92-101697 92-/O16 97
CITY OF FEDERAL WAY BUILDING PERMIT PERMIT NO.: BLD92-22 56
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 10/07/92
Federal Way, WA 98003 BY: JJ
661-4000
SITE ADDRESS: 4751 SW 315TH PL
PARCEL NO.: 211572-0230
PROJECT DESCRIPTION: HVAC = INSTALL GAS RANGE
OWNER CONTRACTOR -- LENDER
SHARON SLOAN ABC GAS INSTALLATION
4751 SW 315TH PL 9923
illiERAL WAY WA PUYALLUP WA
2574 2010 845-7482
ABCBAI113N3
A
BLD?: MEC?:X PLM?: FLR--EXIST--PROP--- DWELLING UNITS: 0 COMP PLAN •7 FEES:
TYPE OF WORK:ALT USE:RES 1ST.: 0: O:sf STORIES • 0 REQUIRED PARKING..: 0 SPRINKLERS?......:? MEC PRMT ISSUANCE... $ 20.00
i CENSUS CATEGORY -434 2ND.: 0: 0:sf HEIGHT • 0.00 ft HAZARD CLASS...:? MEC APPLIANCE FEES.* $ 8.50
OCCUPANCY GROUP 3RD.: 0: 0:sf VALUATION REQUIRED SETBACKS------- FIRE FLOW • 0 gout
I :? :? :? :? OTHR: 0: 0:sf EXIST..$: 0 FRONT • 0.00 ft
TYPE OF CONSTRUCTION BSMT: 0: O:sf PROP...$: 0 SIDE • 0.00 ft WATER SERVICE..:?
:? :? :? :? DECK: 0: O:sf REAR..........• O.00:ft SEWER SERVICE..:?
I OCCUPANT LOAD GAR.: 0: 0:sf RECEIVED.:10/06/92
1 : 0: 0: 0: 0: TOIL: 0: 0:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
FUEL TYPES.:GAS FANS • 0 BOILERS/COMPRESSORS WATER CLOSETS • 0 URINALS • 0 TOTAL FEES $ 28.50
I GAS PIPING.: 25 ft HOOD • 0 0-3 HP • 0 BATH TUBS • 0 DRINKING FOUNT.: 0
FURN<100K..: 0 DUCT WORK • 0 3-15 HP • 0 SHOWERS • 0 SUMPS • 0
GAS HWT • 0 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 0 VAC BREAKERS...: 0
CONV BURNER: 0 FURN>100K • 0 30-50 HP • 0 SINKS • 0 DRAINS • 0
BBQ • 0 MISC • 0 5+ HP • 0 DISH WASHERS • 0 LAWN SPRINKLERS: 0
,AD
DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELEC WTR HEATERS...: 0 OTHER FIXTURES.: 0
GE • 1 <=10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS...: 0
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
ALL 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 FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
4,-*OWNER OR AGENT DA ?N.,
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CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 TENANT NAME:
OWNER •_ /L . �, �✓,�c- ,t- SITE LOCATION ,"2 -S' 5 4 7 / 1'L.
OWNER'S ADDRESS y, 7 / s 3 /S �< CITY � � PHONE ` * ' .,7J 3 C'
DESCRIBE JOB % � ` � __ z
THE PROPERTY IS OWNED BY: SINGLE'MA RED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG. # jt-(Y
Card MUST be presented
CONTRACTOR'S ADDRESS 9V/23 ° CITY PHONE '51-
EXPIRATION DATE 2. <2-.3
— 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 `f S :4/%5
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER _`<)/' 72
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 $
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.
OWNER/AGENT: ��` "��� ��• �� DATE: /d' — f
ANP-008 3/90