92-101777 CITY OF FEDERAL WAY lvi EC HAN I CAL PERMIT PERMIT NO9 BLD92?2311
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 10/15/92
Federal Way, WA 98003 BY: FLF
661-4000
SITE ADDRESS: 3613 SW 328TH ST
PARCEL NO.: 873195-0340
PROJECT DESCRIPTION: HVAC e INSTALL GAS LOGS
-- OWNER — CONTRACTOR LENDER
DAMGAARD RENNIE SHEET METAL, INC.
iiii SW 328TH STN ST 4820 S. WASHINGTON
RAL WAY WA TACOMA WA 98409
661-1701 472-4099
RENNISM1100N
0
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 • 0 WOOD STOVES...: 0 15-30 HP • 0
CONV BURNER: 0 FURN>100K • 0 30-50 HP • 0
BBO • 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...: 1 > 10,000 CFM: 0 UNDERGROUND.: 0 TOTAL FEES $ 26.50
INSPECTION RECORD
41?ater Line OK Mechanical Inspection Notes:
GAS PIPING OK Date0141., By 1-
C 'riR
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THAT THE INF ATION FURNISHED BY ME IS TR ND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
.1.
OWNER OR AGENT j"--1 : JJ DATE , //,)--'''
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bld meth 07/01/92
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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
DATE BY
4 7/4?& /z:/flog ../‘..A1111 o di / let-61J d'L•
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Trr,71 f D • Per (3 (7 Z - 2-311
U f 1 4 1992 CITY OF FEDERAL WAY
or/Of FEUE9INLVVAY
r. BUILDING PERMIT APPLICATION
BULDING — Please Print—
BOX 1 TENANT NAME:
OWNER ThA-rrv- aA-Y ! SITE LOCATION
OWNER'S ADDRESS� 3 ,a3 SO 3.2 SL , CITY hole v 04-9 PHONE 1()/- l7o /
DESCRIBE JOB tcuj qns Lccf,5
THE PROPERTY IS OWNED Bq': SINGLE)'MARRIED PARTNERSHIP_ CORPORATION
BOX 2 CONTRACTOR'S NAME k 1t- 3 zt -��'� • CONTRACTOR'S REG. #1E010-L IY1110 CLO
Card MUST be presented
CONTRACTOR'S ADDRESS 4C6(01O ` U3I �� CITY I'-e-. PHONE q---m ci cj
EXPIRATION DATE ///dui_
— 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 // EA) PHONE - l
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER $7iq.5 — 341 O
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET $
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 rs 1-S4— $
DRAINS (J $
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 EMPLOYEIESS,, UPON TH CCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: j
l.(%l(/X.01) DATE: /O— i4
l f-
ANP-008 3/90