93-103043 9 -/n3 t V;
CITY 335300F FEDERAL WAY Firstt Way South MECHANICAL PERMIT PERMIT NO:ISSUED: 111/29/9373
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 05/28/94
ADDRESS:33321 10TH CT SW
NO. : 926496-0910
PROJECT DESCRIPTION:INSTALL 10 FEET OF GAS PIPING AND A GAS LOG
OWNER — CONTRACTOR — LENDER
ROBIN MAY GOLDEN FIRE INSTALLATIONS
33321 10TH CT. SW 1006 N MAIN
-5EDERAL NAY NA 98023 PUYALLUP NA 98371
874-5518 841-9379 839-0998
GOLDEFI088KQ
FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 10 ft HOOD • 0 0-3 HP . 0 NEC PRMT ISSUANCE... $ 20.00
FURN<IOOK..: 0 DUCT MORK - 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 9.50
GAS HNT . 0 WOOD STOVES...: 0 15-30 HP • 0
CONY 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...: 1 > 10,000 CFM: 0 UNDERGROUND.: 0
TOTAL FEES $ 29.50
ies 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 Water Line OK Mechanical Inspection Notes:
GAS PIPING OK Date By
1
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 FURNISED ME IS TRUE AND CORRECT TO THE BEST OF NY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL NAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT "4- - :7,(./Z � DATE _.d_./4-1 "
4
^f LE 3OPv
'vb. v
94j- 0—, L., y1,
CITY OF FEDERAL. WAY MECHANICALPEIZMIT PER1ISSUED: 1/9 739/9333530 First Way Southa11►1L.y I
Federal Way, WA 980031 Building Inspection Requests 661-4140 BY: FC
161-4000 - EXPIRES: 05/28/94
ADI?RESS:3 3321. 10TH CT SW
NO.. : 926496-0910
PROJECT DESCRIPTION:INSTALL 10 FEET 1E GAS PIPING AMD A GAS LOG
ONNER CONTPACTOa. � �. . ,. _.._..., __.. .
ROBIN MAY GOLDEN FIRE INSTALLATIONS
33321 10TH CT. Sii 1006 N MAIM
EDERAI NAY NA 98023 PUYAEIUP MA 98311
874-5518 841-9379 8390948: '
g
_ �._..,. _ ...._ _..-....._. .....,.h...".xT.G:,._......_..... f ._ w� .._..._. • ,.a +Ir..v� w.+..._.. 3'e.r�. T_ x.xr iw..L....�......r..+a..�w.......'9C ".+.tCq^r' 52•'....u...."TFr�S'Yc..+.t....rzw.."..':Af'Y___F.IS^_T�"�Y,. i ..,..
r� �
FUEL TYPES.:GAS ?
FANS 0 4 8r' E - �, FEES:
`�� �` v j°. ro a MIC PPM ISSUANCE... 28.IN1
GAS PIPING.: 10 ft HD00 �N�tp ,3 'f �
FURM<1001(..: 0 DUCT NORX : `� ISS ~- s,, �� E FEES-* $ 9.50
GAS Hifi • 0 S� �� � 3 P
CONY BURNER: 0 FU1T1 e` P r '
,
BBII • 0
GAS DRYER..: 0 AIP", 4 ` TisE "-- ' ITV - N ' ."):,'''''%'', „„
RANGE • 0 ,j . v--,--%fy -, e a. - all ..
V im% " ,e, 'ry).-,
GAS LOSS...: 1 > 10'444 , ` RG _� ,,:1.: 0
LOYAL. FEES I 29.50
v _._ms s � _
s .. . �__. __.. ,.�y� .��_. � �, M.._
loss the eater supply systes contain a Pressure Reduction Device or Check valve? () Yes () No (If 'Yes' then eater expansion tank is required on Hot Nater Tank)
Inspection Record Nater Line DX _____ Mechanical Inspection Notes:
GAS P[PI10" ., '5
X Date9By LAA'
(7i < fez Aie' f
.',.;...z_..^....
"EMITS EXPIRE 180 DAYS AFTER ISSUANCE IF 110 NORX IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF 4SUANCE..
I CERTIFY GNAT THE INFORMA(IONF ISED QY'ME IS TRUE AND CORRECT TO THE REST OF MY XNONLEDGE AND THE APPLICABLE CITY OF FERERAL NAY REQUIREMENTS MILL BE NET.
f 7 i * -
y
Ir
ONiHER OR AGE hi %�' `l
' f '/' V cc17
N
t) 1
FIELD COPY
'' sr
1
RECEIVED
•
Peat # '27b-P ( ( -7
NOV 2 91993 CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
CITY OF FEDERAL WAY — Please Print—
BUILDING DEPT_
BOX 1 TENANT NAME:
OWNER /-42' //M.- SITE LOCATION � /�
OWNER'S ADDRESS �3-? 1 /Cs��� Se) CITY _)-�/a fze.47 �vr PHONE i3'.2-1/—,3 %�'
DESCRIBE JOB �, ,f:,u;%:.y . ///i/- C `i &%2 A'`e
THE PROPERTY IS OWNEb BY: SINGLE'/MARRIED / PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME . 1 REG. #(;.'412Wl-Y -V3f- �
Card MUST be presented
CONTRACTOR'S ADDRESS , (LI. /J �� ��. CITY .'. PHONE .1-"'Ji`
l' Y
EXPIRATION DATE •57/1,M/
— 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 ( t •// PHONE d �
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER `?L (? AIM
(1 '//&
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 1 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 S
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 H00�9 $
SUMPS, SPRINKLER VACUUM BREAKERS I OTHER 9 Xl $
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 THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT:( � ��{y�/�'�f DATE: /7/' ��
ANP-008 3/90