93-101932A
93.
/0j�3.)
CITY OF FEDERAL WAY
MECHANICAL P
PERIISSUED:
33530 First Way South
08/12/9349
Federal Way, WA 98003
Building Inspection Requests 661-4140
BY:
FLF
661-4000
EXPIRES:
02/08/94
ADDRESS:30745 12TH PL SW
NO.: 178830-0180
PROJECT DESCRIPTION :HVAC - INSTALL GAS FURNACE
OWNER
CANDACE ROSSIGNAL
30745 - 12TH PL SW
FEDERAL WAY WA 98023
946-0635
CONTRACTOR
NORTHWEST WATER HEATER
8201 DURANGO ST SW
TACOMA, WA WA 98499
984-6404
NORTHWH103R2
LENDER
FUEL TYPES.:GAS FANS..........: 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 0 ft HOOD..........: 0 0-3 HP......: 0 MEC PRMT ISSUANCE... $ 20.00
FURN<t00K..: 1 DUCT WORK.....: 0 3-15 HP.....: 0 t :� �� . „: MEC APPLIANCE FEES.$ $ 10.00
GAS HWT..... 0 WOOD STOVES.... 0 15-30 HP..... 0
Ti��
CONV BURNER: 0 FURN>100K.....: 0 30-50 HP...:: 0 k d
BBQ......... 0 MISC........... 0 5+ HP........ 0
GAS DRYER..: 0 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 30.00
Inspection Record Water Line OK ---------- Mechanical Inspection Notes: -----------------------------------------
GAS PIPING OK --------- Date ------ By -------------------------------------- --
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED, RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION F RNIS ME IS TRUE AND CORRECT TO THE BEST OF NY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT -----_<L - `� -h' `-` ------------------------------------ DATE
FILE COPY
CITY C&FEOERAL WAY
BUILDING PMIT APPLICATION
Please print
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;CTO R'S A00:?ESS 8207 D ,-=nr*(n ci
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PHONC 984-6404
TIO"; DATE 12-22-g-)
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—OR—
;cAOCHAP TER 18.27.010 REL'TIA:G TO OEFENITIONS OF GEN EPA LCONTnACTORSANO SPECIALTY CatsTRACTOFS ANO
:R 18.27.110 WHICH PROH181TS ISSUING PEcFtv',ITS V,'IT-OUT PROOF OF REG-iSTRATION1.
:T PERSON Angel Foster
PHONEQAa_c�n +
DISTRICT
WATER ER DISTRICT
JEO PROJECT COST I 10
EXISTING BUILDING VALUATION
;Tf TAX ACCOUNT NUMSER f 30 -0160
- -
DESCRIPTION
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descripticn.)
r'G SQUARE FOOTAGE:.(_�'ving/Fropcsec)
iST' FLOG= 1 2ND
FLOOR
FLOOR f B,S�f.6ENT
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( )Nom.'/ CONSTRUCTION
ULTIFAMILY (NO, OF UNITS = )
( } Ei STING STRUCTURE
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:,,, ,E=SCIA11INQUST?.IAL
TOTAL ARE.' OF PROPERTY
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ING FIXTURES (including rot:^, 4-ins)h;ECHANICAL
APPLIANCES — cAS10 FE= S ----' -
_ V,'A TER C LO S ETS
CAS ?IFING F_cl S__Mis�S..
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NO.. FURNACE, EL -C. UCAS
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H07 WATER HEATER ...
- — — --
. L.'VATOFIES -
CONVEaSrtON SURNER - _
_ _--- S_ _
—SINKS
BOILER, SIZE 6 7 S
AIR 'ANOCJNG UNITS
_.- 5.----
ELECTRIC HOT WATER HEATER _.. _. HEAT PUMPS, SIZE
-- S-
LAUNORY WAS .ER OUTLET
UNIT HEATERS
S
URINALS
- - -- - - 'AIR COOLING UNITS, SIZE
DRINKING FOUNTAINS
-• - COaAMERCIAL HQOQ
S
SUMPS. SPRINKLER VACUUM BREAKERS
- 0 T HER
S
ORAINS
_._ ._
-- S - - -- -
_
O TH ECA
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�----
TOTAL MECHANICAL FEE
*,- S
ER PENALTY OF?ERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE ANO CORRECT TO THE SES OF MY KNOWLEOGE
THAT I AM AUTHORIZED HY THEO�tiNER OF THE AEGVE P, E',ISES TO PERFORM THEV:ORKFOR WHICH PERMIT APPLICATION IS
;`R AGREE TO S:.�1E HA^p; LESS THE CITY OF FEDERAL b'fAY AS TO AJJY CLAIM (INCLUQING COSTS, EXPENSES, ANO ATTORNEYS"
:D 1'd It;VESTIG.;T 10'J Ati0 CEI—a G= SUCH CLAIM), ), l'�'HICH h'.AY Sc I�'AOE BY At:Y PERSON. INCLU0'(NG THE UNOERSIGNEO,
^INST
T, -;c Cl -1y OF FEDERAL WAY. 8UT ONLY WHERE SUCH CLAIrA ARISES OUT OF THE RELIANCE OF THE CITY, INCLUOING ITS
I EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIEO TO THE CI i f AS A PART OF THIS APPLICATION.
CITY OF FEDERAL WAY MECHAN[CAL Q
33530 First Way South
Federal Way, WA 98003 Building Inspection Requests 661-4140
661-4000
ADDRESS:30745 12TH PL SW
NO.: 1 78830-01 80
PROJECT DESCRIPTION: HVAC - INSTALL GAS FURNACE.
OWNER CONTRACTOR �®
CANDACE ROSSIGNAL NORTHWEST WATER NEATER
30745 - 12TH PL SW 8201 DURANGO ST SW
04EDERAL WAY WA 980443 TACOMA, WA WA 48499
948-0635 9841404
FUEL TYPES. ;GAS FANS. 0 BOU-sRsr"emmm
GAS PIPING.: 0 ft HOOD....
FUR00 00C .: I DUCT WORK
s#iP
GAS HWT. , O WOOD URIv�2
CONV BURNER: 0
BBD......... 0
GAS DRYER... 0 AlR L'�
RANGE....... 0 <21
GAS LOGS.... 0 > 10,
Inspection Record Water line OF, !dechanical Inspection Notes:
GAS PIPING OK-
TTT ,r4 L
LENDER
PERMIT NO: BLD93-0849
ISSUED: 08/12/93
BY: FLF
EXPIRES: 02/08/94
FEES.
NEC PRMT ISSUANCE... ; 20.00
A FEES.* 1 10.00
TOTAL FEES
3 30.00
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION F, MISE BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REOUIREMENTS WILL BE NET.
OWNER OR AGENT --- -- - - I�i`�...._ .�i'G,IJ _ !SATE
FIELD COPY