93-102793 �' 93 , tbc)793
CITY
335300Firstt Way South F FEDERAL WAY M ECHAN I CAI_ P E R M I T PERISSUED: 111 /02/9370
Federal Way, WA 98003 Building Inspection Requests 661 -4140 BY: FLF
661 -4000 EXPIRES: 05/01 /94
ADDRESS: 1803 SW 307TH ST
NO. : 770380-0040
PROJECT DESCRIPTION:HVAC - INSTALL GAS LOG 6 PIPING
O — CONTRACTOR — LENDER
JOANWNERKELSEY
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NORTHWEST WATER HEATER
1803 SW 307TH ST 8201 DURANGO ST SW
EDERAL WAY WA 98023 TACOMA, WA WA 98499
838-1556 984-6404 588-0393
NORTHWH103R2
FUEL TYPES.:GAS FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 40 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.* $ 9.50
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 • 0 <_10,000 CFM: 0 ABOVE GROUND: 0
GAS LOGS...: 1 > 10,000 CFM: 0 UNDERGROUND.: 0
TOTAL FEES $ 29.50
oes 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 Water 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 TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT —7:..7„.;:a;. DATE //—.P--,3
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OCT-28-83 THU 16:03 NW WATER HEATER TACOMA FAX NO. 206 588 0353 � � P. 01
• Derr( 1 -'�1 '3' )i ?r;
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CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
-Please Print—
BOX 1 TENANT NAME' ---- -
OWNER 4Z_ . K . '�.�1 ---
SITE LOCATION L. ` ^ -,
OWNER'S ADDRESS I , CC. _ -F CITY f, IAL.__-� _- PHONE_‘,3R..- 1.15.:__;..‘_
DESCRIBE JOB a�Y'?-) c _ C • j.."'
THE PROPERTY IS OWNED BY: StNGLE/MARRI i 17 .PARTNERSHIP _ . CORPORATION
BOX 2 CONTRACTOR'S NAME .- 5.a) 11) y,it �`t ;gyp4 CONTRACTOR'S REG. # NoRT 14w 3
CONTRACTOR'S ADDRESS • 1 wy _. Q n S+S%TY l CC cera MusT be presen e
EXPIRATION DATE la as r.' �( _ _. PNON G�-
— 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 WITHOJT PROOF OF REGISTRATION,
BOX.3 CONTACT PERSON • ' r 1 P_ _ _-. PHON dIMIMO
BOX 4 SEWED DISTRICT WATER DISTRICT _ _______
_
BOX 5 ESTIMATED PROJECT COOT �r _- EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NLMBER—fit k 3 C ) C 0
LEGAL DESCRIPTION _
—
(I`necessary, please sJbmit a separate page with the legal descrictiOn.)
KC. Flat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR -l. 2ND FLOOR _ .1
3RD FLOOR ../_� BASEMENT . _I — DECK I GARAGE—____ I
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ___) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY _SO FT
SOX g PLUMBING FIXTURES(including rough-ins) MECHA I A,.APPLIANCES—BASIC FEE 3
NO___t,_ WATERCLOSETS GAS PIPING, FEET $
�BA''HTUBS NO FURNACE, ELEC. GAS_.. $ +_
SHOWERS GAS HOT WATER HEATER 3 _ _
LAVATORIES CONVERSION BURNER $
SINKS BOILER, SIZE__. ETU 3
DISHWASHERS r__. _._AIR HANDLING UNITS $
__ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE^ 3
— ____ LAUNDRY WASHER OUTLET UNIT HEATERS 3 _
URINALS __AIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS COMMERCIAL H033 3
SUMPS, SPRINKLER VACUUM BREAKERS ._OTHER . . _ $
_— DRAINS $
OTHER _ _ 3
.TOTAL FIXTURES _ 3
TOTAL MECHANICAL FEE $ _ __
CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OFMY 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'
;EES 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
)FFICERS AND EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION,
t_A , �
OWNER/AGENT: .J 4-`` L) i ' DATE: IC .12
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