92-101448 9.)-/N 9 y 8
CITY OF FEDERAL WAY MECHANICAL PERMIT PERMIT NO.: BLD92-2134
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 09/03/92
Federal Way, WA 98003 BY: MH
661-4000
SITE ADDRESS: 3 617 SW 311TH LN
PARCEL NO.: 058755-0140
PROJECT DESCRIPTION:
OWNER - CONTRACTOR -- LENDER
HELMER PACIFIC B & B HEATING & A/C
22035 SE WAX RD SUITE 14 5309 84TH ST E
MAPLE VALLEY WA TACOMA WA
432-5055III
536-6681
BBHEAA*094RC
FUEL TYPES.:GAS FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 99 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... S 20.00
FURN<100K..: 0 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 15.00
GAS HWT • 0 WOOD STOVES...: 0 15-30 HP • 0
CONV BURNER: 0 FURN>100K • 0 30-50 HP • 0
BBO • 0 MISC • 0 5+ HP • 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS
RANGE • 1 <=10,000 CFM: 0 ABOVE GROUND: 0
GAS LOGS...: 1 > 10,000 CFM: 0 UNDERGROUND.: 0 TOTAL FEES S 35.00
INSPECTION RECORD
v 3
Water Line OK Mechanical Inspection Notes:
41111kS PIPING OK iU- 7-' n7N Date By 4.
1 1 1 I • a ill *
•
Itf/ 17.3.0•001
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. '(t// /
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICA TY OF "'AY REQUIREMENTS WILL BE MET.
/ () ,"
OWNER OR AGENT t.--/-- -I /! !C �Z---i-- DATE ��. -Z-
bld_mech 07/01/92
1
eyr) Pe )- .2/.3c'
EW �-
v 2 192 CITY OF FEDERAL WAY
cnvSEP GL �� BUILDING PERMIT APPLICATION
Wtp
DEPT -- Please Print--
BOX 1 TENANT NAME: ,
OWNER (pk_ ,_ L _ SITE LOCATION, ,-� ) A/ . -i/
OWNER'S ADDRES,S�g03 a `)l-F, Ccs; k' � +'. /ct CI ry fcce,�, Ci cul, PHONE a2-,c0
DESCRIBE JOB 4� /-- e.. �h--,L -6- f T
THE PROPERTY IS OWNED BY: SIN MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME ( �� ny . ,g� ,
�� � �'` _ � CONTRACTOR'S REG. # ��cl,� ,k
,, n Card MUST re presented
CONTRACTOR'S ADDRESS ,��, "1 2 d1 :LC CITY 7-6.1.__ PHONE , /) --6
EXPIRATION DATE
— OR ---
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 ICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON `t, PHONE h1_
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST -- EXISTING BUILDING VALUATION _
BOX 6 PROPERTY TAX ACCOUNT NUMBER-c j 5-0 i' 0
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 1
3RD FLOOR /_ BASEMENT _-_ / DECK / GARAGE I
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = __--_-- - ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SO FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET IAA\(LA t,CO — $
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 ____OTHER -_j- L- Lt(�ki-e $
- - DRAINS I---�- U $
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 TH CITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLOS UPON H A C AC OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: 6 ' /
— — DATE: >6-0,�` A _q
ANF'OflR 1MM