92-102169 M46.116
CITY OF FEDERAL WAY IVI EC HAN I CAL PERMIT PERMIT NO.: ELD92-2533
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 12/09/92
Federal Way, WA 98003 BY: FLF
661-4000
SITE ADDRESS: 29440 4TH AVE S
PARCEL NO.: 186270-0090
PROJECT DESCRIPTION: INSTALL GAS PIPING & LOG LIGHTER
OWNER CONTRACTOR .— LENDER
RANDY GARBERG NORDIC HEATING, INC.
29440 4TH AVE S 3401 C ST. NW BAY 1
FEDERAL WAY WA 98003 AUBURN WA 98002
.7084931-0503
NORDIHIO99BJ
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 NWT • 0 WOOD STOVES...: 0 15-30 HP • 0
CONV BURNER: 0 FURN>100K • 0 30-50 HP • 0
BBO • 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
Water Line OK Mechanical Inspection Notes:
OS PIPING OK 1 Date By
- '' CC ‘:-4. N'lk
wool ,,,_ 1 , 4
. .,. :..
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTS(
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 j M�T.
-1,>.._\ l , �� DATE -�
OWNER OR AGENT ]'� DATE / 2 f(
bld_mech 07/01/92 13
• •mit # G01PIECE Iv
CITY OF FEDERAL WAY
NOV - 81992 BUILDING PERMIT APPLICATION
iYI 11 CF ED F ALAY - Please Print—
p
s.
BOX 1 TENANT NAME:
OWNER Her m Dy GAR 1 eQG- SITE LOCATION 4/0 l" 4 v
OWNER'S ADDRESS o(q'/Y0 y-/ s. CITY FPDE-PolLw�-t/ PHONE gill- 708`1
DESCRIBE JOB C-as PIPE-- /Rcryn tO& Tv Fi R/ PL4 I Zn sr4 - Loci jAck
THE PROPERTY IS OWNED BY: SINGLE/MARRIED X PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME NO R G_ Tna, CONTRACTOR'S REG. #AIORP/,i t c 91 i33
Card MUST be presented
CONTRACTOR'S ADDRESS .?`/D I C• S T AlE # I CITY 4u13 VR r/ PHONE 93 1-0 5-0
3
EXPIRATION DATE /- 4- '73
— OR—
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECITRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. ]]
BOX 3 CONTACT PERSON b. irk PHONE F3/_n50 3
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST r 9/v. 00 EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER //i 7-1C -
LEGAL
lC -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
( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET 320 $
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 X I OTHER /07 4 i yyrfR $
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.
}OWNER GENj) Lr,1 DATE: L l
ANP-008 3/90