93-101079CITY OF FEDERAL WAY
33530 First Way South
Federal Way, WA 98003
661-4000
SITE ADDRESS: 33709 40TH CT SW
PARCEL NO.: 921151-0650
PROJECT DESCRIPTION: HVAC
OWNER
KEN LARSON
33709 40TH CT SW
FEDERAL WAY WA 98023
874-3155
FUEL TYPES.:GAS ?
GAS PIPING.: 30 ft
FURN<100K..: 1
GAS HWT....: 1
CONV BURNER: 0
8130.. ... 0
GAS DRYER..: 1
RANGE......: 1
GAS LOGS...: 0
MECHANICAL PERMIT
BUILDING INSPECTION - 661-4140
CONTRACTOR LENDER
NORDIC HEATING, INC.
3401 C ST. NW BAY 1
AUBURN WA 98002
931-0503
NORDIN10998J
93-/OiO7q
PERMIT NO.: BLD93-0478
ISSUED: 05/04/93
BY: JJ
FANS..........:
0
BOILERS/COMPRESSORS
FEES:
HOOD..........:
0
0-3 HP......: 0
NEC PRMT ISSUANCE... S 20.00
DUCT WORK.....:
0
3-15 HP.....: 0
NEC APPLIANCE FEES.* $ 32.50
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 $ 52.50
INSPECTION RECORD
Water Line OK Mechanical Inspection Notes:
* PIPING OK 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 AGEN r DATE � ���e2
bld meth 07/01/92
. tvermit #ok
_
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME:
OWNER KeN L ® SITE LOCATION
OWNER'S ADDRESS 3 3 �-E • l� - CITY � � J- "' 9 �1 PHONE 7 ��
DESCRIBE JOB EIRP pie. Fared A /2 o Vlts �rar,A C_OA/yN12.��DY+
THE PROPERTY IS OWNED BY: SINGLE/MARRIED M Ax.n ec, n PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME
CONTRACTOR'S ADDRESS
EXPIRATION DATE
AT/i✓6
/-0S s,(.le jl�00&� d
CONTRACTOR'S REG. #A-0
CITY //1, A 940-A)
/# /U 9,9e
Card MUST be pi
PHONE
—OR—
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF OR
CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON b o'Qk 8,1/b W6 i ePHONE—9
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST ASD,0. ° ° EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NU
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_____J_ GARAGE /
BOX 8 (V SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) (%r) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY / FO ® SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES — BASIC FEE $
N0. WATERCLOSETS
GAS PIPING, FEET 3 O
$
BATHTUBS
NO. FURNACE,ELEC. GAS 'f
$
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 HOOP
$
SUMPS, SPRINKLER VACUUM BREAKERS
OTHER _64,5 Dif�zje-r'
$
DRAINS
(osis 0.}4eyK
$
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 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 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 Y OF FEDERAL Y, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLO ESU NTHE URACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT:
DATE: _ 1
ANP -008 3/90
CITY OF FEDERAL WAY
3530 First Way South
'.Federal Way, WA 98003
661-4000
SITE ADDRESS: 33709 40TH CT SN
PARCEL NO.: 921151®0650
PROJECT DESCRIPTION: HVAC
- OWNER
KEN LARSON
33709 40TH CT SW
W -_RAL WAY WA 98023
3155
FUEL TYPES.:GAS 7
FANS..........: 0
GAS PIPING.:
30 ft
HOOD..........: 0
FURN<10OK..:
1
DUCT WORK.....: 0
GAS HWT....:
1
WOOD STOVES...: 0
CONV BURNER:
0
FUR0100K.....: 0
BBQ........:
0
MISC..........: 0
GAS DRYER..:
1
AIR HANDLING UNITS
RANGE......:
1
<=10,000 CFM: 0
GAS LOGS...:
0
> 10,000 CFM: 0
leter Line OK
MECHANICALPERMIT PERMIT NO.: BLD93-0478
BUILDING INSPECTION - 661-4140 ISSUED: 05/04/93
BY: JJ
CONTRACTOR
NORDIC HEATING, INC.
3401 C ST. NW BAY 1
AUBURN WA 98002
931-0503
NORDIHI099BJ
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:
GAS PIPING OK ate JBy
LENDER
FEES:
NEC PRMT ISSUANCE... S 20.00
NEC APPLIANCE FEES.'* S 32.50
TOTAL FEES $ 52.50
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 C6AGEq
bld me h 92
DATE