92-101730 CITY OF FEDERAL WAY IVI EC HAN I CAL PERMIT PERMIT NO.: BLD92-2281
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 10/08/92
Federal Way, WA 98003 BY: JJ
661-4000
SITE ADDRESS: 505 SW 328TH CT
PARCEL NO.: 926491-1230
PROJECT DESCRIPTION: HVAC
r– OWNER — CONTRACTOR LENDER
BOLDT AMERICAN HEATING SERVICE, INC.
' 505 SW 328TH CT 7517 PORTLAND AVE.
FEDERAL WAY WA 98023 TACOMA WA 98404
952-3625 847-8399
AMERIHS083M5
1110FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 95 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 1 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 12.00
GAS HWT • 0 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 $ 32.00
INSPECTION RECORD
Water Line OK Mechanical Inspection Notes:
S PIPING OK /6/ 2., Date !/ By
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
`/ DATE IC4/2
bld_mech 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
DAT0Z3�L1 BY 4I----,,,
/4/Q //A? <A
Permit # �j�. %� 4Z _- 2ZJ/
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print-
BOX 1 TENANT NAME:
OWNER4 J d, ( SITE LOCATION_.
OWNER'S ADDRESS b05 3'L' -7c& C.+, CITY (—esti LL1e1y PHONE 96---.� - , � , S-
DESCRIBE JOB
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME ". ' . I 11 ' CONTRACTOR'S REG. # mid iii . /07P22 -,
iiCard UST be presented
CONTRACTOR'S
DA DATE / dJl -3`1
,.4,
EXPIRATG � C11Y 1iletr, 7
�� PHONE � ' � �I!
- 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 Z.-40c( Glilf (^ PHONE
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER )6, `�i t --/d�,4 (5
_! 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 I BASEMENT / DECK / GARAGE /
BOX 8 (/) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) (A EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) ME H NICAL APPLIANCES - BASIC FEE$-
NO. WATERCLOSETS GAS PIPING, FEET ,,�. . $- -
BATHTUBS NO. j FURNACE, ELEC. GAS C- $
SHOWERS
GAS HOT WATER HEATER _ "- $LAVATORIES - - CONVERtON 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, VON T.E ACCU ACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: 1,4, �� DATE: �� iir
ANP-008 3i(p