92-101396 CITY OF FEDERAL WAY IVI E C H A N I C A L PERIVIIT PERMIT NO.: BLD92-2119
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 09/10/92
Federal Way, WA 98003 BY: MH
661-4000
SITE ADDRESS: 4743 SW 313TH PL
PARCEL NO.: 211570-0100
PROJECT DESCRIPTION: )
OWNER CONTRACTOR LENDER
KENETH DISHBROW ABC GAS INSTALLATIONS
iiSW 313 PL9923 64TH AVE. CT. E•
RAL WAY WA 98003 PUYALLUP WA 98373
927-3051 ; 845-7482
ABCGAI*113N3
FUEL TYPES.:GAS ? 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 • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 6.50
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 $ 26.50
INSPECTION RECORD
•ter Line OK Mechanical Inspection Notes:
GAS PIPING OKZc<,.7 %"r,,/ Date//-/O-51 - By 4,7L/
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.
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OWNER OR AGENT ,__ Zie . _ _ DATE ! ` /e' %.-. )
bld_mech 07/01/92
SET BACKS AND FOOTINGS O.K TO POUR FOUNDATION WALLS PLUMBING GROUNDWORK
DATE -...... BY - DATE -..- -_ BY DATE _. -_. - ___BY
PLUMBING ROUGH IN WATER LINE O.K. _ MECHANICAL INSPECTION
DATE.... BY GAS PIPING O.K. ___- DATE - __- BY
O.K. TO ENCLOSE FRAMING INSULATION WALL BOARD AND FIRE WALL
DATE BY DATE - __BY DATE - BY
FINAL O.K. TO OCCUPY
DCD PSD FD
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CITY OF FEDERAL WAY
AUG 31 1992 BUILDING PERMIT APPLICATION
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fitatikAL itAY - Please Print—
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BOX 1 TENANT NAME:
OWNER -1,I16. SITE LOCATION 4 7 S l3 f-'4
OWNER'S ADDRESS - - - TY u• /U, PHONE x'02 7 "30 s" /
DESCRIBE JOBS 1
THE PROPERTY IS OWNED :Y: SINGLE/MA`RRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME Q C: - . - -r CONTRACTOR'S REG. #8cC,' '' (13 y
Card MUST be presented
CONTRACTOR'S ADDRESS 9?.„--7 3 .- e'-re CITY �� PHONE 6i 4('
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 PHONE g'.4/-74/A
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER o?//..5-7 0 o / Q C.)
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 ( ) 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 C� $
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 $
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: i/1 DATE: (2—
ANP-008 3/90