93-102449 93-/a)YY
CITY
3353O0Firstt Way Sout�,F FEDERAL MECHANICAL PERMI T PERMIT ISSUED: 09/29/9328
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 03/28/94
ADDRESS:30202 23RD AVE S
NO. : 042104-9130
PROJECT DESCRIPTION:HVAC - INSTALL GAS FURNACE, GAS HOT WATER HEATER, & PIPING.
OWNER — CONTRACTOR — LENDER
SHARLENE MORROW AMERICAN HEATING SERVICES INC.
30202 - 23RD AVE S 7503 PORTLAND AVE STE.tB
FEDERAL NAY NA 98003 TACOMA NA 98404
941-5913 539-1702 531-8696
AMERIHS083M5
FUEL TYPES.:GAS FANS . 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 59 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.* $ 19.50
GAS NMT 1 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 $ 39.50
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 NAY REQUIREMENTS WILL BE NET.
.� DATE 9--;,;!q:1_9:2.—
OWNER OR AGENT �� - � -r-s-��-r—�'-
Ii__F COPS'
Permit #
• 411 31,D15- ?0';'45 —
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 TENANT NAME:
OWNER .K me ' nye)ill: SITE LOCATION
OWNER'S ADDRESS 0—r- VP- - ' CITY e ,- a , rC' PHONE_.---N
--
DESCRIBE JOB I7 / / ME-1,jV71 6e
THE PROPERTY IS OWNED BY: SINGLE/MARRIED2c PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME id' 'Jr `to i'' 1 . V' _ '1(`, _CONTRACTOR'S REG. # 1 iiii$.0.?3,4_5
r _ Card MUST be resented
CONTRACTOR'S ADDRESS 9503'P C • akid Alt v CITY PHONE 39_ / 70,2,
,
EXPIRATION DATE • ---i -3-6- Qi3
— OR —
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON _ _! _ PHONE T
77
BOX 4 SEWER DISTRICT _ WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST _ EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER MW i, i
LEGAL DESCRIPTION "—
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE' (Existing/Proposed) 1ST FLOOR J 2ND FLOOR J
3RD FLOOR / BASEMENT / DECK ./ GARAGE . J
BOX 8 SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY ___ SQ FT
BOX 9 PLUMBING FIXTURES (Including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET / $
BATHTUBS NO. ) FURNACE, ELEC. GAS/ $
SHOWERS _1_GAS HOT WATER HEATER $
LAVATORIES CONVERSION BURNER $
SINKS . _.
_ BOILER, SIZE or
BTU $
DISHWASHERS c _..@IR 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 — S
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,OPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: r//'! _A T, '' �4 //...4DATE; C3-ICD
4hn.008 3,130
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