93-100115 9 ,;, /00 i)5.-
CITY OF FEDERAL WAY MECHANICAL PERMIT PERMIT NO.: BLD93-0027
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 01/15/93
Federal Way, WA 98003 BY: JJ
661-4000
SITE ADDRESS: 31211 3RD AVE SW
PARCEL NO.: 555750-0120
PROJECT DESCRIPTION: HVAC
— OWNER — CONTRACTOR — LENDER
DAVID POORTVLIET WASHINGTON NATURAL GAS
31211 3RD AVE SW 3130 S 38 ST
FEDERAL WAY WA 98023 FEDERAL WAY WA
iiii7006 475-6700
WASHING285C6
L
FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 25 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 0 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 9.50
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 • 1 <=10,000 CFM: 0 ABOVE GROUND: 0
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0 TOTAL FEES $ 29.50
INSPECTION RECORD t .'
- - I
Water Line OK Mechanical Inspection Notes: , ,
411/S PIPING OK Date By 111 I
, DATE j
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
1 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 / ' /qLRAY: DATE —J ^9 3
bld mech 07/01/92 /
RECEIVED 8Y Permit # 6 09 3 -6 0 2 7
COMMUNITY DEVELOPMENT DEPARTM`NT
JO13 1993 CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 TENANT NAME:
OWNER DAVID POORTVLIET SITE LOCATION 31211 3 AV SW
OWNER'S ADDRESS SAME CITY FEDERAL WAY PHONE 206-839-7006
DESCRIBE JOB Gas piping and install gas dryer
THE PROPERTY IS OWNED BY: SINGLE/MARRIED X PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME WASHINGTON NATURAL GAS CONTRACTOR'S REG. # WASHING285CB
Card MUST be presented
CONTRACTOR'S ADDRESS 3130 S 38 ST CITY Tacoma PHONE 475-6700
EXPIRATION DATE 3-1-93
— 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 Dena Ivey PHONE 473-8337
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER 5557500120
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 (X ) 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 25' $
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 1 OTHER gas dryer $
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: 111 ILI_ �, DATE: 1rytA_,LQ it Cf
• • ANP-008 3/90