92-102316CITY OF FEDERAL WAY
'33530 First Way South
Federal Way, WA 98003
661-4000
MECHANICAL PERMIT
BUILDING INSPECTION - 661-4140
SITE ADDRESS: 33015 .22ND AVE 8W
PARCEL NO.: 894500-0250
PROJECT DESCRIPTION: INSTALL GAS FURNACE is GAS PIPING
OWNER
CONTRACTOR
MICHAEL DAVIS
PACIFIC GAS HEATING & AIR INC
33015 - 22ND AVE SW
11002 34TH AVE S
FEDERAL WAY WA 98023
TACOMA WA 98444
927-2074
582-5882
WOOD STOVES...: 0
PACIFGH110ME
FUEL TYPES.:GAS
FANS..........: 0
GAS PIPING.:
5 ft
HOOD..........: 0
FURN<100K..:
1
DUCT WORK.....: 0
GAS HWT.... :
0
WOOD STOVES...: 0
CONV BURNER:
0
FURN>100K.....: 0
Bao........:
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
4v PIPING OK
1 CERTIFY THAT THE INFORMA
OWNER OR AGENT
bld mech 07/01/92
-r
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
Date .1-15-95
Notes:
LENDER
af�- 1bP) I LP
PERMIT NO.: BLD92-2598
ISSUED: 12/29/92
BY: FLF
FEES:
MEC PRMT ISSUANCE... S 20.00
NEC APPLIANCE FEES.* S 12.00
TOTAL FEES S 32.00
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
FURNISHED BY ME IS TRUAND RECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
1'
DEC 2 41992 CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION x
OM OF FRAL MY — Please Print —
SULOM WEPT
BOX 1 TENANT NAME: i f, q� � j 91a y
OWNER SITE LOCATION O cA r"'C' /.J
OWNER'S ADDRESS CI ani 9-10 LA> PHONE Q
DESCRIBE JOB ir1 a,o /s,en4 '
THE PROPERTY IS OWNED BY: SINGLEAAARRIE PARTNERSH CORPORATION
BOX 2 CONTRACTOR'S NAME
REG. # P4 6'-f?6 H I i,)m A
CONTRACTOR'S ADDRESS 1/1 �3' �V CITY _7 //m -r» R PHONE .-rX,)- X&
EXPIRATION DATE
—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 Llt - PHONE Xf a- 18�
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT
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_____J_ DECK /
GARAGE /
BOX 8 ( ) SINGLE FAMILY
( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = )
( ) EXISTING STRUCTURE
( ) COMM ERCIAL/INDUSTRIAL
TOTAL AREA OF PROPERTY
SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES
— BASIC FEE $
N0. WATERCLOSETS
GAS PIPING, FEET .S�' /
$
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 OFTHE ABOVE PREMISESTO 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: L -%?Z/ % .�'C�n.�z// DATE: __ %C� 9�
ANP -M 3/90
K-- -L'%
CITY 0r FEDERAL WAY
33530 First Way South
Federal Way, WA 98003
661-4000
MECHANICALPPERMIT NO.: BLD92-2598
BUILDING INSPECTION - 661-4140 ISSUED: 12/29/92
BY: FLF
SITE ADDRESS: 33015 22ND AVE SW
PARCEL NO.: 894500-0250
PROJECT DESCRIPTION: INSTALL GAS FURNACE A GAS PIPING
OWNER CONTRACTOR
ICHAEL DAVIS PACIFIC GAS HEATING & AIR INC
15 - 22ND AVE SW 11002 34TH AVE S
W0ERAL
WAY WA 98023 TACOMA WA 98444
927-2074 582-5882
PACIFGH110NE
FUEL TYPES.:GAS
FANS..........: 0
GAS PIPING.:
5 ft
HOOD..........: 0
FURN<100K..:
1
DUCT WORK.....: 0
GAS HWT.... :
0
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
Water Line OK
GAS PIPING OK
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
FEES:
NEC PRMT ISSUANCE... $ 20.00
NEC APPLIANCE FEES.* $ 12.00
TOTAL FEES $ 32.00
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 �i �' /' DATE
bld meth 07/01/92