92-101756 • ic,)
CITY OF FEDERAL WAY MECHANICAL PNO.: 'BLD92-2 99
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 10/13/92
Federal Way, WA 98003 BY: FLF
661-4000
SITE ADDRESS: 230 368TH SW
PARCEL NO.: 570780-0040Lot-,
PROJECT DESCRIPTION: HVAC ® INSTALL GAS STOVE
r OWNER CONTRACTOR — LENDER
i MR/MRS CHI GOLDENFIRE INSTALLATIONS
230 368TH SW 29408 PACIFIC HIGHWAY S
FEDERAL WAY WA FEDERAL WAY WA 98003
841-9679 839-0998
1111 GOLDEFI088KQ
FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS FEES: I
GAS PIPING.: 25 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 0 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 8.50
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 • 1 <=10,000 CFM: 0 ABOVE GROUND: 0
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0 TOTAL FEES $ 28.50
INSPECTION RECORD
Water Line OK Mechanical Inspection Notes:
likS PIPING OK /O-j1-6.2. /)IA,' 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.
i
OWNER OR AGENT7,:‘'‘77----���� DATE /' '//A,_
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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
DATE BY
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CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print-
BOX 1 TENANT NAME:
OWNER /if i' 7 1412-5 6/I' SITE LOCATION SA'''E- .
OWNER'S ADDRESS' 2-3C) 31.:S'i-:`) 5 ✓tCITY ;4[I2 ,� , ,,
PHONE M- 7?
DESCRIBE JOB cis -rove"
THE PROPERTY IS OWNED BY: SINGLE/MARRIED / PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME Cie, -e-r-4 ; 4CONTRACTOR'S REG. ,' .,ei L)Q F/6 e0
o
Card MUST be presented
CONTRACTOR'S ADDRESS /o s .A/,,/ CITYforpth P PHONE V- moi-di,3j'7
EXPIRATION DATE /-> Mir r
I-1
— 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 . '7he f:";"Es riAc 5110 t° - -4 IPHONE`�3��'�F
c.
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER '?-7 0-1 D c 0 4
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 1 2ND FLOOR / - -
3RD - FLOOR I BASEMENT / - DECK I 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) -. MECH4NICAL APPLIANCES — BASIC FEE$ ^- - _.
NO. -. WATERCLOSETS - GAS PIPING, FEET Z _ c$__._
BATHTUBS NO. FURNACE, ELEC. GAS / $
SHOWERS GAS HOT WATER HEATER- .- ----
LAVATORIES
- - - CONVERFON BURNER - -- -- $_ _
SINKS BOILER, SIZE BTU $
DISHWASHERS
_ - AIR HANDLING UNITS $ ------- --
ELECTRIC HOT WATER HEATER -•• - - - - HEAT PUMPS, SIZE _ _ _
LAUNDRY WASHER OUTLET — $
- ----_ UNIT HEATERS S
URINALS - AIR COOLING UNITS, SIZE -- - .
DRINKING FOUNTAINS $ _
-- - - COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER GN-5 5rov.' $
DRAINS
OTHER -- $ - -- -- - -
TOTAL FIXTURES _ - . - . - _. _ S "
$
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 AC URACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
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OWNER/AGE �nf---7 -../....../'-
DATE: 7
AHP-008 31.0