93-102038 CITY OF FEDERAL WAY MECHANICAL PERIVI I°T PERMIT NO.: BLD93-089,1
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 08/11/93
Federal Way, WA 98003 BY: FC
661-4000
SITE ADDRESS: 4224 SW 314TH PL
PARCEL NO.: 8731990530
PROJECT DESCRIPTION: HVAC
OWNER .- CONTRACTORLENDER
CHARLES ACKERMAN G & G GAS APPLIANCE INST 1
4224 SW 314 PL 27027 316TH AVE SE
FEDERAL WAY WA 98023 RAVENSDALE WA 98051
00836 886-7112
GGGASAI093B2
FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 80 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 0 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 22.50
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..: 1 AIR HANDLING UNITS FUEL TANKS
RANGE • 0 <=10,000 CFM: 0 ABOVE GROUND: 0
GAS LOGS...: 1 > 10,000 CFM: 0 UNDERGROUND.: 0 TOTAL FEES $ 42.50
INSPECTION RECORD
•ter Line OK Mechanical Inspection Notes:
GAS PIPING OK -/ 7/f3� Date /;//c5 By/e±
1
j
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 OR AGENT ��S.- /7/e ' , ,l��/ DATE• . //, " ..) (t� �\��f
��� ��ti
bld_mech 07/01/92 � ^
City of Federal Way
APPLICATION FOR BUILDING PERMIT
PLEASE PRINT APPLICATION #:
SITE LOCATION 1 Address /,-102_? / 344 /7G
Ten (if known) Lot# Assessor's Tax #
Tenor);
�l G'i'1 c C. K G rv2ioi'
Building Owner Name Address �}
i 1- -/ ti22u S L-2- Vii// Pz-
City FCGf / 0..State 0..,„ 9:27
(� Zip L�� 3 Phone 7- 0
Nature of Work C` t� C�j - v� 5 7:4'//0',`/0
APPLICANT
Name (F,M,L)
6....
Address
79 3.7 6' /7(7e:(7F
City j)/Jt�' /r��'/� I/ State 1-7 Zip / d
Contact rson Day Pho Other Phone Fax
BUILDING CONTRACTOR:
Company Name
Address
City State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No
ARCHITECT
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
CD0492(Rev 4/93)
MEW
STRUCTURE Existing Use Proposed Use
Permit includes: ❑ Building ❑ Plumbing ❑ Mechanical ❑ Other
Type of Work: ❑ Residential ❑ New ❑ Remodel ❑ Number of Units_ 1=1Deck
❑ Commercial ❑ Addition ❑ Garage 0 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 ❑ On-Site Septic System Availability ❑ Project Valuation $
Zoning Lot Size Existing Bldg Valuation $
LENDER
Name Address
City State Zip
MECHANICAL CONTRACTOR
Contra for Name / ,� Address
4` 6- 6'G,L App//:->i„,.'-P �1 Jc Ti"7/ i T 01 '-/ia'7 �?/e iii//c" L
Cityeti �? State fizz-5 L 7 Zip c/g- �%
Contact Phone Fax f —,
tS,61:////i 0 _4_,) GI'edt i 6. 1-'?
License # (T..6._6_A_.c.: 21 0 ..71----e; -" Expiration Date i-ti//- Verified (14--Yes ❑ No
PLUMBING CONTRACTOR .
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes ❑ No
PLUMBING FIXTURE COUNT
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total Fixture Count.
..................
MECHANICAL UNIT COUNT
Fuel Type (electric/other) Gas Dryer f Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping 03 ,' Range Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUs Gas Log I Unit Heater 50+ Tons
Furn >100 BTUs Fans Miscellaneous Fuel Tanks
Gas Hwt 1 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 s ch claim),which may be made by any person,including the undersigned,and filed against the City of Federal Way,
but only where s - •. arises out a relic ce of the ity, including its officers and employees,upon the accuracy of the information supplied to the City as a part of this
application.
Owner/Agent; i -.7�r / E - Date: - 1/ i