93-100337 3- Jo 0337
CITY OF FEDERAL WAY MECHANICAL PERMIT PERM NO.: BLD93®0136
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 02/09/93
Federal Way, WA 98003 BY: FC
661-4000
SITE ADDRESS: 31203 2ND AVE SW
PARCEL NO.: 555750-0010
PROJECT DESCRIPTION: INSTALL (1) GAS FURNACE
OWNER CONTRACTOR LENDER
BRUCE LANG PACIFIC GAS HEATING & AIR INC
31203 2ND AVE SW 11002 34TH AVE S
FEDERAL WAY WA 98023 TACOMA WA 98444
946-1343 582-5882
PACIFGH110ME
FUEL TYPES.:GAS FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 1 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 10.00
GAS HWT • 0 WOOD STOVES...: 0 15-30 HP • 0
CONV 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...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0 TOTAL FEES $ 30.00
INSPECTION RECORD
Water Line OK Mechanical Inspection Notes:
GAS PIPING OK/655 /#4,0 6 ' Date y/c'-5'3 By /.ir.'
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 APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT , .y-� DATEk- / 2 ,
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CITY OF FEDERAL WAY e400 - 0 ) 3(0
BUILDING PERMIT APPLICATION
Please Print—
BOX 1 TENANT NAME: %
OWNER _ .S'Q .y� L SITE LOCATION., 31c3.
OWNERS ADDRESS_ —SR 1kP4.PHONE q
DESCRIBE JOB -RAL )I1 91.4,Q -P,An a
THE PROPERTY IS OWNED BY:SINGLEJMARIED_ V PARTNERSHIP CORPORATION--- .._.—
BOX 2 CONTRACTOR'S NAME ` - ! CONTRACTOR'S REG.# r2 e•1 6-, Wein£
Card MUST be presented
CONTRACTORS ADDRESS J/(D�r�_-- ,az/ s ---CITY %1'6".17""'' PHONE �S 8
EXPIRATION DATE �)-* '9-� -------
--OR---
I HAVE READ CHAPTER 18.27.0,0 RELATINBTO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. —
BOX 3 CONTACT PERSON (-1a4+ PHONE ScS- A'S d\
BOX 4 SEWER DISTRICT - WATER DISTRICT ^�
BOX 5 ESTIMATED PROJECT COST.._ EXISTING BUILDING VALUATION______
BOX 6 PROPERTY TAX ACCOUNT NUMBER ---
LEGAL DESCRIPTION _ ---_._..-...._..._--
(11 necessary,please submit a separate page*In the legal description.)
K.C.Plat Recording#
BOX 7 BUILDING SQUARE FOOTAGE' (ExlstIng/Proposed) 1ST FLOOR____/ 2ND FLOOR --_J
3RD FLOOR J BASEMENT 7 DECK I GARAGE
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY(NO.OF UNITS e- EXISTING STRUCTURE
( ) COMMERCIA'JINDUSTRIAL TOTAL ARA OF PROPERTY _ -�-�- SQ FT
BOX 9 PLUMBING FIXTURES(rnc uding ro gh-ins) MECHANICAL APPLIANCES-BASIC FEE$
NO. W.ATERCLOSETS GAS PIPING,FEET C' $
BATHTUBS NO.—L_FURNACE.ELEC.
SHOWERS GAS HOT WATER HEATER S
LAVATORIES _ . CONVERSION BURNER S
SINKS _BOILER,SIZE BID S _
DISHWASHERS -___AIR HANDLING UNITS $
ELECTRIC HOT WATER HEATER _ HEAT PUMPS,SIZE S
_LAUNDRY WASHER OUTLET _UNIT HEATERS $ -
URINALS AIR COOLING UNITS,SIZE 5
DRINKING FOJNTAINS COMMERCIAL HOOD $
_..__-_SUMPS,SPRINKLER VACUUM BREAKERS .. OTHER S
DRAINS -_ _ -.__.... $
- OTHER — ---- -- - $ - .
_TOTAL FIXTURES
TOTAL MECHANICAL FEE S
I CERTIFY UNDER PENALTY OF PERJJRY 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 1O SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(INCLUDING COSTS,EXPENSES,AND ATTORNEYS'
FEES INCURRED IN INVESTIIiATION 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 OJT 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: ;moi 9 ,M1...6 e,6