93-102771 9340)77 /
CITY OF FEDERAL WAY MECHANICAL P ERM I T PERISSUENO:D: 160/28/9362
33530 First Way South
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 04/26/94
ADDRESS:221O SW 322ND PL
NO. : 873180-0040
PROJECT DESCRIPTION:HVAC - INSTALL GAS FURNACE.
OWNER
—.CONTRACTOR -- LENDER
PAUL FLOOD AMERICAN HEATING SERVICES INC.
2210 SN 322ND PL 7503 PORTLAND AVE STE.#B
EDERAL WAY NA 98023 TACOMA NA 98404
661-3679 539-1702 531-8696
AMERIHS083M5
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..: 1 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 10.00
GAS NWT • 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...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
TOTAL FEES $ 30.00
a
Does the eater supply system contain a Pressure Reduction Device or Check valve? () Yes () No (If 'Yes' then Beater 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 NAY REQUIREMENTS WILL BE MET.
1
_
prOWNER OR AGENT _ _ _ __ = DATE
FILE COPY
CITY
FEDERAL
SoIEC I CAL PERMIT PER ? 3j 8/ " 62
ISSUED: 10/28/93
33530 Wyuth
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 04/26/94
ADDRESS:2210 SW 322ND PL
NO. : 873180-0040
PROJECT DESCRIPTION:NVAC - INSTATE GAS FURNACE.
NKR CONTRACTOR -- . -----�
PAUL FLO00 AMERICAN HEALING SERVICES INC.
2210 SN 322ND PL 7503 PORTLAND AVE STE.IB
•EDERAL NAY WA 98023 TACOMA NA 98404
661-3619 5.'..9-1702 531-8696
FUEL TYPES.:GAS FANS ..: 0 841ER /CONPKF 1 FEt5:
GAS PIPING.: 0 ft MOOD....... .,: 0 -3 ► � 0 NEC PRAT ISSUANCE... S 20.00
FURN<E001... 1 DUCT WORE--- JL5 HP. ,: '�, "' ,S it � . _. , - " -` E FEES.a $ 10.00
GAS NIT • 0 NQ w � ..; 0 1S 30 HP 41 ,�aa ,u,„,,.,,, fr.- 4,},f -- i
CONY BURNER: 0 FURN)1A011.....». .0s„ 30-50'HP ...: ii w pis °°
BBQ • 0 H '
GAS DRYER..: 0 AIR. 51 l t '
RANGE 0 (_!1 1 t"iaa a, a t �w` �� "a��4
GAS LOGS...: 0 ) 10,1 C , ►ERG .: 0 ,
4 �t TOTAL FEES 8 30.00
es the water supply systea contain a Pressure Reduction Device or Check valve? () Yes () No (If 'Yes' then water expansion tank is required on Hot Nater Tank)
Inspection Record Nater tine OK _ _ Nechanical Inspecti n Notes: __._.__ _ ___
GAS PIPING OK alf4___!t)v .__ _.___.e._. __.__—_--__.—_.-_._..__
... — - - _..._...a.n___..z¢-..._._-..-. ... tip A .w..ww.a..m-.._`—._____..... _ .... ^_yam-. -._ . -_'_^MY—'..._._......y...
PERMITS EXPIRE 180 DAYS AFTER ISSUAP< IF NO NORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT IRE INFORMATION FURNISED BY NE IS TRUE AND CORRECT TO THE BEST OF NY IRANLEDGE AND IRE APPLICABLE CITY OF FERERAL NAY REQUIRENENTS RILL BE MET.
C.1'. MIEN, 1 . ____________________ 0 r
FIELD COPY
Permit # `w A3- /10-
1
• .
°CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
---------/---;
BOX�1 TENANT NAM "4-iLL, r-' .,t)t jh
OWNER ..<1 t/ SITE LOCATION
OWNER'S ADDRESS (;2-2- D5 _ArgOTHAlfav CITY i'f'~.Z'. td/ PHONE -- A�
DESCRIBE JOB ` , i .' ' , 4 Gt --.. —
—_ THE PROPERTY IS OWNED BY: SIN 4 MARRIED /17 PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME MT '--:e_' CONTRACTOR'S REG. #/l/Y?ek f ° S'i1 ci'•3ltir j
J ��/ Card MUST be presented
CONTRACTOR'S ADDRESS 7_Se)� t_644 -XGL "•Q• CITY /�C Ir'—yX�-v PHONE` •5'-3 --. %7 f, P---
EXPIRATION DATE •
— OR —
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHI H PROHIBITS 1 ING.PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON ;;-•67, _ : __ PHONE 7—c(----
BOX 4 SEWER DISTRICT . WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER r1 %,3/i'' -- 4' ✓y-C r
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 /
3RD FLOOR / BASEMENT / DECK � _ GARAGE
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION W
( ) 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 J $ _
SHOWERS GAS HOT WATER HEATER $
LAVATORIES CONVERSION BURNER $
SINKS BOILER, SIZE BTU S _
_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 S
SUMPS, SPRINKLER VACUUM BREAKERS _. OTHER $
DRAINS i $
_. OTHER .. $
TOTAL FIXTURES S
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 EM' 0 ES, UPON THE ACCUR, Y OF THE INFORMATION SUPPLIED TO THE CITY ASA PART OF THIS APPLICATION.
OWNER/AGENT: 4;.,e16 ,- DAT E: LIL7 _Q____‘„_2 ()