92-101621 61 G
CITY OF FEDERAL WAY lvi EC HAN I CAI PERIVI IT PERMIT NO IBLD92/2225
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 09/28/92
Federal Way, WA 98003 BY: MH
661-4000
SITE ADDRESS: 29806 5TH AVE SW
PARCEL NO.: 2337000090
PROJECT DESCRIPTION: HVAC
OWNER —
SWANSON
29806
5TH AVE SW
gilWRAL WAY WA 98023
•4647 CONTRACTOR -- LENDER
FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 1 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.* $ 8.50
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 • 0 <=10,000 CFM: 0 ABOVE GROUND: 0
GAS LOGS...: 1 > 10,000 CFM: 0 UNDERGROUND.: 0 TOTAL FEES $ 28.50
INSPECTION RECORD /
•ter Line OK Mechanical Inspection Notes: , , - /? _67 Z F<ULq( c tj j 6< , A1'4 QCCc°j c,
illiS PIPING OK Date )/)Z;/l7i By ��/! a�� /,- ° /fit Jr L 7 %0�.
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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.
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OWNER OR AGENT
/... DATE C�
bld_mech 07/01/92
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CITY OF FEDERAL WAY RECEIVED BY
"''°" �'TY""` F'OPMENT DEPARTMENT
BUILDING PERMIT APPLICATI N'"N EIFL
— Please Print—
StP 2 5 1992
BOX 1 TENANT NAME:
OWNER 'Ii AYA S(% lI SITE LOCATION
OWNER'S ADDRESS ‘=: 1/YOD ' fit)- SCu/ CITY r-lle raf GL'ct/ PHONE 94&-Z/6C-I1
DESCRIBE JOB ZY'c 4a( 1 c i S Loc,S
THE PROPERTY IS OWNED BY: SINGLE/MARRIED y PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME -/ .: i ick / i U L'-. CONTRACTOR'S REG. #/44//:R/HSOK�/W
/� / �, fe Card MUST be presented
CONTRACTOR'S ADDRESS -7S-03 1�'die7i��v' '. d CITY �iegiVii PHONE sD %/rI(✓a
EXPIRATION DATE 7- a5 `!
— 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
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER WOO—006-/Z)
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 1
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 (,X) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY(NO. OF UNITS = ) ( ) EXISTING STRUCTURE •
( ) COMMERCIAUINDUSTRIAL 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 $
URINALSIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS ---7-ICOMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER C�St /O(
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 I FORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT/ � / L/< IiI /--r--df
/,C :ATE: d EA.
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