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CITY
335300FirstF DEWay South RAL WAY IVI E C H A N I CA L PERM 1 T PERISSUED: 01/11/9534
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661 -4000 EXPIRES: 07/10/95
ADDRESS: 33301 9TH AVE S
NO. : 926501 -0130
PROJ ECT DESCRIPTION :HVAC - RELOCATION OF DIFFUSERS.
OWNER -- CONTRACTOR LENDER
R ,lhifin�l Physicrans PACIFIC AIR CONTROL INC
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12886 INTERURBAN AVE SO. 11812 NORTH CREEK PKWY N.
SEATTLE WA 98168 BOTHELL WA 98011
248-7300 206 682-6393
PACIFAC23OP8
FUEL TYPES.:? ? FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 0 DUCT WORK . 1 3-15 HP • 0 MEC ".:PLIANCE FEES.; $ 6.50
GAS HWT • 0 WOOD STOVES...: 0 15-30 HP • 0
CONY 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 $ 26.50
•
1
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 WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
"CERTIFY THAT THE INFOTTION FURNISED BY E IS UE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE ITY F FERERAL WAY REQUIREMENTS WILL BE MET.
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Omit # Lf9 - 0 03(1
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
-Please Print-
\% k e e Pi/9-,14uis� /gig/N� /J
BOkt.1 TENANT NAME: (JN l Rol 77/7L,6/r
OWNER �i 5A : Al. C SITE LOCATION /33o/ A !9✓eA)u-F I /
OWNER'S ADDRESS /Z % 17,A~— - CITY ).Ea,' - PHONE
DESCRIBE JOB /YIPC y-n91/#49 T t-z Vitiz l/pe-71
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME ((La(iZ 05-owl CONTRACTOR'S REG. #
Card MUST be presented
CONTRACTOR'S ADDRESS /WO CZPe7r f N'/o6/ CITY PHONE -31I3
EXPIRATION DATE LF' /g5
- 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 r/Ji1✓�c /,C, PHONE(fec7- (v g
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST /' ( C • OC EXISTING BUILDING VALUATION / -'6,0.OD
BOX 6 PROPERTY TAX ACCOUNT NUMBER '9 - '5O/-
LEGAL DESCRIPTION 9(7-(i /- U/ 3f)
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording # We �'�rnG)r t_sV'fC ' /c-i/t e i7! ✓/5/c iu 6 Z —Q O/
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/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. 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 nimile. sury0/ d�tt 4 $
DRAINS Z"owuwcu/4/ �lizefut�JarP $
OTHER ?inn/idi / 7/Ce ivPr cJ0(4 12 $
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 EMPLOY ES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: 1.„‘„,, DATE: / A Aiz,-
ANP 008 3/90