93-102755 t , /Ds
CITY OF FEDERAL WAY MECHANICAL P ERM I T PERMIT NO:
180/28/9349
33530 First Way South
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FLF
661-4000 EXPIRES: 04/26/94
ADDRESS:32428 8TH AVE SW
NO. : 926492-1.050
PROJECT DESCRIPTION:Install gas piping and fire standing stove
OWNER — CONTRACTOR --- LENDER
iFf.JOSEPH BLACHE PACIFIC ENERGY SUPPLY INC
32428 - 8TH AVE SW P.O. BOX 2144
EDERAL NAY NA 98023 6920 - 22ND ST W./TACOMA
GIG HARBOR NA 98335
838-1245 565-4594
PACIFES077K0
FUEL TYPES.:? ? FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 50 ft HOOD • 0 0-3 HP . 0 MEC APPLIANCE FEES.* $ 6.50
FURN<100K..: 0 DUCT WORK • 0 3-15 HP • 0 MEC PRMT ISSUANCE... $ 20.00
GAS NWT - 0 WOOD STOVES...: 1 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 $ 26.50
III
Does the water supply system 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
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT e,, ___ DATE 9/0 3
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' SETBACKS & FOOTINGS
Date By
FOUNDATION WALLS
..... ....................
Date By
PLUMBING GROUNDWORK
Date By
UNDERFLOOR FRAMING
Date By
SHEAR WALLS
Date By
PLUMBING ROUGH-IN
Date By
GAS PIPING
Date By
MECHANICAL ROUGH-IN
Date By
MECHANICAL (OTHER)
Date By
FRAMING
Date By
INSULATION
Date By
GWB - 1ST LAYER
Date By
GWB - 2ND LAYER
Date By
SUSPENDED CEILING
Date By
PLANNING FINAL
Date By
ENGINEERING FINAL
Date By
FIRE FINAL
Date By
BUILDING FINAL
Date p By /�
OTHER Ft t-2 E t 2e�C
�1�vtiL� --t/I JO ✓4�G1 > " CO
Date ,.// )E. 5 c By.&z
OTHER
Date By
CD01 93
VAN
RsGti\k.00�cn O pP � Wit # �60 93 -- //g'/`'
C- 2 . 199 CITY OF FEDERAL WAY
0
BUILDING PERMIT APPLICATION
— Please Print-
BOX 1 -14#14144-NAM E:27O.S-ph LA — -
OWNER .0OS�jail 'moi A0�►�__ SITE LOCATION -H+'►'�'e
OWNER'S ADDRESS .x'l'L-^ r4::-A. f? vl� 50 --___CITY_ _F-? -eP--�-1- _ . PHONE 137--'/2--[t5
DESCRIBE JOB AS �'N i N 6k�t1 tgax 95 FlZee- S'Ifi'►U 'iAii� ,3440 v._.
THE PROPERTY I'OWNED��B,,Y,,: SINGLE/MARRIED PARTNERSHIP___-_.-___ _._.____- CORPORATION
BOX 2 CONTRACTOR'S NAME 1 �iL_ ckJe.rLi 3: Its CONTRACTOR'S REG. # P 0- / KG?
1 Card MUST be presented
CONTRACTOR'S ADDRESS 6110-2-? D UL-). CITY 1
Gt. ,m 4 PHONE 5b5-*5 q7"
EXPIRATION DATE 3i Tel
— 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 REGIST RATION.
--- -----
•
BOX 3 CONTACT PERSON —._ --_-----_...----__.___.._..�.----._-----------.- PHONE
BOX 4 SEWER DIS1RICT WATER DISTRICT -__--__
BOX 5 ESTIMATED PROJECT COST _�EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
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 1 2ND FLOOR / - - -
3RD - FLOOR_______J BASEMENT / - DECK / GARAGE /
BOX 8 (i -rSINGLE FAMILY ( ) KW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ISTING 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 $
•SHOWERS - GAS HOT WATER HEATER. . -- $ -
_
LAVATORIES - - • • - CONVERSION BURNER - -- - -.-- S- -- •
SINKSBOILER, SIZE BTU $
DISHWASHERS . - _. ...... AIR HANDLING UNITS - S'----
ELECTRIC HOT WATER HEATER --- - - • - • HEAT PUMPS, SIZE - --- S-- - -
_ _ LAUNDRY WASHER OUTLET _ __ UNIT HEATERS $
URINALS • ._• AIR COOLING UNITS, SIZE • - - - - $ —.. .-..-
- - DRINKING FOUNTAINS . - • -. • COMMERCIAL HOOD - S
SUMPS, SPRINKLER VACUUM BREAKERS OTHER $
DRAINS - - - - .... $ - --
- OTHER / e4-- $\
TOTAL FIXTURES • - ...44. - •�- $•--- ---
TOTAL MECHANICAL FEE $c,C
CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
MD FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APPLICATION IS
AADE.I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(INCLUDING COSTS,EXPENSES,AND ATTORNEYS'
EES INCURRED IN INVESTIGATION AND DEFEAJ SE OF SUCH CLAIM),WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED.
►ND FILED AGAINST THE CITY /F F 9 RAL NY,BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY.INCLUDING ITS
IFFICERS AND,EMPLOYEES, 4 PO 1 E . C i R: e • i - ' , e ' SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
IWNER/AGENT: - sor' DATE: /U c lc
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