93-102733 93' t oa-733
CITY
3353O0FirstF DEWay South RAL WAY MECHANICAL P PERMSSUED: 1IT NO: 10/25/9345
Federal Way, WA 98003 Building Inspection Requests 661 -4140 BY: FC
661 -4000 EXPIRES: 04/23/94
ADDRESS:3OO72 10TH AVE SW
NO. : 515320-0525
PROJECT DESCRIPTION:HVAC - INSTALL GAS INSERT
4OWNER — CONTRACTOR — LENDER
ROBERT WADE G 6 G GAS APPLIANCE INST
30072 - 10TH AVE SW 27027 316TH AVE SE
FEDERAL WAY WA 98023 RAVENSDALE WA 98051
941-8525 886-7112
GGGASAI09382
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..: 0 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 6.50
GAS NWT • 0 WOOD STOVES...: 0 15-30 HP • 0
CONY BURNER: 0 FURN>100K • 0 30-50 HP • 0
BBQ • 0 MISC • 1 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
4110
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 TION FURNIS ` ME TRUE A 0 CORRECT TO E BEST OF Y KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS WILL BE MET.
1.11fr
OWNER OR411111$ !/' -„/ _ �/,i/:/�� - - _ DATE 7-
FILE COPY
F FEDERAL WAY
NO:
CITY
0Firstt Way South MECHANICAL_ PERM T PERIISSUED: 100J25/9345
335
Fed
Federal Way , WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 04/23/94
ADDRESS:30072 10TH AVE SW
NO. : 515320-0525
PROJECT DESCRIPTION:HVAC - INSTALL GAS INSERT
OWNER ...-_.____ .-__. _.. -_._-_.. . _ _ _. __....... _.-._.---_--.--_ CONTRACTOR __.,- LENDER -------.-----. _. ___ -___� .r.
ROBERT MADE G 3 G GAS APPLIANCE INST
30072 - 10TH AVE SW 27021 316TH AYE SE
FEDERAL MAY MA 98023 RAYENSDALE MA 98051
941-8525 886-7112
X382
,d
FUEL TYPES.:GASFANS.... .._ C WCILf' JCOMPFESAR. - s'' FEES:
GAS PIPING.: 0 ft ROOD. ..
. .. 0 0-3 )t"...... 0 MEC PRMT ISSUANCE... 8 20.00
FURN<1001..: 0 Dl�^T .,. u T-1 NP.....>: 0 a,`°m' "'it'44 00 ` "-" 1ANCE FEES.* $ 6.50
GAS HIT • 0 WOCC STC`t.i.. - 0 1S-30 RP w e ��°
CONY BURNER: 0 IRI{>I00K ....: O 30 a0 MP,.... O ��; ti
BOO • 0ISC...,�......: 1 5+ HP..,.....:. 0 --1
GAS DRYER..: 0 AI,, HANDL r , vNtIS IUEL fANF ---- - ^--
<: o,00 CFU D AD4
RANGE • 0
GAS LOGS...: 0 ' it 000 cit 0 UN ND..
TOTAL FEES 8 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 Mater Tank)
Inspection Record Mater Line OK _______ Mechanical Inspectia. Notes:
GAS PIPING OKtf* 4 D/V` .-_ L4 I
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 TJEORMATION FURNIS Y ME I TRUE A 0 CORRECT TO THE BEST OF/MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS MILL BE MET,
INE ,:,q , �,_ 1. � . `y` .- DATE /; " Z
�l
1"
FIELD COPY
RECEIVED
OCT 2 51993 CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
CITY OF FEDERAL WAY —Please Print—
BUILDING DEPT.
BOX 1 TENANT NAME:
OWNER !in��7` L(;c:C/t✓_ SITE LOCATION
OWNER'S ADDRESS &'0'7,2 /C) 4" 5•;. CITY PHONE '7"4/-
DESCRIBE
7"4/DESCRIBE JOB
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME -'1- r�--/n5 }�'�'�i ‘.7c:c , -A 74_91TRACTOR'S REG. #��G- SA- -T 3r;
/ / Card MUST be presented
CONTRACTOR'S ADDRESS .1'X>7s 7 3/G 4-tiL-7 2 CITY jc?✓G-e,-, PHONE
EXPIRATION DATE r -
— 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 /a), 7 PHONE 1SW
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER 6-7S-30 -2-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 / 2ND FLOOR l
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 I 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 T. AC ,RACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT/ , DATE: �"�—LS
ANP-008 3/90