92-101645IftyCi�M•
CITY OF FEDERAL WAY MECHANICAL PPERMIT NO.: BLD92-2236
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 10/05/92
Federal Way, WA 98003 BY: MH
661-4000
SITE ADDRESS: 137 S 293RD ST
PARCEL NO.: 720250-0040
PROJECT DESCRIPTION: MECHANICAL
OWNER
CONTRACTOR
LENDER
RICHARD HOLMAN
NORTHWEST WATER HEATER
137 S 293RD ST
8201 DURANGO ST SW
DERAL WAY WA
TACOMA, WA WA 98499
�9-5197
984-6404
NORTHWH103R2
FUEL TYPES.:GAS ?
FANS..........:
0
BOILERS/COMPRESSORS
FEES:
GAS PIPING.: 25 ft
HOOD..........:
0
0-3 HP......: 0
MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 0
DUCT WORK.....:
0
3-15 HP.....: 0
MEC APPLIANCE FEES.* $ 15.00
GAS HWT.... : 1
WOOD STOVES...:
0
15-30 HP....: 0
CONV BURNER: 0
FURN>100K..... :
0
30-50 HP....: 0
BBQ........: 0
MISC..........:
0
5+ HP.......: 0
GAS DRYER..: 1
AIR HANDLING UNITS
FUEL TANKS ---------
RANGE ...... : 0
<=10,000 CFM:
0
ABOVE GROUND: 0
GAS LOGS...: 0
> 10,000 CFM:
0
UNDERGROUND.: 0
TOTAL FEES $ 35.00
INSPECTION RECORD
#ter Line OK
Mechanical Inspection Notes:
GAS PIPING OIC!
Date By 0&
�o lis � SSM ►N �
�� c�----
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
bld_mech 07/01/92
DATE ( \ J I q —2 —
S,rEq � 1992
ufty
r
CITY OF FEDERAL WAY
R m i t
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME:
OWNER r SITE LOCATIO 15 ` - `=
OWNER'S ADDRESS I RLI 5 - "4 CI c�c . PHONE
DESCRIBE JOB '
THE PROPERTY IS OWNED BY: SINGLE/MARRIED— V -D PARTNERSHIP CORPORATION
CONTRACTOR'S ADDRESS
EXPIRATION DATE
N61U mu')l uc 1JI cool ICU
CITY f� PHONE
—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 -'-i LJ
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER `:jaC�j CZ -- COY (.3
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 / GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAt TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
NO. WATERCLOSETS
BATHTUBS
SHOWERS
LAVATORIES
SINKS
DISHWASHERS
ELECTRIC HOT WATER HEATER
LAUNDRY WASHER OUTLET
URINALS
DRINKING FOUNTAINS
SUMPS, SPRINKLER VACUUM BREAKERS
DRAINS
OTHER
TOTAL FIXTURES
MECHANICAL APPLIANCES — BASIC FEE $
GAS PIPING, FEET .2-3- — __D -C' $
N0. FURNACE, ELEC. GAS $
_GAS HOT WATER HEATER $
CONVERSION BURNER $
BOILER, SIZE BTU $
AIR HANDLING UNITS $
HEAT PUMPS, SIZE $
UNIT HEATERS $
AIR COOLING UNITS, SIZE $
COMMERCIAL HOOD $
_OTHER _�, 4-_ _ $
U $
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 ASTO 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 Cluj THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
�n-1
OWNER/AGENT: 1� 6 _ 11 �U d y DATE:
ANP -008 3/90
<1000 --1
CITY OF FEDERAL WAY
33530 First Way South
Federal Way, WA 98003
661-4000
SITE ADDRESS: 137 S 293RD ST
PARCEL NO.: 720250-0040
PROJECT DESCRIPTION: MECHANICAL
OWNER
RICHARD HOLMAN
137 S 293RD ST
FEDERAL WAY WA
839-5197
FUEL TYPES.:GAS ?
GAS PIPING.: 25 ft
FURN<100K..: 0
GAS HWT.... : 1
CONV BURNER: 0
BBQ......... 0
GAS DRYER..: 1
RANGE....... 0
GAS LOGS...: 0
Water Line OK
S PIPING OK
MECHANICAL PERMIT
BUILDING INSPECTION - 661-4140
CONTRACTOR LENDER
NORTHWEST WATER HEATER
8201 DURANGO ST SW
TACOMA, WA WA 98499
984-6404
NORTHWH103112
kg-- IV IWC-)
PERMIT NO.: BLD92-2236
ISSUED: 10/05/92
BY: MH
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.* $ 15.00
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 $ 35.00
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 AGENTDATE 61
bld mech 07/01/92