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CITY 335300F FEDERAL WAY Firstt Way South M E C H A N I C A L ID ERM I T PERMIT NO: BLD95 ISSUED: 02/22/9540
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 08/21 /95
ADDRESS:30127 10TH AVE S
NO. : 515390-0180
PROJECT DESCRIPTION:HVAC - INSTALL FURNACE TO 100,000 BTU (CHANGE OUT)
= OWNER CONTRACTOR — LENDER
TIMOTHY FARNAM WASHINGTON NATURAL GAS
0 30121 - 10TH AVE S 3130 S 38TH ST
FEDERAL WAY WA 98003 P 0 BOX 11066 TAC WA 98411
TACOMA WA 98405
946-6678 800-999-4964
WASHING285CB
FUEL TYPES.:? ? 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 HWT • 0 WOOD STOVES...: 0 15-30 HP • 0
CONY 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 $ 30.00
Does the water supply system contain a Pressure Reduction Device or Check valve? () Yes () No (If 'Yes' then Mater expansion tank is required on Hot Water Tank)
Inspection Record Water Line OK Mechanical Inspection Notes:
GAS PIPING OK Date By
PERMITS EXPIRE 18' JAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THE I FORMA ON FURNISHED BY E IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
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CITY OF FEDERAL WAY RECEIVED •
BUILDING PERMIT APPLICATION FEB 221995
— Please Print—
CITY OF FEDRAL 11AY
BOX 1 TENANT NAME: BUILDING DEPT,
OWNER F i--iRWA AIL SITE LOCATION
OWNER'S ADDRES CITY PHONE ' , _-
DESCRIBE JOB EI-1.0(1E E(JRN/1 C_L,
THE PROPERTY IS OWNED BY: SINGLE/MARRIED X PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME L=1/11 tR(Mk 11lLnrrAL A.) ( h_k:CONTRACTOR'S REG. #I )L!ik'iDI l' [
Card MUST be presented
CONTRACTOR'S ADDRESS 32? �y. C�"^ CITY /n 1) PHONE x 3.2- 24/7
EXPIRATION DATE - I I - 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 C E C'L Ll i1 PHONE 1f 3'2 - 47
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST1 kjaT). OCA EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER )57"5 ��0 C I SY)
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 SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET / $
BATHTUBS NO. ' FURNACE, ELEC. GAS to $
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 AGAINS •E CITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND . PLOY .S, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: . I' 111° V9,,A DATE: -
ANP-008 3/90