93-101566 g3-lo156k
CITY OF FEDERAL WAY MECHANICAL PER M I T PERMIT NO.: BLD93®0688
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 07/14/93
Federal Way, WA 98003 BY: FLF
661-4000
SITE ADDRESS: 4103 SW 328TH ST
PARCEL NO.: 873203®0330
PROJECT DESCRIPTION: HVAC®INSTALL GAS FURNACE, HOT WATER HEATER, OSBORNE FIREPLACE, & PIPING.
— OWNER CONTRACTOR LENDER
MARK WON PACIFIC GAS HEATING & AIR INC
4103 SW 328TH ST 11002 34TH AVE S
FEDERAL WAY WA 98023 TACOMA WA 98444
E<'-c503 582-5882
. PACIFGH110ME
FUEL TYPES.:GAS FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 40 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.* $ 26.00
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...: 1 > 10,000 CFM: 0 UNDERGROUND.: 0 TOTAL FEES $ 46.00
INSPECTION RECORD
Water Line OK Mechanical Inspection Notes:
(0_, PIPING OK 7-A-93 1//t,% Date 7-,)8- 3 By Gi 1/t/i
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 /GC „,,,,4 • -C� DATE / > c/ �bld_mech 07/01/92
-Aot • perm _.._ .0 .13 .tq ._____.
i CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
--Pleaen Print-_.
BOX 1 TENANT NAME: 624k h)61),) 1/l03
OWNH OWNER'S 7:- "Q i".. ._ ......-. SITE LOCATIO ....0__a-_- __11.,�., -- - '.-
S cr• _, _. rte , PHONE �i 1 . mss .
DESCRIBE JOB 4:A..f 1 -J 17i_ ,A,� - L.�..ilr�?1 5<D
THE PROPERTY IS OWNED BY, SINGLE/MARRIED.-._- ►-! FARTNEP:EHIP,-
- CORPORATION.- r��n,�
BOX 2 CONTRACTOR'S NAME a.(+v zNe 1-/x �", „1,I .. .— _CONTRACTOR'S REG, #!i�(' ./., i././JD'0,6 U
/� Card MUCT be preser;tad
CONTRACTORS ADDRESS _,L.2.,Ot1 - '/t" -/91) J' CITY 1 G et'''r'-, . PHONE _4:-4. . ---rjl '.1
EXPIRATION DATE _ __ :_ ..Q.>'
•-- CFI ....
.
I HAVE READ C HAPTER I6.27.010RbLAI!NU ID DEFINITIONSOFBENERALCONTRACTORSANDSPECIALTYCONTRACTORSAND
CHAPTER 1$.27,110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. _
BOX 3 CONTACT PERSON A duai __. —,._.. PHONE_._ 2 . ..,,,..._
BOX 4 SEWER DISTRICT ----: -- -- WATER DISTRICT �. ,� __:._:.:.. . .,
BOX a ESTIMATED PROJECT COST kXISIING BUILDING VALUATION _..__-_. _.::.-._,.:....,.._....--..._-
bUX 6 PROPERTY TAX ACCOUNT NUMBER_._._ - ,3? J -.---� --.._.. ..__...
LEGAL DESCRIPTION c � 3- is _ --_... ... - -
Tac Bey . --.------------..
(IF sdry, please submit a separate page wiUl[!le!eVl OeSCription.)
1c.0. NH hem ding# ,_.._........:.:... -- - ..._ -------
—
BUX i BUILDING SQUARE FOOTAGE: (ExistIrtg/Proposed) 1S1 FLUUH , .-a. 2ND FLOOR /_
3RD FLOOR 1_—.._......._ BASEMEN'! /_.__..... .___-. DECK /�.....,.___. GARAGE _1____..__.__:.
tsUX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION T ---
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) LX!S!MG SI HUC I UHE
( ) COMMERCIAL/INDUSTRIAL IU IAL AREA OF PROPERTY SU I-I
HO.{9 PLUMBING FIXTURES(Including rough-Ins) MECHANICAk APPLIANCIS— BASIC FEE$
NO. —WATERCLOSETS CTAS PiPINu, FLE I 1 —
BATHTUBS NO.........J.—._FURNACE, ELEC._._ GAS...v_._ $ _____
. _. _.. ....SHOWERS / GAS HOT WATER HEATER $
__-_—,_—LAVATORIES __CONVERSION BURNER 4,
SINKS ---._... ..,BOILER, SIZE_ Di U
DISHWASHERS
----.-... _ _AIR HANDLING UNITS
ELECTRIC HOT WATER HEATER MAI PUMPS,51a - y
__ LAUNDRY WASHER OUTLET .......... ....UNI 1 HIAI EHS $
_ _._..Uf11NALS ---___AIR COOLING UNITS. Silt .,-__-.
DRINKING FOUNTAINS _.__—.___COMMERG DOD / S __,
..._ SPRINKLER VACUUM BREAKERS /—OTHER -tS'1at_,.-. $ .
bkAINS $ - •
$ .
—._'TOTAL FIXTURES
TOTAL MECHANICAL.FEE 4i ...____. _
I LEH 1 IFY UNDER PENALTY OF PERJURY THAT THE INFORMAT ION FURNISHED BY ME IS TRUE AND CORRECT TO 1 HE BES1 OF MY KNOWLEDGE
AND FURTHER THAT I AM AUT HORIZED BY THE OWNER OFTHE ABOVE F'REMISES I1)PE11FU1M I HE WORKI-OH WHICH PERM'I AFYLICAT ION IS
MADE !FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS FU ANY CLAIM(INCLUDING COSTS,EXPENSES.AND ATTORNEYS'
FI-tS INCURRED IN INVESTIGATION AND DEFENSE Of-SUCH CLAIM).WHICH MAY BE MADE BY ANY PERSON,INCLUDING THE UNDERSIGNED,
AND FILED AGAINST711E CIT Y OF FEDERAL WAY,BUT ONLY WHLHL SUCH CLAIM ANISES DUI OF THE RELIANCE OF THE CITY,INCLUDING ITS
(Ai KERS AND EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUYI'l.It-U I I HE UI I Y AS A PART OF THIS APPLICATION.
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OWNER/AGENT: 7a../n1�i-r.2s C_ _,. DATE: +F' _