92-101760 CITY OF FEDERAL WAY MECHANICAL PERMITPERMIT NO B D92-2 97
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 10/13/92
Federal Way, WA 98003 BY: ELF
661-4000
SITE ADDRESS: 30040 5TH AVE SW
PARCEL NO.: 0395900010
PROJECT DESCRIPTION: HVAC
17
OWNER — CONTRACTOR - LENDER
GAGE RENNIE SHEET METAL, INC. I
30040 5TH AVE SW 4820 S. WASHINGTON
FEDERAL WAY WA 98023 TACOMA WA 98409
472-4099
RENNISM1100N
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
BBC) • 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 3 30.00
INSPECTION RECORD
Water Line OK Mechanical Inspection Notes:
WS PIPING OK /6% Date/70z By S44
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 1-- / -Qi DATE /G - / --Cf 2
bld mech 07/01/92
i/
(i v) r
Permit # g 1.16 9 DO 3 7
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
r
BOX 1 TENANT NAME:
OWNER C } SITE LOCATION
OWNER'S AEbRESS 3O04C 5 4uc �(- CITY c pm CLI PHONE X53 — 3+< �1 •
DESCRIBE JOBL4 tJ
THE PROPERTY IS OWNED BY: gINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME yti ti ie_. €€L (Y AL-_i ce CONTRACTOR'S REG. #REkti n I Ie C N
Card MUST be presented
CONTRACTOR'S ADDRESS 'AU Sc • Ix)AJ‘ Wc;,0 R% CITY �At._ PHONE 4-1 - �t`f
EXPIRATION DATE 1! ' q u 'JJ
— 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 Yhta i%Lk �' PHONE /#7,L— 'cVi `(
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER O36i 5 0 00 I 0
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 ( ) 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 $
BATHTUBS NO. l FURNACE, ELEC. GAS $
SHOWERS GAS HOT WATER HEATER $
LAVATORIES CONVERSI RNER $
SINKS BOILER, SI BTU $
DISHWASHERS AIR HAND UNITS $
ELECTRIC HOT WATE EATER HEAT PUMPS, SIZE $
LAUNDRY WASHER OUTLET UNIT HEATERS $
URINALS AIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS _COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER $
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: DATE: /b — 6 '4
ANP-008 3/90