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CITY OF FEDERAL WAY IVI EC HAN I CAL PERMIT PERMIT NO.: BLD92-2543
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 12/11/92
Federal Way, WA 98003 BY: FLF
661-4000
SITE ADDRESS: 29434 4TH AVE S
PARCEL NO.: 186270-0100
PROJECT DESCRIPTION: INSTALL GAS PIPING & LOG LIGHTER
r OWNER -- CONTRACTOR -- LENDER
1 TIM MCFERRIN NORDIC HEATING, INC.
29434 4TH AVE S 3401 C ST. NW BAY 1
FEDERAL WAY WA 98003 AUBURN WA 98002
931-0503
• NORDIHI099BJ
FUEL TYPES.:GAS FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 20 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 0 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 8.50
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..: 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 $ 28.50
INSPECTION RECORD 1
Water Line OK Mechanical Inspection Notes: ' ..
•S PIPING OK 111, Date By 11111 Il , la
__ -,[1.43
tor ijv-P-1 .---DAT
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 l 14 ,,,,//7 ;;;Z/ DATE /'y// 2
bld_mech 07/01/92
•1it # 1' 617 c7-13
9 tes2 CITY OF FEDERAL WAY
' DSL ,' BUILDING PERMIT APPLICATION
rarAte nen - Please Print—
BOX 1 TENANT NAME:
OWNER T/h') /v/ it/ SITE LOCATION cr4ftt 2 `/"tilt`(31( OWNER'S ADDRESS 4/ y fe` 5> CITY F-c � v PHONE
DESCRIBE JOB Gu-a 1).-la—.0 /WW1 —Z1:41.-. 1'0 fie:41.2-& ;1.,,..z,-e. 7 key L� 4ri-iz
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME NO R Ai C 11- i rJ_7-i�f e CONTRACTOR'S REG. #1110/iD i/4/c 9 c /i C
Card MUST be presented
CONTRACTOR'S ADDRESS 3 Lf 01 0 S T Al 1 / CITY 13 Li RA/ PHONE 7 37- 0`..5-c 3
EXPIRATION DATE %- 7- 23
— 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 Deetc B i C c PHONE 9 5/--c-5-c) 3
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST c 9&' ,CJ EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER / T6- A7 -0/ 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 /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 (44- 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 9.0/
$
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 K( OTHER I-7I f'4,f-YZ $
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 APART OF THIS APPLICATION.
OWNER/AGENT: R-417 Ji ,(�c�v DATE: 21(a/
ANP-008 3/90