92-101403 92- /0 ! YD3
;ITY OF FEDERAL WAY , MECHANICAL PERMIT PERMIT NO.: BLD92-2114
13530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 09/09/92 •
.ederal Way, WA 98003 BY: MH
i61-4000
SITE ADDRESS: 29900 4TH AVE SW
'ARCEL NO.: 720500-0180
'ROJECT DESCRIPTION: MECHANICAL--INSTALL WATER HEATER
— OWNER .— CONTRACTOR — LENDER
CARL LINE, JR NORTHWEST WATER HEATER
29900 4TH AVE. SW 8201 DURANGO ST SW
FEDERAL WAY WA 98023 TACOMA, WA WA 98499
941-1971 984-6404
NORTHWH103R2
FUEL TYPES.:GAS 7 FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 30 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 • 1 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 S 28.50
INSPECTION RECORD
Water Line OK Mechanical Inspection Notes:
OS PIPING OK "1/11 Date, ' By -`<;Y
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
CERTIFY THAT THE INF TI• ED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
1100
NVNER OR AGENT ���, DATE l /6` Jcj
ld_mech 07/01/92 ,
/
y '
/\
SET BACKS AND FOOTINGS O.K TO POUR FOUNDATION WALLS PLUMBING GROUNDWORK
DATE BY — DATE BY DATE _ — BY
PLUMBING ROUGH IN W WATER LINE O.K. _ ^ MECHANICAL INSPECTION
DATE ..BY . —_.. GAS PIPING O.K. in r'h- t Z iN DATE _.. _—...— BY
O.K. TO ENCLOSE FRAMING INSULATION WALL BOARD AND FIRE WALL
DATE . BY_...... ... DATE ---......_ DATE BY
FINAL O.K. TO OCCUPY
/ DCD PSD FD
/..
DATE_. 0 V/ BY
S
Permit # 1
RECEIVECCITY OF FEDERAL WAY
AUG 3 1992 BUILDING PERMIT APPLICATION
- Please Print-
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BOX 1 TEN TENMNXik
OWNER ((IL•v L - -}1/ SITE LOCATIQN J :S �\~°' a,
OWNER'S ADDRESSC j100 �`v l�,�rt , lam CITY- e4 t-k U)CL&i PHONE `'I`-1 1 - `tel-1 I
DESCRIBE JOB Q.�,�--* i e � ^c1 ¢ �,-� t-C- Q
THE PROPERTY IS OWNED BY: SINGLE/MARRIED c PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME-�f\m(` 1A -4JA c -1. CONTRACTOR'S REG. # S :\ IA 16 jt? -
Card MUST be presented
CONTRACTOR'S ADDRESS )1 ��CR✓v vup CITY14-?, ‘.:-` PHONE GVL
) IELIUy
EXPIRATION DATE 0-1?,)-I i•�
- 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 t `I -�.Lt W-1
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST 1--• EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER 7-�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 3O ' $
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 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: a DATE: CLQ . - .76-
( (.9
• ANP-008 3,90