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CITY OF FEDERAL WAY PERMIT NO: BLD95-0614
33530 First Way SouthMECHANICAL d � ERM . q ISSUED: 08/10/95
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC2
661-4000 EXPIRES: 02/06/96
ADDRESS:31311 10TH AVE S
NO. : 787540-0025
PROJECT DESCRIPTION:HVAC - CHANGE OUT FURNACE TO 100,000 BTU & GAS HWT
= OWNER = T CONTRACTOR T LENDER
4111 AGNES WANTLAND ! HAYES HEATING COMPANY I
31311 10TH AVE S 1 2300 S 118TH ST
FEDERAL WAY WA 98023 SEATTLE WA 98168
839-0430 I 244-HEAT
I HAYESH*101QE
6
tt: CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE = 8.25 XXX
1 FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS —. T FEES:
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 1 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 16.50
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..: 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 $ 36.50
Does the water supply system contain a Pressure Reduction Device or Check valve? () Yes () No (If "Yes" then water expansion tank is required on Hot Water Tank)
Inspection Record Water Line OK Mechanical Inspection Notes:
GAS PIPING OK Date By
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO NOR IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THE INFORMATION FURISHED NE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
li
OWNER OR AGENT _,,,b70) DATE ---
/c "6-,
FILE COPY
.t # . LN,3 14
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 TENANT NAME:
OWNER 7 6/Jt /itIn/U/ 0', r SITE LOCATION
OWNER'S ADDRESS ,_-5/,-3/1 /0/ vE S - CITY 1 ' _PHONE afir
DESCRIBE JOB 095 FCa i9C'C t Ltl/97ZZ %i/I/ij c.A (//fkol eL-IV
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME /14 YE° /7`f/ /i/C?h CONTRACTOR'S REG. #N/;YPSH7 /o/ (--
Card MUST be presented
CONTRACTOR'S ADDRESS /3/30 4/4/14 /9e7_.5 CITY S i9l7L/- PHONE ��'I3
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 Tin f1/9 /f' S PHONE 279-1/32'
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST 2:3/5' `714/ EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER --r-3 ci-tU - 062
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 ( ) W CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET / $
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 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 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: ,4)U) hek DATE: B-"/‘'
ANP-008 3/90