92-102326 9laa
CITY OF FEDERAL WAY IVI EC HAN I CAL PERMIT PERMIT NO.: BLD92-2602
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 12/30/92
Federal Way, WA 98003 BY: JJ
661-4000
SITE ADDRESS: 33600 6TH AVE S Unit: #216
PARCEL NO.: 926480-0205
PROJECT DESCRIPTION: HVAC - RELOCATE EXISTING DIFFUSERS
OWNER — CONTRACTOR LENDER
AXIOM MANAGEMENT ELECTROMATIC
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1605 116TH AVE NE #215 800 MERCER ST
BELLEVUE WA 98005 SEATTLE WA
206-454-4180
06 454 4180 624-3370
ELECTI*233NE
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..: 0 DUCT WORK • 1 3-15 HP • 0 MEC APPLIANCE FEES.* $ 6.50
GAS HUT • 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...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0 TOTAL FEES 26.50
INSPECTION RECORD of
Water Line OK Mechanical Inspection Notes: R
03 PIPING OK Date By
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ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THAT THE INFORMATION FUR .SHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE 4'LICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET,
OWNER OR AGENT /G-,_ 4°I. r DATE /2.'2_ :5 e--) 9
bld_me 07/01/92
J
Permit # 13LD (12 z (-CJ2—
g§
g§ CITY OF FEDERAL WAY
LO' BUILDING PERMIT APPLICATION
- Please Print—
BOX 1 TENANT NAME:
OWNER i . % _ i SITE LOCATION 3 3 _ Ate.
OWNER'S ADDRESS /6O5 r /4+1( 4/E `c S_" CITY Je//eV PHONE 5",,S" 'Yl9c
DESCRIBE JOB Iee_/oc4,7� EX/.574) 9
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION A—
BOX 2 CONTRACTOR'S NAME Ele—cd-remna)i'c. CONTRACTOR'S REG. # Ekcii'i- 3JI E
Card MUST be presented
CONTRACTOR'S ADDRESS if e) r— S7`. CITY $ ' 2/e. PHONE 6cX — 3 3 7.(2__
EXPIRATION DATE /93
— 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 54gc#,, x--/44 7 PHONE
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST ".Sao. 00 EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER 9v26- ye0- O?-c5
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
(> COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY a, 000 is.4 SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE S
NO. WATERCLOSETS GAS PIPING, FEET S
BATHTUBS NO. FURNACE, ELEC. GAS S
SHOWERS GAS HOT WATER HEATER S
LAVATORIES CONVERSION BURNER S
SINKS BOILER, SIZE BTU S
DISHWASHERS AIR HANDLING UNITS S
ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE S
LAUNDRY WASHER OUTLET UNIT HEATERS S
URINALS AIR COOLING UNITS, SIZE S
DRINKING FOUNTAINS COMMERCIAL HOOD S
SUMPS, SPRINKLER VACUUM BREAKERS OTHER S
DRAINS
OTHER S
TOTAL FIXTURES __ S
TOTAL MECHANICAL FEE S
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, UP N THE ACCURACY OF THE INFORMATION SUPP'L:ED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: girs DATE: "oA /9oZ-
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