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CITY OF FEDERAL WAY IV! EC HAN I CAL PERMIT PERMIT NO.: BLD93®0770
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 07/22/93
Federal Way, WA 98003 BY: FC
661-4000
SITE ADDRESS: 4319 SW 322ND ST
PARCEL NO.: 873202-0210
PROJECT DESCRIPTION: HVAC
r OWNER — CONTRACTOR LENDER
IJORN JORGENSON *OWNER IS CONTRACTOR*
4319 SW 322ND ST
1 FEDERAL WAY WA 98023
I -9805
*OWNER*
FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 2 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
Water Line OK Mechanical Inspection Notes:
•S PIPING OK 4,210 e Date ;Vi3 bl By
Vo 161 ilAi
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.
OWNER OR AGENT //{ %c2._,) J� DATE 7 ZG - J3
bld_mech 07/01/92
1
l/9; '/
,
CiTY N FEDERAL W;
BUILDING PRMIT APP ATION
— P(ease ?rim( —
/ 014 93 —a > 7O
,NT NAME:
:R 6.-A e: _ "'1 Si TE LOCATION p G �' _ • � .fi
ERS ACO,SESS CITY t ttX PHONE ULlr l ctscia
10?E-.-Y IS OwN,E0 SY: SINGLE :'.ARRIE0 PARTNERSHIP CORPORATION
.,...CTCR'S NAME Northr t W='-or i~v.=+ CONTRACTOR'S REG. = NORTFrr 1O IR7
Cart AUS i be pressnte4
R.ACTOR'S ADDRESS 8201 Dt•77-=r r-r ci- crt • • CITY Tacoma PHONE 984-6404
;ATION DATE 12-22-97 J .
— OR —
E READ CHAPTER 18.27.010 RELATING TOO EFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS ANO
TER 16.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
'ACT PERSON Angel Foster - PHONE02a_aA0•4 • •
.R DISTRICT WATER DISTRICT
V.ATEO PROJECT COST 1 S SS EXISTING BUILDING VALUATION
'ERTY TAX ACCOUNT NUMBER a1 )--C \Q •
L DESCRIPTION
. f• .
cessa.y, please submit a separate pa,_ with the legal description.) •
Plat Recording = - .
DING SQUARE FOOTAGE:. (Ex?szinc/Fropcsed) 1ST• FLOOR • / 2ND FLOOR ' / • - .
• FLOOR B'SE r . . . / GARAG_
I BASEMENT______/ DECK �.,
SINGLE FAMILY ( ) NEW CONSTRUCTION .
MULTIFAMILY(NO. OF UNITS = ) ( ) EXISTING STRRUCTURE _. _.. _. ...
COrMMERCIAUINDUSTF,IAL TOTAL AREA OF PROPERTY .- - SQ
•;SING FIXTURES (including rough-ins) _._ .._.. .. . MECHANICAL A?PLIA4ES — BASIC FEE S-------
- WATER CLOSEIS • GAS PIPI'rG, FEET l - _ S.. .
BA T HTU3S NO. 1 FURNACE, ELEC. GAS K S
• SHOWERS - - . _--- - GAS HOT WATER H -,TEP.• • - - • ---- S-•._.—
LAVATORIES . • • . . . CONVERS`tON BURNER - - .- - ---- S- •
-
SINIcS BOILER, SIZE ETU S
DISHWASHERS . . — -----AIR HANDLING UNITS - 5 ----
ELECTRIC HOT WATER HEATER -.• -.... .. . HEAT PUMPS, SIZE LAUNDRY WASHER OUTLE► UNIT HEATERS S
URINALS - • - -- --AIR COOLING UNITS, SIZE - 1 S'--.' •-...
DRINKING FOUNTAINS ••• -•- - - COMMERCIAL HOOD . •. . S
SUMPS, SPRINKLER VACUUM BREAKERS OTHER S
_ DRAINS
. ..._ ._ . .... . . . . . . .. -- S - - -- -
OTHER S',
TOTAL FIXTURES _ - .. _
• • TOTAL MECHANICAL FEE IN. S
4OER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE ANO CORRECT TO THE BEST OF MY KNOWLEDGE
:R THAT I AM AUTHORIZED BY THE OWNER OFTHE AEOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APPLICATION IS
THEP,AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(INCLUDING COSTS,EXPENSES,AND ATTORNEYS'
RED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM), WHICH MAY SE MACE BY ANY PERSON. INCLUDING THE UNDERSIGNED,
LGAINST THE CITY OF FEDERAL WAY,BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY,INCLUDING ITS
-I`Q EMPLOYEES, UPON HE ACCURACY OF THE INFORMATION SUPPLIED TO T 'E CI i i S A PART OF THIS APPLICATION.