92-102002 CITY OF FEDERAL WAY I\/I E C H A N I CA L PERIIIIT PERMIT NO.: BLD92-2414
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 11/10/92
Federal Way, WA 98003 BY: FLF
661-4000
SITE ADDRESS: 32924 6TH AVE SW
PARCEL NO.: 926491-0670
PROJECT DESCRIPTION: INSTALL GAS PIPING AND GAS DRYER; CONVERT ELECTRIC FURNACE TO GAS
-- OWNER s CONTRACTOR LENDER
JIM STERNOD *OWNER IS CONTRACTOR*
32924 - 6TH AVE SW
FEDERAL WAY WA 98023
-1313
*OWNER*
iii
FU L TYPES.:GAS FANS 0 BOILERS/COMPRESSORS FEES:
GA PIPING.: 16 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... $ 20.00
FU N<100K..: 1 DUCT WORK 0 3 15 HP 0 MEC APPLIANCE FEES.* $ 18.50
GAS HWT • 0 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..: 1 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 $ 38.50
INSPECTION RECORD 1111i :"
,A 1
Water Line OK Mechanical Inspection Notes:
Will"r"
OAS PIPING OK ])/iz/4Z Date By �` ' ,---)
EV ---4W-----". _
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 4...,.
� �..�� DATE 1 1 — 1:\•-
`-moi
bld meth 07/01/92
- Permit # 131-D 2 Z6-7/z1
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 TENANT NAME:
OWNER SITE LOCATION 3��q �� I7 ' ,�J� �•
OWNER'S ADDRESS la"-} CITY ti=mes r.1/4- PHONE 71-t,- ► ��
DESCRIBE JOB G tis "c P ,y,5 trti� 4� a���e,z -�t� C-exy 00-‘c"a...-Cv Vis, ---
THE PROPERTY IS OWNED BY: SINGLE/MARRIED X PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME C.5jvJ �1�� CONTRACTOR'S REG. #
Card MUST be presented
CONTRACTOR'S ADDRESS CITY PHONE
EXPIRATION DATE -
— 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 - ���^^ �re �a PHONE 874- 1 l3
X,- _E_ ER-11$TRtDTSTRIC
BOX 5 ESTIMATED PROJECT COST \., X EXISTING BUILDING VALUATION �ThC), L ,v
BOX 6 PROPERTY TAX ACCOUNT NUMBER q'�b'+ci t - O Cil 0
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7ILDING (1 E FOO : '-• •roe:. •d L00_ R / 2ND FLlJOR�`
3 FLOOR BASEMENT / DECK / " GARAGE /
BOX 8 X) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET 1 b'
BATHTUBS N0._ 1 FURNACE, ELEC. GAS X $
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 GFt-
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 EMPLOYE S, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: • DATE: \ -' at
ANP-008 3,90