93-102352 CITY OF FEDERAL WAY MECHANICAL PERMIT PERMSSUED: 09/13/9393
33530 First Way South
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 03/12/94
ADDRESS: 30926 5TH PL S
NO. : 241330-0120
PROJECT DESCRIPTION:HVAC - INSTALL GAS LOG 6 PIPING.
= OWNER — CONTRACTOR — LENDER
MICHAEL ANDERSON NORTHWEST WATER HEATER
30926 - 5TH PL S 8201 DURANGO ST SW
FEWAY WA 98003 TACOMA, WA WA 98499
941-4898 984-6404
NORTHWH103R2
FUEL TYPES.:GAS FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 60 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 0 DUCT WORT • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 9.50
GAS HWT • 0 WOOD STOVES...: 0 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...: 1 > 10,000 CFM: 0 UNDERGROUND.: 0
TOTAL FEES $ 29.50
a
Inspection Record Water Line 01 Mechanical Inspection Notes:
GAS PIPING OK Date By _
?REMITS EIPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EIPIRE ONE YEAR AFTER DATE OF ISSUANCE.
[ CERTIFY THAT THE INFORMATION FURNISED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AID THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS WILL BE MET.
IWNER OR AGENT DATE
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SEP--10-93 F R 1 14:01 NW WATER HEATER TACOMA FAX NO, 206 588 0353 P. 03
Pen" (--D g 3 - o i 3
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
—Pie3se Print—
BOX 1 TENANT NAME: -
OWNER f)'C oy`) SITE LOCATION '.t , '# +(�
OWNER'S ADDRESc1c - 5'0"' L _ -�_. CITY _Fkc l PHONE
DESCRIBE JOB 1n ' tj 1 .+ '
THE PROPERTY IS OWNED BY: SIN LE/MARRIED _ . PARTNERSHIP_ CORPORATION_..
BOX 2 CONTRACTOR'S NAMEtii., I l S )O2tJ{i !'•z_ I -_ _CONTRACTORS REG.#
Card MUST be orese^ted
Sb,CONTRACTOR'S ADDRESS 1 _ LIQ ^f�Cc) CITY T-- .-_Q PHONE "nif--C -i
EXPIRATION DATE I-Qa 9 fl,--\c6
c)
- OR—
I HAVE READ CHAPTER 18.27.010 RELATING TG DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
3;,'X;r• CONTACT PERSON
OPJ ���. J.
BOX 4 SEWER DISTRICT —�. WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST 4,-�q() _EXISTING BUILDING VALUATION
BOX B PROPERTY TAX ACCOUNT NUMBER_ =PR �
LEGAL DESCRIPTION _
(It 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 _ I
3RD FLOOR J BASEMENT / DECK _J GARAGE
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY(NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY _ - SQ FT
BOX R PLUMBING FIXT'ARES (including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$
NO. WATERCLDSETS GAS PIPING, FEET (_Cif) --- --- $
BATHTUBS NO. FURNACE: ELEC. GAS_ $
SHOWERS GAS HOT WATER HEATER $
—LAVATOORIES CONVERSION BURNER $
—SINKS _,tl.�. 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 C224 3-__-___ $
GRAINS ____,___. - — $
OTHER �_ $
TOTAL FIXTURES S
TOTAL MECHANICAL FEE $
l CERT..FY UNDER PENALTY OF PERJURY THAT THE INFORMAT'ON 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 HARM LESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(INCLUDING COSTS,EXPENSES,AND ATTORNEYS'
FEES INCURRED IN INVESTIGATION AND DEFENSE CF 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: 9 io/g3