92-102187 gc.. 10)12.7
CITY OF FEDERAL WAY VI EC HAN I CAL PERM IT PERMIT NO.: BLD92-2525
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 12/11/92
Federal Way, WA 98003 BY: FM'
661-4000
SITE ADDRESS: 27946 22ND AVE S
PARCEL NO.: 422230-0140
PROJECT DESCRIPTION: HVAC
OWNER — CONTRACTOR -- LENDER
PHYLLIS STRINGER NORTHWEST WATER HEATER
27946 22ND AVE S 8201 DURANGO ST SW
FEDERAL WAY WA 98003 TACOMA, WA WA 98499
941-6765•
984-6404
NORTHWH103R2
FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS FEES: 1
GAS PIPING.: 10 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 1
RANGE • 0 <=10,000 CFM: 0 ABOVE GROUND: 0
GAS LOGS...: 1 > 10,000 CFM: 0 UNDERGROUND.: 0 TOTAL FEES $ 28.50
INSPECTION RECORD
Water Line OK Mechanical Inspection Notes:
WS PIPING OK /-2- ..S /4// Date /-7-5' 3 By 61-72/
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THAT TH IN •RMATION 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 AGEN 414 ` DATE (Z----" 1 r I
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CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 TENANT NAME:
OV NER &. . Q . ►Y\ ' -_ (SITE LOCATION ;fl c}L-t(.> 3-).::D }!}v•-•<__
OWNER'S ADORE•L D- =" CITY-4--( CL-.-,z �- 1. PHONE 'ILI( - -1(47,
c
`, DESCRIBE JOB r.1lhZ5'Ca_(- __; ,:_ }te ) ;L.e,�'� -
THE PROPERTY IS OWNED BY: SINGLE/MANRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME Northwest Wat-Pr Heater CONTRACTOR'S REG. # NORTHWH1O3R2
Card MUST be presented
CONTRACTOR'S ADDRESS 8201 Durango St_ SW CITY Tacoma PHONE 984-6404
EXPIRATION DATE 12-22-92
— OR —
I HAVE READ CHAPTER 18.27.010 RELATING ING T O DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
3OX 3 CONTACT PERSON Angel Foster
PHONE984-6404
30X 4 SEWER DISTRICT WATER DISTRICT
30X 5 ESTIMATED PROJECT COST ) 1/4V7\J EXISTING BUILDING VALUATION
30X 6 PROPERTY TAX ACCOUNT NUMBER k-1-.)-(3)-`60. 01 Li l-
LEGAL DESCRIPTION
•
(If necessary, please submit a separate page with the legal description.) . . - -
K.C. Plat Recording # - •
30X 7 BUILDING SQUARE FOOTAGE:. (Existing/Proposed) 1ST" FLOOR I 2ND FLOOR I - -
3RD - FLOOR / BASEMENT / - - DECK I GARAGE / -
30X 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE _ __
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
•
;OX 9 PLUMBING FIXTURES (including rough-ins) .- ..... .. . MECHANICAL APPLIANCES — BASIC FEE S ---- •-•
NO. • - WATERCLOSETS GAS PIPING, FEET O 5...- .
BATHTUBS NO. FURNACE, ELEC. GAS S
SHOWERS —. . - -- - GAS HOT WATER HEATER. - - 7— S__.._. -
.
LAVATORIES • CONVERtON BURNER - -- -- S-
SINKS BOILER, SIZE BTU $
DISHWASHERS . -
_
- AIR HANDLING UNITS — S ---- -
ELECTRIC HOT WATER HEATER -.- . . HEAT PUMPS, SIZE
LAUNDRY WASHER OUTLET _ _ UNIT HEATERS S
URINALS - AIR COOLING UNITS, SIZE - - i.• - S — .- --
DRINKING FOUNTAINS ..• - - COMMERCIAL HOOD „ - . S
SUMPS, SPRINKLER VACUUM BREAKERS _OTHER C).) ,,-/_) .,k,L,‘c S
DRAINS - .-
-- - - OTHER
-- TOTAL FIXTURES - S'
' TOTAL MECHANICAL FEE *fly S
2ERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
ND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APPLICATION IS
ADE.I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(INCLUDING COSTS,EXPENSES,AND ATTORNEYS'
=ES INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM), WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
ND FILED AGAINST THE CITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
:FICERS AND EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY S A PART OF THIS APPLICATION.
0-/V
v r"NER/AGENT: 4 .) J DATE: