92-101696 9 , Jo) (a9&
CITY OF FEDERAL WAY IVI EC HAN I CAL PERMIT PERMIT NO.: BLD92m2253
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 10/13/92
Federal Way, WA 98003 BY: JJ
661-4000
SITE ADDRESS: 29633 22ND AVE S
PARCEL NO.: 879800-0040
PROJECT DESCRIPTION: HVAC
OWNER .- CONTRACTOR LENDER
DIANA DEANS NORTHWEST WATER HEATER
29633 22ND AVE S 8201 DURANGO ST SW
FERAL WAY WA 98003 TACOMA, WA WA 98499
4688 984-6404
NORTHWH103R2
FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 1 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 10.00
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 $ 30.00
INSPECTION RECORD
.iter Line OK Mechanical Inspection Notes:
GAS PIPING OK,,, , , //I/Li C Date /7.-6-/i- By a/AI
I
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.
OWNER OR AGENT ,i-(L( `. u, DATE ( -
b1d_mech 07/01/92 \_ l Z
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SET BACKS AND FOOTINGS O.K TO POUR FOUNDATION WALLS PLUMBING GROUNDWORK
DATEBY DATE __-__ _aY _ 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//- .-5-2. avid-iv�-_____
_
.
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Permie /S( _ 7 2
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 TENANT NAME:
OWNER 0 «V SITE LOCATION `=Ilr- 3`� C9x19 S
OWNER'S ADDRESS --1(0'33 S. CITY rrkc OLD PHONE 31 - L-RA
DESCRIBE JOB tvc(�
THE PROPERTY IS OWNED BY: SINGLE/M ARIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME V zrf\�-o--L-, -� is-tea �- �v CONTRACTOR'S REG. # IVB
,� Card MUST be presented
CONTRACTOR'S ADDRESSc amu\ T..urz,v1)--63\
0 CITY ct�_e� � PHONE97`y'4tc
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 CONTACT PERSON PHONE C%-H (4,1-{01
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST IP EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER i b QCT -
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
3RD FLOOR / BASEMENT / DECK / 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. FURNACE, ELEC. GAS ' $
SHOWERS GAS HOT WATER HEA ER $
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 AGAINSI I HE CITY OF FEDERAL WAY, BU I ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: �ti"'�– � U:=.Y���� � ��` ` DATE:
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