93-103212 9 /6 3.14CITY
335300F FEDERAL WAY Firstt Way South MECHANICAL P E�I T PERMIT NO:ISSUED: 162/20/9353
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 06/18/94
ADDRESS: 1829 S 308TH ST
NO. : 785360-0120
PROJECT DESCRIPTION:INSTALL GAS FURNACE (CHANGEOUT)
i= OWNER — CONTRACTOR — LENDER
STEEL LAKE PREESBYTERIAN CHRCH NORDIC HEATING, INC.
1829 S 308TH ST 3401 C ST. NW BAY 1
EDERAL WAY NA 98003 AUBURN WA 98002
965-6210 931-0503
NORDIHI0998J
FUEL TYPES.:GAS FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... $ 20.00
FURN<IOOK..: 1 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 10.00
GAS HMT • 0 WOOD STOVES...: 0 15-30 HP • 0
CONY 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
.des the water supply system contain a Pressure Reduction Device or Check valve? () Yes () No (If 'Yes' then water expansion tank is required on Hot Water Tank)
Inspection Record Mater Line OK Mechanical Inspection Notes:
GAS PIPING OK Date By
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISED BY ME IS TR E AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS WILL BE MET.
N �J / 7OWNERORAGENT _..L-g - DATE _ (_f`121'/`lam
F LE COPY
- /CITY
335300F E i rs0t FWay South ERAL WAY lr 1EH� AL E� PERMIT
ISSUED: 112/20/9353
Federal Way , WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 06/18/94
ADDRESS: 1829 S 308TH ST
NO_ : 785360-0120
PROJECT DESCRIPTION:INSTALL GAS FURNACE (CHANGEOUT)
OWNER . _.______ ._.. CONTRACTOR .,= _. ,mss LEIR3ER
STEEL LAKE PREESBYTERIAN CHRCH NORDIC HEATING, INC.
1829 S 306TH ST 3101 C ST. NM SAY 1
DERAL NAY NA 98003 AUBURN NA 98002
965-6210 9.I 0S0
FUEL TYPES.:GAS TANS : 0 WItiR 1 II FEES:
,GAS PIPING.: 0 ft HOOD 0'` - TIP 0 :.. P' ISSUANCE... $ 20.00
FURN<100K..: tDUCI M X..,..; 0 .15 HP ^ �� �`' ' r� >E FEE" $ 10.00
GAS HMT....: 0 HOOD SI .: 0 15-30 HP ...: A SV
CONY BURNER: 0 FURI!91441... ..: °0 -50 HP _- 0
880 0 MTSC. .....*may4
GAS DRYER..: 0 AIR IWIDL G
RANGE • 0 (-10,000 ellk 0 AVE 116ND: :'s
GAS tOGS...: 0 > 10,000,CFN: 0 IMDERGRO000 • 9
ITOTAL FEES 1 30.00
Does the water supply systea contain a Pressure Reduction Device or Ciiec1 Yaws? () Yes () No (If 'Yes' then water expansion tank is required on Hot Water Tank)
Inspection Record Water line OK 4:'chlnie31 ,inspection Notes:
/yam s ,. '
GAS PIPING OK
iX ..-- vase t /r/93'i _- _ __-
ss. 3" a
PERMITS EXPIRE 180 DAYS AFTER ISSUANI,L IE NO MORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISED BY ME IS TRUE AND CORRECT To THE BEST OF NY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAt WAY REQUIREMENTS MILL BE NET.
OWNER OP AGM �. - {Z GaT
/,7- C;i1/
FIELD COPY �� //1.af / ?"Zio
Pert # �D11, '
CITY. OF FEDERAL WAY t) - 2-21
BUILDING PERMIT APPLICATION //
-- Please Print— Lek
100
BOX
BOX 1 TENANT NAME:
OWNERy'✓i/��/ chL4 c til SITE LOCATION / �1�/ Si 3r)S Sf
OWNER'S ADDRESS CITY Fe—bet/Az/ Lt.44. PHONE s�3'+ 1 f).1 C) _
DESCRIBE JOB cr .1-Th,-nac e,- e h THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP_ CORPORATION____
BOX 2 CONTRACTOR'S NAME R-01 C /1/cm- CONTRACTOR'S REG. # /W1/4 fl¢1C31 1 87
Card MUST be presented
CONTRACTOR'S ADDRESS / ' - CITY A1-c- b U/!-rU' PHONE .31-0,s1 j
EXPIRATION DATE / - ( 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 _�� - A1ICr KA-'T-m PHO E `►' 3'-
BOX 4 SEWER DISTRICT -WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST _ EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
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 J_„
3RD FLOOR-------.—/-------_-_.-- BASEMENT / DECK _I 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._ I FURNACE, ELEC. GAS $ _ _
SHOWERS GAS HOT WATER HEATER $
LAVATORIES CONVERSION BURNER S
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 TH ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: 4-2, / (/ t�ii DATE: �, -� - ----
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