92-102228 91-100),)„2a
CITY OF FEDERAL WAY MECHANICAL PERMIT PERMIT NO.: BLD92=2 554
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 12/16/92
Federal Way, WA 98003 BY: ELF
661-4000
SITE ADDRESS: 204 SW 313TH ST
PARCEL NO.: 555750-0050
PROJECT DESCRIPTION: INSTALL GAS FURNACE & GAS PIPING
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CONTRACTOR — LENDER
GLENN ANKENMAN PACIFIC GAS HEATING & AIR INC
204 SW 313TH ST 11002 34TH AVE S
FEDERAL WAY WA 98023 TACOMA WA 98444
0362 582-5882
PACIFGH110ME
FUEL TYPES.:GAS FANS • 0 BOILERS/COMPRESSORS
GAS PIPING.: 5 ft HOOD • 0 0-3 HP • 0 0i MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 1 DUCT WORK • 0 3-15 HP • 0 , MEC APPLIANCE FEES.* $ 12.00
GAS HWT • 0 WOOD STOVES...: 0 15-30 HP • 0
CONY BURNER: 0 FURN>100K • 0 30-50 HP • 0 1 x �� /
BBQ • 0 MISC • 0 5+ HP 0 O
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS
RANGE • 0 <=10,000 CFM: 0 ABOVE GROUND: 0 - , , I
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0 lu TOTAL FEES $ 32.00
4
INSPECTION RECORD
Water Line OK Mechanical Inspection Notes: I//S 7-c 6:4 s c///0-/vC-/z o ,T,2
SS PIPING OK Date By 2 /is S ;-/// /1-% 6 ' c, i$ /9/,4 r `-
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 , �,. / DATE / , 22
bld_mech 07/01/92
Per # ��g. -
mom) •
DEC 151992 CITY OF FEDERAL WAY
;iryQFFEDERAL WAY BUILDING PERMIT APPLICATION
BUILD DEPT - Please Print—
BOX 1 TENANT NAME: H /`,
C�/ -1 (7,-)/7 /l
OWNER SITE LOCATION L92' L-e-) 7
OWNER'S ADDRESS CITY-kt-&4aIid PHONE ?(,--.59-
DESCRIBE JOB /;).$/a r 46
THE PROPERTY IS OWNED BY: SINGE/MARRIEt i PARTNERSHIP COP( RATION
BOX 2 CONTRACTOR'S NAME ��.1 g L /41 /An L/eiL. CONTRACTOR'S REG. # 144 . /,,/-///I'/7)J3
!v / Card MUST be presented
CONTRACTOR'S ADDRESS //4 / GL) -� CITY c% PHONE_
EXPIRATION DATE
— OR —
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON (/2,4 PHONE a)`ii,) r13.`
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER 5S'- L) ),,O
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET
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 $
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 EMPLOYEES, UPON THE ACCURACY, /
OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
/.C�/)
OWNER/AGENT: l/.�i S0 i DATE: / - /
ANP-008 3/90