94-100527 •
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CITY OF FEDERAL WAY MECHANICAL PERMIT PERMIT NO:ISSUED: 03/23/9415
33530 First Way South 1 1
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FLF
661-4000 EXPIRES: 09/19/94
ADDRESS:3O513 4TH AVE S
NO. : 232960-0310
PROJECT DESCRIPTION:HVAC - INSTALL GAS FURNACE
OWNER CONTRACTOR — LENDER
CHARLES BRUSSEAU NORTHWEST WATER HEATER
30513 - 4TH AVE S 8201 DURANGO ST SW
EDERAL WAY NA 98003 TACOMA, WA WA 98499
941-0653 984-6404
NORTHWH103R2
FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 0 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.* $ 10.00
GAS HNT • 0 WOOD STOVES...: 0 15-30 HP • 0
CONV BURNER: 0 FURN)100K • 0 30-50 HP • 0
BBD - 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 ) 10,000 CFM: 0 UNDERGROUND.: 0
TOTAL FEES $ 30.00
likes the water supply systea 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
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PERMITS EXPIRE 180 DAYS • TER ISS +NCE IF NO WORK,IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT T OR ,TION FUR ISED BY NE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT �A4 f - �` DATE 2._2 r 3-V
N
FILE COPY
MIT NO: BL
CITY OF FEDERAL WAY MECHANICAL 13ERMIT PERISSUED: 03/23/9415
33530 First Way South
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FLF
661-4000 EXPIRES: 09/19/94
ADDRESS:30513 4TH AVE S
NO. : 232960-0310
PROJECT DESCRIPTION:NYAC - INSTALL GAS FURNACE.
OWNER _ vim.-. -: — - CONTRACTOR - -- -�........�.... .,W,._... . ..,...—:-.-._f_ - IENIThR -16,-..,--.� ___W
CRARLLS BRUSSEAU NORTHWEST WATER NEATER il
30513 - 4TH AYES 8201 DURANGO ST SN
1EDERAL MAY NA 98003 TACOMA, NA WA 98499
941-0653 984-6404
�NTMTTOAp?
FUEL TYPES.:GAS ? FAIL ..: 0 Bt)l)., ,:.'001..i.. , FEES:
GAS PIPING.: 0 ft1000,..,......" x3 ! MEC PRMT ISSUANCE...
70.00
fURWc104K... i DUCT MORK t 0 3-Is . . . ---Z------4'44F--- -k7O "old Via; �r E FEES.' f 10.00
GAS MMT • 0 MIS ST 'S : 0 - 30 HP• ...,.: $ iv t4,� a�
�p �� T
CONY BURNER: 0 f1'I�a ' .. `; : 5 HP. iK
BBB • 0 .... . �µ � HP. • 0
GAS DRYER..: 0 AIR114100111‘ ITS - MEL NI u
RANGE • 0 <._19,006 tI11: 0 `' -• a.a .r
GAS LOGS...: 0 > 10,E C� .. ��
TOTAL FEES $ 30.00
... �—__. �._a_ _ . .w..L w��_. -_ _� . �_ _ �r-- �.. ,s _._._...__. _.............,..a.......,_ _.S. . "._.�_..
.s the water supply systes contain a Pressure Reduction Device cr 'heck valve? () Yes () No (If 'Yes' then water expansion tank is required on Rot Water Tank)
Inspection Record Nater line OK ._ _ Mechanics" 149 +s:
GAS PIPING ftt _ _ Date//__
__ 6Y _ .___...
'd
1.______________----. :„<.— . E, — __ -____ _...r..__.__.,---- ._0...s _ _.___ - _. .. __ . __ :.,.-- _ _
PERMITS EXPIRE 180 DAYS TER TSS .NCE IF NO MORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT TH E0 TION FUR ISED BY NE IS TRUE AND CORRECT TO THE BEST Of MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL NAY REQUIREMENTS WILL BE NET.
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OWNER OP AGENT __.. ft/
_.___- [ATt '' Z
FIELD COPY Al\14(
11—=1 tt
C ( OF FEDERAL WAY ad3(( 7
BUILDING PERMIT APPLICATION `F-
-Please Prtnt—
TENANT NAME:
OWNER hL ' A L . . li ♦ _ . SITE LOCATION ♦ L'+4\ • t'
OWNER'S ADDRESS :1)(-)-5 13 '-t t C U • CITY 7 U ; PHON •
DESCRIBE JOB I 0'�-I- t Q C co ' AJZNYli C
THE PROPERTY IS OWNED BY: SIN(c_E/MARR D k-! PARTNERSHIP CORPORATION
CONTRACTOR'S NAME M 1 ) L.1.)CITIZIO P11, CONTRACTOR'S REG. # RTI+W InRQ
_ Card MUST be presented
CONTRACTOR'S ADDRESS Sap 1 0 SL( erne '1 -SL-`"CITY (C-co-Y\Q PHONE cr:icf.'L' oV
EXPIRATION DATE to . a pq_
— 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.
CONTACT PERSON !AJ.J` It 1 L -' -- ; PHON • _ •
SEWER DISTRICT WATER DISTRICT
ESTIMATED PROJECT COST 'L 0 •00 EXISTING BUILDING VALUATION
PROPERTY TAX ACCOUNT NUMBER n-,-3(S. 9(0CYl, i IC)
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
' BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
I ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
1 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET \-1 Y $
BATHTUBS NO. I FURNACE, ELEC. GAS $
SHOWERS GAS HOT WATER HEATER ' $
LAVATORIES CONVERSION BURNER $
SINKS BOILER, SIZE BTU $
DISHWASHERS AIR HANDLING UNITS S
ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $
LAUNDRY WASHER OUTLET UNIT HEATERS $
URINALSAIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS COMMERCIAL HOOD S .
SUMPS, SPRINKLER VACUUM BREAKERS OTHER S
DRAINS S
OTHER S
TOTAL FIXTURES S
TOTAL MECHANICAL FEE S
T1FY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
=URTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APPLICATION IS
E.I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(INCLUDING COSTS,EXPENSES,AND ATTORNEYS'
INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM), WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
FILED AGAINST THE CITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
:.ERS AND EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
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ER/AGENT: 1,i . �C X DATE:
A rM.0011 190