94-100699 4s..
9y-yob 6 y�
CITY OF
33530 First Way South MECHANICAL PERMIT PER ISSUED: 198
04/13/94
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 10/10/94
ADDRESS:2961S 10TH PL S
NO. : 515160-0300
PROJECT DESCRIPTION:HVAC - INSTALL GAS STOVE
OWNER CONTRACTORii[ --- — LENDER
EVERETT LUNDY *Y* OWNER IS CONTRACTOR a*E
29615 10TH PL SO
FEDERAL WAY WA 98003
839-2833
s** NONE tn.
FUEL TYPES.:GAS ELE FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 0 ft HOOD • 0 0-3 HP......: 0 AEC PRAT ISSUANCE... $ 20.00
FURNU OOK..: 0 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 6.50
GAS HNT • 0 WOOD STOVES...: 0 15-30 HP • 0
CONV BURNER: 0 FURN>100K • 0 30-50 HP • 0
BBQ • 0 MISC.... • 0 5t 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
4111 TOTAL FEES $ 26.50
Does the'aater supply system contain a Pressure Reduction Device or Check valve? () Yes () No (If 'Yes' then mater 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 INFORM ION 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 4d . . 6_ .J, > „�/, / DATE _./. ]`
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a„� G City of Federal Way
\I`) APPLICATION FOR BUILDING PERMIT
PLEASE PR/NT APPLICATION #: 4- Q Z-
S1TE LOCATION Address /c3U/c j !U r'.77C,SO'• ,c4?'I- ' -4'-c/ Gz/4,
Tenant (if known) Lot # `, Assessor's Tax#..._.70
Buildin caner Name ( 3/5 o �co
Addres
...- Z
-) `--/C7/4/ (-..
SO
City f-4;---2)44---. -� -C t4, <�S tate 4 Zip / Phone �` /
/AL of Work ( S/L�
2-c4-14)
c4 ) -xe - .5>e--6,v-47
APPLICANT :
Name (F }
G%dLL"'/>_4ff- S . /A/ 'VC�
Address
%fx, —/0744 "Z_ S •
City rte_ e--c-oric_a tJCSP, State eel C Zip CM F-, ?›Con�tta-ct��rson �� . � Day Phone G Other Phone Fax
Katail G CONTRACTOR
.........................
Company Name
Address
---/---- -
City 5‘21
State Zip
Contact Person Phone Fax
Contractor's #(card must be presented) Expiration Date Verified 0 Yes 0 No
[RCH rECT
Name
Address PP(
City
State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION ` 1. 7 fi
liclifr 2 )
/ a-(7(/1-e lq, [7 s Pivisy0)-1 7 .
Please Complete Reverse Side
CD0492(Rev 4/93)
r STRUCTURE Fng Use •osed Use
1 Permit includes: ❑ Building ❑ Plumbing iMechanical ❑ Other
Type of Work: 'Residential ❑ New ❑ Remodel ❑ Number of Units ❑ Deck
❑ Commercial ❑ Addition ❑ Garage ❑ Shed ❑ Other
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
O
-
Water Availability/'� Sewer Availability `�] On-Site Septic System Availability ❑ Project Veluat7ar $ ,:.
Zoning Lot Size Existitiig Bldg Valuation
LENDER
Name / ' r ' Address
City fV / �1`\ State Zip
MECHANICAL CONTRACTOR
Contractor Name Address
•-c---
City 0� State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
'PLUMBINGCONTRACTOR
Contractor Name Address
City Y ) State r Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBINGFIXTURE;COUNT`
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total Fixture Count
MECHANICAL;UNIT-COUNT
Fuel Type (electric/other) 7— Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping Range Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUs Gas Log 1 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 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 jr sgs 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. .f1/ J
/
Owner/Agent: - ._`- !,/ - Date: / -- _.