0
30-50 HP....: 0
BBQ.........
0
MISC...........
0
5+ HP........ 0
GAS DRYER..:
0
AIR HANDLING UNITS
FUEL TANKS ---------
RANGE ...... :
0
<=10,000 CFK:
0
ABOVE GROUND: 0
GAS LOGS...:
1
> 10,000 CFM:
0
UNDERGROUND.: 0
Inspection Record Water Line 01
GAS PIPING 01
Kechanical Inspection .Notes:
Date By
LKNDRR
PERMIT NO:
ISSUED:
BY:
EXPIRES:
FEES:
KKC PRKT ISSUANCE... # 20.00
KEC APPLIANCE FEES.x 9.50
TOTAL FRKS
$ 29.50
RRKITS EIPIRE 180 DAYS AFTER ISSUANCE IF NO WORI IS STARTED. RESIDENTIAL AND GRADING PRRKITS KIPIRR ONE YEAR AFTER DATE OF ISSUANCE.
CERTIFY THAT THE INFORKATION FURNISED BY KE IS TUR AND CORRECT TO THE BEST OF KY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAI EKQUIRKKRNTS WILL BE KKT.
t s �cl
WhER OR AGENT ----------- �----------------------------- DATE
FILE COPY
I1�4109if,,)
BLD93-0992
09/13/93
FC
03/12/94
SEP -10-93 FRI 14;00 NW WATER HEATER TACOMA FAX NO. 206 588 0353 P.02
I* Perm l�C_l�%'j3 _ 0 C Z_
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
Pt4PP0 Print --
BOX 1 TENANT NAME:
OWNER J L j b()SITE LOCATION 31505 � S L"',
OWNER'S ADDRESS ' 5 C•,TY aQLU�y_PHONE 9
DESCRIBE JOB `I 19G
THE PROPERTY IS OWNED BY: Sl LE/MARRi PARTNERSHIP _ CORPORATION
BOX 2 CONTRACTOR'S NAME
CONTRACTOR'S REB.
CONTRACTOR'S ADDRESS '3 c �L�CITY �PHONE � �-t��a�''
EXPIRATION DATE ���3
--
OR —
I HAVE READ CHAPTER 1$.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18,27 110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. _
BOX CONTACT PERSON 14 PHONE
BOK 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST ` . _ EXISTING BUILDING VALUATION
BOX G PROPERTY TAX ACCOUNT NUMBER -11-03 10 " G
LPGAL DESCRIPTION
( f necessarv, please submit a separate page with the legal description.)
K.C, Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE; (Exi sting /Proposed' 1ST FLOOR 1 2ND FLOOR t
31101 FLOOR i BASEMENT.__ 1. DECK r_ OARAOE 1
BOX 8 ( j SINGLE FAMILY ( NEW CONSTRUCTION
( } MULTIFAMILY (NO, OF UNITS - ____._._ .} ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY _-- _ SO FT
BOX 0 PLUMBING FIXTURES (including rough -ins) MECH NICAL APPLIANCES -- BA$IC FEE $
NO..� WATERCLOSETS GAS PIPING, FEET ( _.__� $
—SATHTUS6 NO. __FURNACE, ELEC.� GAS _ _ _ $
SHOWERS —GAS HOT WATER HEATER $
—LAVATORIES --CONVERSION BURNER $
--.SINKS —SINKS _ _ BOILER., SIZE —I3TU $
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 CQ)`,� _. _. $ -.--- - -
__DRAINS __-- _-.. $
OTHER ---
TOTAL FIXTURES _ $
TOTAL MECHANICAL FEE $
I CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECTTO THE BEST OF MY KNOWLEDGE
AND FURTHER THAT i AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORKFOR 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 INVESTMATION AND DEFENSE OF SUCH CLAIM), WHICH MAYBE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
AND FILED AGAINST THE CITY OF FEDERALW.AY, BUT ONLY WHERESUCH 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: __ — A�j "�(�__ X —DATE: /10/U
ANF,005 W90