92-102342 g . Iv1 LY1
CITY OF FEDERAL WAY MECHANICAL PERMIT PERMIT NO.: BLD92-2 616
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 12/31/92
Federal Way, WA 98003 BY: JJ
661-4000
SITE ADDRESS: 33910 31ST AVE SW
PARCEL NO.: 536020-0043
PROJECT DESCRIPTION: INSTALL GAS FURNACE, HOT WATER HEATER, DRYER, & PIPING
OWNER — CONTRACTOR -- LENDER
ROBERT HARRISON PACIFIC GAS HEATING & AIR INC
•
33910 - 31ST AVE SW 11002 34TH AVE S
FEDERAL WAY WA 98023 TACOMA WA 98444
952-8163 582-5882
PACIFGH110ME
FUEL TYPES.:GAS FANS • BOILERS/COMPRESSORS FEES:
GAS PIPING.: 55 ft HOOD • 0-3 HP • 0 MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 1 DUCT WORK • 3-15 HP • 0 MEC APPLIANCE FEES.* $ 25.00
GAS HIR • 1 WOOD STOVES...: 15-30 HP • 0
CONV BURNER: 0 FURN>100K • 30-50 HP • 0
BBQ • 0 MISC • 5+ HP • 0
GAS DRYER..: 1 AIR HANDLING UNIT FUEL TANKS
RANGE • 0 <=10,000 CFM: ABOVE GROUND: 0
GAS LOGS...: 0 > 10,000 CFM: UNDERGROUND.: 0 TOTAL FEES $ 45.00
INSPECTION RECORD
Water Line OK Mechanical Inspection Notes:
OPIPING OK /-,)a-Q3 Mit) Date /).o-43 By 17/ii
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPUCABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT ,_5-4-12, /'oce9eZy�'-eL���' DATE 'G j// 2
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bld mach 07/01/92
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SET BACKS AND FOOTINGS O.K TO POUR FOUNDATION WALLS PLUMBING GROUNDWORK
DATE_. _._ _ BY_.. __ _. DATE _ _BY DATE BY
PLUMBING ROUGH IN WATER LINE O.K. MECHANICAL INSPECTION
DATE.... _.._BY GAS PIPING O.K. ._ __ DATE BY
O.K. TO ENCLOSE FRAMING INSULATION WALL BOARD AND FIRE WALL
DATE........ BY DATE BY DATE _BY
FINAL O.K. TO OCCUPY
/ DCD PSD FD
DATE -202.9 3 BY mil/ _
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Pest # AG/Z- Z�l
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
—Please Print—
BOX 1 TENANT NAME:
OWNER a M SITE LOCATION X39 /1S /` ,,d
OWNER'S ADDRESS CIT _ _ _ PHONE clr'a,)4'/lv.2)
DESCRIBE JOB L/�"�// J 9CLO �.in a j / ,114/A u) a iii Lam/ eJ1 S'S''
THE PROPERTY IS OWNED BY: SINGLE/MARRIED / PARTNERSHIP ' CORPORATION J
BOX 2 CONTRACTOR'S NAM/ : 040 _.-. . a CONTRACTOR'S REG. #_________________
Card MUST be presented
CONTRACTOR'S ADDRESS /Mdc.)c -IYZ' Q cJ .9 CITY /C+ lj6Sr»d PHONE 4,d J
EXPIRATION DATE
—OR—
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND r
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON PHONES-47 4.411
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER € d-Z)hd�
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 = ) ( XISTING STRUCTURE
( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
:a 9 PLUMBING FIXTURES(including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$
0. WATERCLOSETS GAS PIPING, FEET .S', ' ' $
BATHTUBS NO. 1 FURNACE, ELEC. GAS ✓ $
SHOWERS / GAS HOT WATER HEATER $
LAVATORIES CONVERSION BURNER $
NKS BOILER, SIZE BTU $
DI WASHERS AIR HANDLING UNITS $
ELEC ' HOT WATER HEATER HEAT PUMPS, SIZE $
LAUNDR SHER OUTLET UNIT HEATERS $
URINALS AIR COOLING UNITS, SIZE $
DRINKING FOUN S COMMERCIAL HOOD $
SUMPS, SPRINKLER CUUM BREAKERS / OTHER
DRAINS U $
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.
OWNER/AGENT: ✓L/JQf d DATE: /c "c72 '
ANP-008 3/90