92-101268 r
/01
CITY OF FEDERAL WAY MECHANICAL PERMIT PERMIT NO BLD92-2 052
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 08/18/92
Federal Way, WA 98003 BY: AJ
661-4000
SITE ADDRESS: 3641 SW 328TH ST
PARCEL NO.: 873195-0270
PROJECT DESCRIPTION: MECH
- OWNER - CONTRACTOR LENDER
ROGER EMMONS PACIFIC GAS HEATING & AIR INC
3641 SW 328TH 11002 34TH AVE S
FEDERAL WAY WA 98023 TACOMA WA 98444
874-9536 582-5882
PACIFGH110ME
AFEllLTYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 25 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.* $ 18.50
GAS HWT • 1 WOOD STOVES...: 0 15-30 HP • 0
CONV BURNER: 0 FURN>100K • 0 30-50 HP • 0
BBC) • 0 MISC • 0 5+ HP • 0
GAS DR"ER..: 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 $ 38.50
INSPECTION RECORD
Water Line OK Mechanical Inspection Notes:
SAS PIPING OK (0-- ?--- 1?..._ Date Li" ;'-12 By b1///t,.
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 �� ) Lam/ Ced DATE / -
bld mech 07/01/92
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2 r1 yN'
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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. fPf/0'/-t42- A&►I 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_./0-("q'/_2--BY 041 - -
•. Permit # L-I)9 2 ()S
•
AR G11231E2 CITY OF FEDERAL WAY
_ ... vygiXBUILDING PERMIT APPLICATION 56
)'d . — Please Print—
BOX 1 TENANT NAME: t c)
OWNER SITE LOCATION .4 ( ,S-14/ S � �S'1 - (P/4-.>33-1
OWNER'S ADDRESS S6CI T4 ai% l.c)Q PHONE 9,rdLi
DESCRIBE JOB i 1"),S1 c,' 1/ / ) �i-c,�n_ � % A /7 / c.4
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATIONF
BOX 2 CONTRACTOR'S NAME 'Pa-e'_t r , i-41,3)q) 4' O tit,, /, c' CONTRACTOR'S REG. #V , L ra ►I to0 Card MUST be presented
CONTRACTOR'S ADDRESS / /l t - -3 /117) S CITY / z [''d/7") 'r PHONE
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 C'AZ a., ,) PHONE -
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER c6‘). 1
_L ri C- 47)
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 J.) $
BATHTUBS NO. FURNACE, ELEC. GAS r $
SHOWERS I 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: / ;,Z2._-/ L1Jci DATE: S" -3 "9
ANP-008 3/90
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL
REMARKS:
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DATE
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL DATE
REMARKS:
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ADD/ALT NEW MULTIFAMILY (UNITS
MULTIFAMILY ADD/ALT TENANT IMP. OTHER
OCCUPANCY TYPE OF CONSTRUCTION STORES
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION
BUILDING DEPARTMENT REMARKS: PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
ASSIGNED ADDRESS:
RECEIVED
AUG 1 3 1992 PARTIAL PLAN CHECK FEE RECEIVED
OTY OF F'OERAL 91#4bunt Date Receipt#
II M.0440 Fr"
BUILDING DEPARTMENT APPROVAL
RECEIVED BY DATE ACCEPTED FOR FILING