93-100073 tr, r 9?-1000'3
CITY OF FEDERAL WAY IVI EC HAN I CAL PERMIT PERMIT NO.: BLD93-0016
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 01/08/93
Federal Way, WA 98003 BY: FLF
661-4000
SITE ADDRESS: 31701 20TH AVE S
PARCEL NO.: 092104-9034
PROJECT DESCRIPTION: HVAC - INSTALL GAS PIPING
OWNER -- CONTRACTOR -- LENDER
JOSEPH HOLMAN BEDROCK GENERAL CNTRNG INC
41
31701 20TH AVE S 16618 NE 128TH ST
FEDERAL WAY WA REDMOND WA 98052
5990 206-869-5862
BEDROGCD99J2
FUEL TYPES.:GAS FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 60 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... S 20.00
FURN<100K..: 0 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 3.00
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 $ 23.00
INSPECTION RECORD
Water Line OK Mechanical Inspection Notes:
It PIPING OK Date By
LL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS RUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT 17Y0Ci- -- 70,9-6, DATE ! 4 -.:,
bld mech 07/01/92 / ,--/
• Pipit # L cls - GO/6r
CITY OF FEDERAL WAY
JAN - 8 X33 ,,
BUILDING PERMIT APPLICATION
f!1R 1`r`" -Please Print—
BOX 1 TENANT NAME:
OWNER G/1''/fi SITE LOCATION
OWNER'S ADDRESS CI ZIP PHONE
DESCRIBE JOB CSD I 471c ,/A-/
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOXBOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG. #
Dept.of 1.81 Card MUST be presented
CONTRACTOR'S ADDRESS CITY ZIP 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 LENDER'S NAME:
ADDRESS CITY ZIP PHONE
BOX 4 CONTACT PERSON e r1 // /1/1/i PHONE 0- 2.z - kO•cp
BOX 5 SEWER DISTRICT WATER DISTRICT
BOX 6 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 7 PARACEL NUMBER
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording#
BOX 8 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR______/ BASEMENT / DECK
BOX 9 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY(NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 10 PLUMBING FIXTURES(including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET
BATHTUBS NO. FURNACE, ELEC. GAS T $
SHOWERS 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 AC7CURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT- v2 1 '�' /y, �� DATE: ��
CITY OF FEDERAL WAY IVI EC HAIV I CAL PERMIT 954.0073PERMIT NO.: BLD93®0016
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 01/08/93
Federal Way, WA 98003 BY: FLF
661-4000
SITE ADDRESS: 31701 20TH AVE S
PARCEL NO.: 092104-9034
PROJECT DESCRIPTION: HVAC - INSTALL GAS PIPING
- OWNER CONTRACTOR LENDER
JOSEPH HOLMAN BEDROCK GENERAL CNTRNG INC
31701 20TH AVE S 16618 NE 128TH ST
FEDERAL WAY WA REDMOND WA 98052
0 990 206-869-5862
BEDROGCD99J2
r FUEL TYPES.:GAS FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 60 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.* $ 3.00
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 $ 23.00
INSPECTION RECORD
Ober Line OK Mechanical Inspection Notes:
•S PIPING OK - AU Date By
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME SS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT
/---) 4���L'2-. DATEbch 07/01/92D27GE
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