92-1017980TY OF FEDERAL WAY MECHANICAL PERI
lilt °T
133530 First Way South BUILDING INSPECTION - 661-4140
Federal Way, WA 98003
63+-4000
SITE ADDRESS: 35421 21 AVE SW
PARCEL NO.: ??????-????
PROJECT DESCRIPTION: BVAC - INSTALL GAS PIPING FROM METER TO EXISTING UNITS
OWNER
NORTHSHORE VILLAGE ASSOC.
35421 - 21ST AVE SW
FEDERAL WAY WA 98023
946-3648
FUEL TYPES.:GAS
FANS..........: 0
GAS PIPING.:
100 ft
HOOD..........: 0
FURN<100K..:
0
DUCT WORK.....: 0
GAS HWT....:
0
WOOD STOVES...: 0
CONV BURNER:
0
FURN>100K.....: 2
BBQ........:
0
MISC..........: 0
GAS DRYER..:
0
AIR HANDLING UNITS
RANGE......:
0
<=10,000 CFM: 0
GAS LOGS...:
0
> 10,000 CFM: 0
Water Line OK
CONTRACTOR
CENTRAL HEATING & A/C
9624 CANYON RD. E.
PUYALLUP WA 98373
206-531-5871
CENTRHA154B4
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
Mechanical Inspection Notes:
S PIPING OK jll Date By
LENDER
PERMIT NO.: BLD92-2322
ISSUED: 11/06/92
BY: FLY
FEES:
NEC PRMT ISSUANCE... $ 20.00
NEC APPLIANCE FEES.* $ 3.50
TOTAL FEES $ 23.50
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 _ & A, -4ea4 DATE
bld meth 07/01/92
t
SET BACKS AND FOOTINGS
DATE BY
OX TO POUR FOUNDATION WALLS
DATE BY _
PLUMBING GROUNDWORK
DATE BY
PLUMBING ROUGH IN
DATE BY
WATER LINE O.K.
GAS PIPING O.K.
MECHANICAL INSPECTION
DATE BY
O.K. TO ENCLOSE FRAMING
DATE BY
INSULATION
DATE BY
WALL BOARD AND FIRE WALL
DATE BY _
FINAL O.K. TO OCCUPY
DATE BY
DCD
PSD
FD
w
Perm* i3L D,9Z-2-322..
CITY OF FEDERAL WAY
BUILDING PERMIT APPL.tCAT1By
DEV
ECELOPMEW AM►9"
— Please Print —
BOX 1 TENANT NAME: t�1 n 0 ie "S, vy"vC.) C -e
OWNER VJ 0t~} f -f_ ; I l ct CftTE LOCATION 3,5 q? L,-= z / A V& S. b .
OWNER'S ADDRESS 3S/Z/ - Z/ Al 1 CITY PHONE_
`C}ESGRIBE JOB /'�+� d 1 � n ,C p,
THE PROPERTY IS OWNED Y: INGLE/MARRIED PARTNERSHIP CORPORATION bC
BOX 2 CONTRACTOR'S NAME �A rz M/_ CONTRACTOR'S REG. #
t� Card MUST be presented
CONTRACTOR'S ADDRESSCITY, D t9t5 PHONEa& 531-5871
_., ,..
EXPIRATION DATE d'
—OR --
1 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 .lS PHONE_ MI -51871-
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER __�2't� 52 /03 _'7002 -0Z
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 1 - - DECK � I GARAGE -
BOX 8 ( } SINGLE FAMILY
( } MULTIFAMILY (NO. OF UNITS = }}
( } COMMERCIAUINDUSTRIAL
( } NEW CONSTRUCTION
EXISTING STRUCTURE
TOTAL AREA OF PROPERTY
�.- — •. -.
SQ FT
3OX 9 PLUMBING FIXTURES (including rough -ins)
� ��
- ' MECHANICALPPLIANCES — BASIC FEE $
W. WATERCLOSETS
GAS PI G, FEET•. _ �� -
�URNACE,
. $..._ .
BATHTUBS
NO ` ELEC.
GAS_ $
GAS HOT WATER NEATER,.. $ _ --
LAVATORIES
CONVERftN 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
$ :,
--L—TOTAL FIXTURES
TOTAL MECHANICAL FEE
$
CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
V41) FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APPLICATION IS
JADE. I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERALWAYASTOANY CLAIM (INCLUDING COSTS, EXPENSES, ANDATTORNEYS'
EES INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM), WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
,ND FILED AGAINST THE CITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
ffIC£RS AND EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
!� NER/AGENT:
DATE: d0- Z/" 1?21
ANP." 3."
CITY OF FEDERAL WAY MECHANICAL PERMIT
33530 First Way South BUILDING INSPECTION - 661-4140
Federal Way, WA 98003
661-4000
SITE ADDRESS: 35421 21 AVE SW
PARCEL NO.: ??????-????
PROJECT DESCRIPTION: HVAC - INSTALL GAS PIPING FROM METER TO EXISTING UNITS
OWNER
NORTHSHORE VILLAGE ASSOC.
35421 - 21ST AVE SW
FEDERAL WAY WA 98023
946-3648
FUEL TYPES.:GAS
GAS PIPING.: 100
FURN<100K..: 0
GAS HWT....: 0
CONV BURNER: 0
BBQ........: 0
GAS DRYER..: 0
RANGE......: 0
GAS LOGS...: 0
FANS..........: 0
ftHOOD..........: 0
DUCT WORK.....: 0
WOOD STOVES...: 0
FURN>10OK..... : 2
MISC..........: 0
AIR HANDLING UNITS
4=10,000 CFM: 0
> 10,000 CFM: 0
Water Line OK
GAS PIPING OK
CONTRACTOR
CENTRAL HEATING & A/C
9624 CANYON RD. E.
PUYALLUP WA 98373
206-531-5871
CENTRHA154114
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
Mechanical Inspection Notes:
Date By
LENDER
PERMIT NO.: BLD92-422
ISSUED: 11/06/92
BY: FLF
FEES:
NEC PRMT ISSUANCE... $ 20.00
NEC APPLIANCE FEES.* $ 3.50
TOTAL FEES $ 23.50
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
1 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 C1 ��1L_ �_ L DATE
bld meth 07/01/92