93-102981 9 .)t)a52 /
tCITY _
335300F FEDERAL WAY Firstt Way South MECHANICAL PERMIT PERMIT NO:ISSUED: 11/19/9351
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: KC
661-4000 EXPIRES: 05/18/94
/3•—tom' 67-- s"-'
ADDRESS: 32I-1nTH CT SW_
NO_ : 926496—O9•.1Ago
PROJECT DESCRIPTION:HVAC - INSTALL GAS LOG & PIPING.
OR — CONTRACTOR -- LENDER
DON
WNEKOLBECK GOLDEN FIRE INSTALLATIONS
11111(
33321 - 10TH CT SN 1006 N MAIN
EDERAL NAY NA 98023 PUYALLUP NA 98371
838-0455 841-9379 839-0998
GOLDEFIO88K0
FUEL TYPES.:GAS FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 18 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 0 DUCT MORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 9.50
GAS HNT • 0 WOOD STOVES...: 0 15-30 HP • 0
CONY BURNER: 0 FURN>100K • 0 30-50 HP • 0
86Q • 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...: 1 > 10,000 CFM: 0 UNDERGROUND.: 0
TOTAL FEES $ 29.50
�oes the water supply system contain a Pressure Reduction Device or Check valve? () Yes () No (If 'Yes' then water expansion tank is required on Hot Mater Tank)
Inspection Record Mater 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 NOTION FURNISf11)'' ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL NAY REQUIREMENTS MILL BE MET.
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.SE &.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) SAY /j/,,L'
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 By
OTHER
Date By
OTHER
Date By
CD01 93
City of Federal Way •
APPLICATION FOR BUILDING PERMIT
PLEASE PRINT (' )(7
APPLICATION #: \,/ y
("9.
STE LOCATION Addres4/ / 1 -(
Tenant (if known) Lot # Assessor's Tax_#
Buildiao Owner Name Address
L.--P/t) /‹ .Z 6
City' t ,4ZZ/94y State Z,e)fq. Zip 9y Phone3 //
Nature of Work /6ex /er/ -- GIqS
. . . . „
ArK4001iNSIMENNEMPapp
Name (F,M,L)
Address
City State Zip
Contact Person Day Phone Other Phone Fax
BUILDING:CONTRACTOltft::,..'• • ''••
Company Name
1,11)S IA/1477043—C
Address
/006 te), /0
City Oa Stet!)A_ Zip
Contact Person
CiLICOL esn ey Phone Fax
9
Contractor's # (card must be presented) Expiration Date Verified 0 Yes 0 No
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
CD0492(Rev 4/93)
STRUCTURE : >I Existing Use Proposed Use
Permit includes: uilding 111Plumbing 'Mechanical ❑ Other
.4'ype of Work: LTJ Residential ❑ New ❑ Remodel ❑ Number of Units ❑ Deck
❑ Commercial ❑ Addition ❑ Garage ❑ Shed ❑ Other
i
Enter 1st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area sq ft
Water Availability ❑ Sewer Availability ❑ On-Site Septic System Availability ❑ ,Project Veluaton $
Zoning Lot SizeExfstfngBldg Va(vation •;�fi
LENDER
Name Address
City State Zip
. ......................... .......................................... .i: :].......
.........................................................................................
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING: 'muoi
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
................................................................................. ........
...... ....................................................................... ...... ...
. . ... . ................................................................................
PLUNI,BING FIXTURE:COUNT
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Totai:Fxture Count.
... . ..................................... .................... . .......................
.......................................... ..........................................
.... ...... ......................................................................
........................................................................................
...... .................................... ...................... ......................
MECHANICAL UNI '.:COUNT
Fuel Type (electric/other) Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping Range "'k Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUs Gas Log / Unit Heater 50+ Tons
Furn >100 BTUs Fans Miscellaneous Fuel Tanks
Gas Hwt Hood Boilers Above Ground
Cony Burner Duct Work 0-3 Tons Underground
BBQ's Wood Stoves 3-15 Tons Total Unit.Count.
DISCLAIMER: 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 lam 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 laim,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.
Owner/Agent: "if, ripf Date: //—/, ,,�