94-100893 ?y-Jtr 53
CITY
33530OFirstt Way South F FEDERAL WAY MECHANICAL P ERMI T PER ISSUED: 05/MI NO: 12/9472
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 11/08/94
ADDRESS:33319 41ST AVE SW
NO. : 327900-0150
PROJECT DESCRIPTION:GAS PIPING AND MECHANICAL INSTALLATION AT RESIDENTIAL REMODEL
OWNER CONTRACTOR LENDER
BARRY+PAT HOMY *14 OWNER IS CONTRACTOR s$:
33319 41ST AVE SW
411[
FEDERAL WAY WA 98023
838-7183
j .±_______t* HONE *n
FUEL TYPES.:GAS ? FANS - 0 BOILERS/COMPRESSORS ! FFFS:
GAS PIPING.: 191 ft HOOD : 0 0-3 HP 0 AEC PRAT ISSUANCE... $ 20.00
FURN(100K..: 1 DUCT WORK - 0 3-15 HP.....: 0 8EC APPLIANCE FEES.* $ 53.50
GAS NWT • 1 WOOD STOVES.. : 0 15-30 HP....: 0 PNA1 PLO CHECK.. _ $ 29.25
CONY BURNER: 0 FURN)100K 3 30-50 HP - 0
BBA • 1 MISC ...: 0 5+ HP - 0
GAS DRYER..: 2 rs.TR NANDLIN UNITS FUEL TANKS
RANGE • 1 <:10,000 CIM: 0 ABOVE GROUND: 0
GAS LOGS...: 1 10,000 CFS?: 0 UNDERGROUND.: 0
TOTAL FEES $ 102.75
Does the water supply systea 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
I _
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 FURNISED B ME IS TRU • 'r CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT ,, 'r - DATE $ -12 _4"
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p,.CF G City of Federal Way
v`) APPLICATION FOR BUILDING PERMIT
- e(&/-03 72-
PLEASE PRINT ( APPLICATION #:
I QCA.TIO,N Address -1733/9 (1/S tt'L/ •JGC)
Tenant (if known) �,,�-� �/ / Lot# Assessor's Tax#
\) .he7r%.7 e r4.fi/(/< ii7:�J 5 327ADO O/So
7�
Building Owner Name
/ Address /
' ) // 73 V / 4// -i L-c)
City /---A.41,.Z4/7 GZ/,- z.
State /A//4 Zip ,c'Zj Phone ,s--1-3 f . 7,,c_, 3
Nature of Work Kee S -`
APPLICANT
Na2a1 (F,M,L) �
/`7/'/Ci 6-- -111 .17,,,,..„..47
sAddress )
. : 319 / SLSyiv `.i 2/
City /�/�:z (Ail 7 State ,f,4. Zip 'l >,_Contact Person / Day Phone Other Phone Fax
S;"3Cc-- 7/ S= 3
BUU DING CONTRACTOR
Company Name
Address .
\/(
City State Zip
Contact Person Phone Fax
Contractor's #(card must be presented) Expiration Date Verified ❑ Yes ❑ No
[RCHirECT
•Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION •
t k ��,`,, rck r _ v r r (_ •/-
1 �{ (sr—
REcFR/FD
MAY 0 6 1994
P/ease Complete Reverse Side MY OF FEDERAL WAY
BUILDWG DEPT.
CD0492(Rev 4/931
1
- STRUCTURE • 9 Use
n •osed Use
Permit includes: ❑ Building ❑ Plumbing . LI Mechanical El Other
Type of Work: ❑ Residential ❑ New ❑ Remodel ❑ Number of Units ❑ Deck
❑ Commercial ❑ Addition ❑ Garage ❑ Shed ❑ Other
Enter 1st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area sq ft
Water Availability ❑ Sewer Availability El On-Site Septic System Availability ❑ . .Project Valuation $
Zoning Lot Size Existing B1dg Vaittation''.. ::.; ?
-:',.----:-•. ::...ENDER
Name Address
City State Zip
MECHANICAL'-CONTRACTOR
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING CONTRACTOR
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING--FIXTURE---COUNT..: .
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water H ters Sumps
Lavatories Washing Machi e-, Drains Total Fixture Count
.......................... .. . ..... ....
MECHANICAL UNIT'COUNT
Fuel Type (electric/other) (15 Gas Dryer '3,./.„,/- Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping /II ' Range I - Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUs bid/'L' Gas Log I 4- Unit Heater 50+ Tons
' ' Furn >100 BTUs Fans Miscellaneous Fuel Tanks
Gas Hwt L ' ( Hood Boilers Above Ground
Cony Burner Duct Work 0-3 Tons Underground
BBQ's / ' Wood Stoves 3-15 Tons Total Unit Count
DISCLAIMER: 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. )
i
`Owner/Agent O.A
(../f�-� Date: =� ' /..7/ l