92-101702 CITY OF FEDERAL WAY IVI EC HAN I CAL PERMIT PERMIT NO.: BLD92-2268
33530 First Way South BUILDING INSPECTION - 6614140 ISSUED: 10/09/92
Federal Way, WA 98003 BY: FLF
661-4000
SITE ADDRESS: 3914 SW 328TH PL
PARCEL NO.: 873213®1220
PROJECT DESCRIPTION: HVAC - GAS TO GAS FURNACE CHANGEOUT
— OWNER CONTRACTOR 1 LENDER
SUSAN ANIBARRO ARCO INSTALLATION, LTD.
3914 1902 S.341ST PL. #9
SW 328TH PL FEDERAL WAY WA 98003
FEDERAL WAY WA
874-1979 2-5433
JDARCOIL*141LE
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..: 1 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* 5 10.00
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 <e10,000 CFM: 0 ABOVE GROUND: 0
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0 TOTAL FEES $ 30.00
INSPECTION RECORD
•
Water Line OK Mechanical Inspection Notes: 17111 '4.4q
OS PIPING OK Date By
BY vv a/ DATE - /6- ('3
ALL P ITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I EricCERTIFY THAT THE INFORMATION ME I TRU CORRECT THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT 'p; , i DATE /C ( / `r L-- ..
bld_mech 07/01/92 G
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
l a i S S Z /it) 14cc c r5 A/O 1 v 5 P, ht 4.1
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CITY OF FEDERAL WAY /���
OCT 0 7 1992 BUILDING PERMIT APPLICATION '- Q°rvit-
o OF F L .t3,A . « "- -please Print- .Z`L<<L n tit�'l'v�✓
URBINO t -
BOX 1 TENANT NAME:
OWNER r SITE LOCATION -- % r .
OWNER'S ADDRESS - : CITY en21 Way PHONE = y-' 4!l Gi
DESCRIBE JOB A s_+ " I' • I'
THE PROPERTY I OWNED BY: INGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME 41 ,P23-'421-42}174221.5CONTRACTOR'S REG. # �L'[�. L `1���.
/ / Card MUST be presented
CONTRACTOR'S ADDRESS /?,1' 5e.gy/si P6. 'e 9' CITY f'ht 1 (Ay PHONE 9Fd`5Vc __
EXPIRATION DATE 1c2-3l- 4a____
- 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 tr72 Air- 17.— _O2- -7-67`�" '^'L° :,' 2.--z-7-331/4 PHONE _
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER g 'T.3Q/3 r IGIA t
LEGAL DESCRIPTION
(It necessary, please submit a separate page with the legal description,)
KC. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR . ' / 2ND FLOOR /
3RD FLOOR_____/ BASEMENT, / DECK ,J _ GARAGE _ I
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 N0._ / FURNACE, ELEC. GAS1 $
SHOWERS , GAS HOT WATER HEATER $
LAVATORIES T 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 ANYCLAIM(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: A.�*< it .,� ` -L��/ "7G,
DATE: