94-100885 M
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CITY OF FEDERAL WAY MECHANICAI, P ERM I T PERMIT NO:
05/05/9468
33530 First Way South
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 11/01/94
ADDRESS:2722 SW 314TH ST
NO. : 150310-0160
PROJECT DESCRIPTION:HVAC - INSTALL GAS WATER HEATER
iiOWNER CONTRACTOR - LENDER
LARRY SIMS WASHINGTON NATURAL GAS
2722 SW 314TH ST 3130 S 38TH ST
FEDERAL WAY NA 98023 P 0 BOX 11066 TAC NA 98411
TACOMA WA 98405
838-1577 475-6700
1 WASFING285CB
FUEL TYPES.:GAS ? FANS.......,..: 0 BOILERS/COMPRESSORS I - FEES:
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 fi . 0 PRICE ISSUANCE... $ 20.00
FIRN<100K..: 0 DUCT WORK.....: 0 3-15 RP ' 0 I HFC APPLIANCE FEES.* $ 6.50
GAS HNT • 1 WOOD STOVES._.: 0 15-30 HP • 0 11
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 > 1C,000 CFM: 0 UNDERGROUND.: 0
TOTAL FEES $ 26.50
Does the water supply systes contain a Pressure Reduction Device or Check valve? () Yes () No (If 'Yes' then water 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 I CERTIFY THAT THE INF ATION / " ► B Y-E IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS WILL BE MET.
114 OWNER OR AGENT DATE *
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'., 05/05/94 •:39 LI.N.G TACOMA EXEC. IAIING 473-8415 002
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Permit # BIAgel -O3(08
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
.._ Please Print
BOX 1 TENANT NAME:
OWNER AMMIONIPIFAIllb I/ • SITE LOCATIO - _
OWNER'S ADDRESS r - - 1ffi - CITY _I RY PHONE '-
DESCRIBE JOB
THE PROPERTY IS OWNED BY: SINGLE/MARRIED ► PARTNERSHIP CORPORATION ._.
BOX 2 CONTRACTORS NAMEU2 �r�1 ciaA (2 CONTRACTOR'S REG.#. .� :•r' 1 1
Card U T be presantad
CONTRACTOR'S ADDRESS — , cITY ('.U4`J/ PHONE 6 Aff-b
EXPIRATION DATE
—OR._
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONI RACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110�Wf HIGH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON (J JU �r AIR �. f �.� PHONE 2 ,1_..
BOX 4 SEWER DISTRICT ._ . WATER DISTRICT
BOX 6 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording # —
BOX 7 BUILDING SQUARE FOOTAGE: (ExIstingtPrOpOsed) 1ST FLOOR. _I ZND FLOOR I_
3110 FLOOR ./ BASEMENT_L. DECK
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. QF UNITS : -) ( ) EXISTING STRUCTURE
( ) COMMERCIAUINOUSTRIAL 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 V 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 .. S
DRAINS •
OTHER _ S
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 PERMITAPPLICATIUN 15
MADE.I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(INCLUDING COSTS,EXPENSES,ANDnATTORNEYS"
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 EMP •YEE5, •t E)AC.URACY OF Tilt INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
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OWNER/AGENT! GU_ArtDATE: I C