92-101566 CITY OF FEDERAL WAY lviECHANICAL PER 9a, )bl92-2
I� PERMIT NO.. BLD92 2195
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 09/22/92
Federal Way, WA 98003
BY: NH
661-4000
SITE ADDRESS: 2500 S 302ND PL
PARCEL NO.: 3655000150
PROJECT DESCRIPTION:
OWNER — CONTRACTOR *- LENDER
ANITA DORION NORTHWEST WATER HEATER
2500 S 302ND PL 8201 DURANGO ST SW
FEDERAL WAY WA TACOMA, WA WA 98499
946-0302 984-6404
NORTHWH103R2
FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... S 20.00
FURN<100K..: 1 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 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 <=10,000 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:
40, PIPING OK 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 f' Lz_.? ( Z
bld_mech 07/01/92
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v'oriVEDCITY OF FEDERAL WAY
P L 192 SE
BUILDING PERMIT APPLICATION
AV — Please Print—
BOXY 1 TENIe `'i Alb
OWNER ( t ,. k_Ok-- Y c51, SITE LOCATIONS � 11 2 P
OWNER'S ADDRESS� IDU eo- L_. CITY;- .R11�l�oc. PHONE `"i`l l c �Y\---)
DESCRIBE JOB L- -z(_C
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAMECAL)G*-- CONTRACTOR'S REG. # NZ‘` 1 t\t- (1W.;2--
Card
—
_ Card MUST be presented
CONTRACTOR'S ADDRESS \ wr:�.ti�c `SI. ` ) CITY----'�&(-i rn'-\ PHONE 4-1 i-lO�1C
EXPIRATION DATE l a / - J 9.3
- 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 PHONE` l`.. 1 L -(
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST . (. (kEXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER .3(.49 L7`,1) jU - (: I _
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 /i
BATHTUBS NO. ( FURNACE, ELEC. ) GAS
SHOWERS GAS HOT WATER HEAER $
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 THEINFFO"RMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: IL-1214tiQ � DATE:
ANP-00.9 3!90