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CITY OF FEDERAL WAY PERMIT NO: BL 95 09 8
33530 First Way South r ;; '�,,.,, y,., i1�"ii I�''°1 .,.�.,. '�,,,.�;,,:!li ,.,, ;� ',�;;.. " Mi.', ,.,�„ ISSUED: 12/05/95
Federal Way , WA 98003 Building Inspection Requests 661--4140 BY: FC2
661-4000 EXPIRES: 06/02/96
ADDRESS :36404 6TH AVE SW
NO. : 302104--9171
PROJECT DESCRIPTION:MECHANICAL - GAS FURNACE
F.4 OWNER ----- ___ -_ CONTRACTOR ---_.. -- -- LENDER - --
LEONARD HILLS 1 OWNER IS CONTRACTOR
36404 6TH AVE SW g
FEDERAL WAY WA 98023 I
927-1818
-__...--------------.... _ -----.i_._ --------------- ---•-----_- --
*** CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE : 8.25 ***
FUEL TYPES.:GAS PRO FANS • 0 BOILERS/COMPRESSORS 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.* $ 10.00
GAS NWT • 0 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 $ 30.00
------------------ a-- __.... ........._..___...___z__...._.__ _ ---- i. ....-•--__ _._- - ..-._---..
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 _____•_
s-..____.._..___ ___.___..__....__-__._...-__..__.____.--.------___-•- -.____-----------. -___._ .. _-__ _ ___.__.._.._._.._. .-
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS MILL BE MET.
OWNER OR AGENT _w e ''1!p (2• ,L�'d `'1 DATE 41—C-- / � ~
ALE COPY
Permit tvgais-o q 1
RECEIVED
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATIOI4EC 0 51995
3 C)2 09 _ 1 I — Please Print—
CITY OF FEDERAL WAY
-BOX 1 TENANT NAME BUILDING DEPT.
OWNER . ; _ ! e SITE LOCATION 34;y h/ i a
P A OWNER'S ADDRESS -ter ',= • ' : CITY PHONE ?A 7 /g /If
I,b- DESCRIBE JOB
THE PROPERTYelfNEflitY":1 =71RIEtl71/17444---- PARTNERSHIP CORPORATION
BOX 2_CONTRACTOR'S NAME OW/1-eye. CONTRACTOR'S REG. #
Card MUST be presented
CONTRACTOR'S ADDRESS CITY PHONE
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.
(BOXY, CONTACT PERSON PHONE
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PRQJECT£115 EXISTING BUILDING VALUATION
-BOX . •ROPERTY TAX ACCOUNT NUMBER _ P --
( i• - - a -•--- • : -.. . - •.s- ,r -' -:. . -- .tion.)
K.C. Pet Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR
3RD FLOOR / BASEMENT / DECK •
BX ; (>4 SINGLE FAMILY ( ) NEW CONSTRUCTI 'j¢6� / r
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCT •
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERT SQ FT
BO • PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
• 0. WATERCLOSETS GAS PIPING, FEET $
BATHTUBS NO. FURNACE, ELEC. GAS 74 $
SHOWERS GAS HOT WATER HEATER $
LAVATORIES CONVERSION BURNER $
INKS BOILER, SIZE BTU $
D .WASHERS AIR HANDLING UNITS $
ELEC •IC HOT WATER HEATER _HEAT PUMPS, SIZE $
LAUND• WASHER OUTLET UNIT HEATERS $
URINALS AIR COOLING UNITS, SIZE $
DRINKING FO TAINS COMMERCIAL HOOD $
SUMPS, SPRIN R 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.
)6WNER/AGENT: e DATE: / �- 5
ANP-008 3/90