93-100863 9S-)D-b63
CITY OF FEDERAL WAY MECHANICAL PERMIT PERMIT NO.: ELD93-0382
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 04/08/93
Federal Way, WA 98003 BY: JJ
661-4000
SITE ADDRESS: 29815 10TH AVE SW
PARCEL NO.: 195460=0135
PROJECT DESCRIPTION: HVAC - INSTALL GAS FURNACE, HOT WATER HEATER, & PIPING
— OWNER -- CONTRACTOR — LENDER
LINDA RENFRO PACIFIC GAS HEATING & AIR INC
29815 - 10TH AVE SW 11002 34TH AVE S
FEDERAL WAY WA 98023 TACOMA WA 98444
*0750 582-5882
PACIFGH110ME
FUEL TYPES.:GAS FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 5 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 HWT • 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 1
Atter Line OK Mechanical Inspection Notes: L r 5 5 7A/1/3 C. 'Gi= ( ,S /'z/-'Y'',-- _
GAS PIPING OK Date _540-'75 By X011)
1
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.
WNEWOt AGENT
?7C"-t----L ° :-.-e r:-7761
z DATE
/ (1"/ -
blfiech 07/01/92
" , A
r A
• ... ,
•
Permit#. bLm3 _ 036Z
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
iA/04 R/Le1 1/`'-0
- -Please,Prim- -__
--
BOX 1 TENANT NAME: 1,.,yr A c.,:.--" ,„,r t\
OWNER .sSa ►-...a_.0 .___.SITE LOCATIO .a.Q.$') 1 L?' J
OWNER'S ADDRESS_- =S--m-e.___. CITY PHONE__ 'if/__O
DESCRIBE JOB _In,S-Ae Li___1 —! nc 1w 1,. I.1,� 11 Ja.r(G4t14-1:43,-4-'--A7
THE PROPERTY IS OWNED BY:SINGLE/MA IED_ 4/ ._,.PARTNERSHIP CORPORRAATION__..___- .n
BOX 2 CONTRACTORS NAME L M,, __ .n ,_. „ .CONTRACTOR'S REG.#,�.µe,C t,r}-I- I)Dm
r.i� Card MUS be preeleued
CONTRACTOR'S ADDRESS N_ .' °�" S. CITY_ HONE •S"gd-..4~1e,
EXPIRATION DATE ,N R .
--OR-
I HAVEREAD CRAFTER 18,27.010 RELATING TO DEFINITIONSOF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF Of REGISI RATION.
BOX 3 CONTACT PERSON 1, k-' ,n PHONE,?CI •,2 .-)
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST _ -EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER____Ig 5J - )135
LEGAL DESCRIPTION
- -v--_.. ---._ ._... ._ -.
(tI necessary, ease submit a separate page with the legal description.)
K.C. Plat Recording$ _ - -
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR__J.___. 2ND FLOOR __.___J,
3RD FLOOR /_-__ BASEMENT /.__. DECK ! _ GARAGE _i
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY(ND.OF UNITS= ) ( ) EXISTING STRUCTURE
_ ( ) COMMEPCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY -SO FT
BOX 9 PLUMBING FIXTURES(Including rough-Ins) MECHANICAL APPLIANCES--BASIS FEE$
NO. WATERCLOSETS GAS PIPING,FEET C ' $
_BATHTUBS NO. ._._FURNACE,ELEC. _GAS _+-' . $
__......SHOWERS I 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 S
URINALS -_.-._AIR COOLING UNITS,SIZE___.._._..- $
_._ _ -_DRINKING FOUNTAINS __.____.COMMERCIAL HOOD $ _
_....__-_SUMPS,SPRINKLER VACUUM BREAKERS _ __OTHER_ - S
.DRAINS ___.__...........-___.-_-- $ ........_..
----._.OTHER-- - - - - _ __.._...._ -_, R .._...,
..-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 CF MY KNOWLEDGE
AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APPLICAT ION 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 SUCE CLAIM ARISES OUT OF THE RELIANCE OF THE CITY,INCLUDING ITS
OFFICERS AND EMPLOYEES,UPON 1HE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: _ \'"NI....NL _U _—CATE: _.__ -___ _21,:..f.._: =........;__