92-102143 9iTY OF FEDERAL WAY IVI ECI�IAN I C�►L PERMIT PERMIT NO.: BLD92m2504
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 12/07/92
Federal Way, WA 98003 BY: FLF
661-4000
SITE ADDRESS: 31634 7TH PL S
PARCEL NO.: 794150®0020
PROJECT DESCRIPTION: INSTALL GAS FURNACE
OWNER — CONTRACTOR -- LENDER
ELIZABETH SPRINCKEL AMERICAN HEATING SERVICES INC.
31634 7TH PL S 7503 PORTLAND AVE STE.#B
FEDERAL WAY WA 98002 TACOMA WA 98404
,6-1735 539-1702
AMERIHS083M5
FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 1 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... S 20.00
FURN<100K..: 1 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* S 12.00
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 $ 32.00
INSPECTION RECORD
Water Line OK Mechanical Inspection Notes:
OAS PIPING OK ; ; - ,-- Date -/ -Q3 By /444,/
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THAT THE INFORMATION FURNISHED B ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENTDATE A
bld mech 07/01/92 /
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CITY OF FEDERAL WAY
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BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 TENANT NAME: �
OWNER / ./�.�J'1 t�.:L�. ' SITE LOCATION
OWNER'S ADDRESS
/cod 7 f. j CITY ,�l.� PHONE L'f_
DESCRIBE JOB .11 fIf 714
THE PROPERTY IS OWNED BY: SING MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME ///i , A._://O/( . CONTRACTOR'S REG. # 'C� i S7) iW
2 �p > �--, Card MUST be presented
CONTRACTOR'S ADDRESS '7 3 TD / / aecfi/gry _..,2`fGL-- PHONE -- �/`7G'
EXPIRATION DATE —7-?,5-9
— 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 PHONE
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER '79051) c>2-C.3
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 J
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 $
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 OTHER $
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.
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OWNER/AGENT 'U 4LG.' 7 '11/47/// DATE: ( 3'57-76- 4/-
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