93-102775 4001011( g3.)oa--75
CITY 335300F FEDERAL WAY Firstt Way South MECHANICAL PERMIT PERMIT NO:ISSUED: 110/28/9368
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 04/26/94
ADDRESS:29918 21ST AVE S
NO . : 798320-0030
PROJECT DESCRIPTION:HVAC - INSTALL WOOD STOVE
ivOWNER — CONTRACTOR — LENDER
CRAIG RAMSAY CLAUSEN ENTERPRISES
29918 - 21ST AVE S P.O. BOX 177
EDERAL WAY NA 98003 CLINTON ISLAND WA 98236
839-9161 321-0836
CLAUSE*102C1
FUEL TYPES.:? ? FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 0 ft HOOD • 0 0-3 HP . 0 NEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 0 DUCT WORK . 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 6.50
GAS HNT • 0 WOOD STOVES...: 1 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 $ 26.50
•
Does 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.
177)
OWNER OR AGENT ,,,ti/. A ic . ..e,:. DATE _J0 --z-a--:)3
FILE COPY
33530CITY
F
WAY
0 First Way South MECHAINTICAL PE1ZMIT PERMITISSUED: 10/28/9368
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 04/26/94
ADDRESS:29918 21ST AVE S
NO. : 798320-0030
PROJECT DESCRIPTION:NVAC - IMSTALL NOOD SIOVE
OWNER COMIfACIDR _ .._ ,_.- LENDER S- ,.. . ----,...-=1,== ,
._
CRAIG RAMSAY CLAUSEN ENTERPRISES - ,_,
9918 - 21ST AVE S P.O. BOX 177 _v
EDERAL MAY MA 98003 CLINTON ISLAND WA 98236
639-9161 321-0836
6 6
FUEL TYPES.:? ? --F ANS--
--,46,4 6OItERSjCO 'RESSOitS FEES: =a
GAS PIPING.. 0 ft HOOD �' r3 et C, NEC PRIT ISSUANCE... 8 20.00
FURNc100K..: 0 DUCT MOR!(*-, ;`, 0 ',15.1...,#0.*': 0 -; E FEES.* t 6.S0 ..
GAS HMT • 0 MOOD SI _ 3Np ''� , gp ` 7 �d: —E
CONY BURNER: 0 TURN>1OO1 �. ,� @ * 50 HP. ' z az a:� +��� ���° ,, ,-.-4,,, . ,, , " a i u
LIT
BBQ... • 0 NISCH .� ,....: `0�� ,0 •. _
GAS DRYER... 0 AIR II6 M S
RANGE • 0 (:10,10K)CML O � ", ; 4: I -
GAS LOGS0 > 10,000"FN" 0 UNDERGROUND.: 0144 -4
TOTAL FEES $ 26.50
_
Does the eater supply system contain a Pressure Reduction Device or Check valve? () Yes (0 No (If -Yes' then eater expansion tank is required on Not Water Tank)
Inspection Record Water Line OK ______ Mechanical Inspection Notes: //Dose //d r DG 21oit.2L arca T Cu JsT?uc7,0./
[...,....,
GAS PIPING OK Datei'-3-13 By MA) 44/2 /4G6lIEC47k, A4- 15 Sam, ce..,fr F--... ,z_ C•,-...ec.sTIn21.
PERMITS EXPIRE 180 DAIS AFTER ISSUANCE IF NO MORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISED NY NE IS TRUE AND CORRECT TO THE BEST OF NY KNOWLEDGE ANT) THE APPLICABLE CITY OF FERIRAL WAY REQUIREMENTS MILL BE MET.
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owNEF ,, , �,-,,Lti< A-IGATE 1) -..:.a- 3
FIELD COPY 0)1''‘/4),/,./d
111111144.
• PAIR # V-03- I(LX
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print-
BOX 1 TENANT NAME: 'Rc ,4 ANO K,iM.r.AJ
OWNER7.-42-a+c- A, An+d w 1�Ai ) 4' SITE LOCATION _ - r A_= < -�
OWNER'S ADDRESS it3 Zi 47-ALrt- S_ CITY{=_w_ A-4 PHONE 839 -3j
DESCRIBE JOB (,-ia," -7r k.'e.
THE PROPERTY IS OWNED BY: SINGLE/MARRIED ✓ PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME J//Vog ;;t;rs-7-- /N: .ati_ CONTRACTOR'S REG.
Card MUST be presented
CONTRACTOR'S ADDRESS P 0. Box 1 '7 7 _ CITY -fivn '. PHONE - Ob z3fe
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 C'.J=\,L- PHONE 839- ,E-‘
B0X&SEWER DISTRICT WATER DISTRICT (OW C1.11V1iz z. # �t
BOX&ESTIMATED PROJECT COST EXISTING BUILDING VALUATION (.6,400
BOX 6 PROPERTY TAX ACCOUNT NUMBER 79830-0) 00:30 - r)h
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOP 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 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 S
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 ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: A. -cnvezd/ DATE: /C -76)
ANP.008 3;90