94-101079 L
q y,/cI 07,
CITY OF
33530 First Way South MECHANICAL P EI�:M I T PERMIT
36
ISSUED: 06/03/94
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 11/30/94
ADDRESS:3O23O 27TH AVE S
NO. : 798480-0070
PROJECT DESCRIPTION:HVAC - INSTALL GAS FURNACE AND NATER HEATER
4 ONNER CONTRACTOR -- — LENDER
FRED VERSCHUEREU MORTHNEST NATER HEATER
30230 27TH AVE S 8201 DURANGO ST SN
FEDERAL NAY NA 98003 TACOMA, NA NA 98499
839-7972 ) 964-0404
1 DRT'r W iO3R2
FUEL TYPES.:GAS ? FANS 0 B0 ERS/COMPRESSORS FEES:
GAS PIPING.: 5 ft HOOD : 0 0-3 iP......: 0 ! AEC PRAT ISSUANCE... $ 20.00
FURN<100K..: 1 DUCT NORK u 3-15 RP.....: 0 AEC APPLIANCE FEES.* $ 19.50
GAS HNT • 1 N000 STOVES 0 5-30 4P - 9 4
CONY BURNER: 0 FURN>IOOK., ..:: 0 30-50 FW..:.:
BBQ - 0 MISC.. .....: 0 5: dr, ....- 0
GAS DRYER..: 0 Al HANOLiRG UWIFS FULL 'ANKS
RANGE • 0 !0,000 Cr+: ABOVE GROUND: 0
GAS LOGS...: 0 '.0,000 UF,° . 0 UNDERGROUND.: 0
TOTAL FEES $ 39.50
*Does the water supply systew contain a Pressure Reduction Device or Check valve? () Yes () No (If 'Yes' then water expansion tank is required on Hot Nater Tank)
Inspection Record Nater Line OK Mechanical Inspection Notes:
GAS PIPING OK Date By
a I
PERMITS EXPIRE 180 DAY AFTE SUANCE IF NIRK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE NFd MATI N FURNISED : ME IS TRUE AND CORRECT TO THE BEST OF MY KNONLEDGE AND THE APPLICABLE CITY OF FERERAL NAY REQUIREMENTS NILL BE MET.
OWNER OR AGENT DATE 6— — 11
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•TY OF FEDERAL WAY • /d &
BUILDING PERMIT APPLICATION C5l
—Please Print—
3c.N(-1(-1-CL-1310
TENANT NAME:
OWNER — • • ) • SITE LOCATION 0.
•. .
OWNER'S ADDRESS • • F•Lc-) PHON .. d - 9 -
DESCRIBE JOB ‘115.0, � rY/CJ -4- (l..Zc'� D 11 �
THE PROPERTY IS OWNED BY: SING MARRIED PARTNERSHIP CORPORATION
CONTRACTOR'S NAME NI i a) l 1)C. 0 ki.0 O.D I CONTRACTOR'S REG.# ND2TI-1..i)1f 1n3Ra
_ Card.MUST be presented/
CONTRACTOR'S ADDRESS SID l pZ
una '114Cr1 -SLLCITY f0-ccrY\Ct PHONE {'C.OLA J 7
EXPIRATION DATE to as_qy
—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.
CONTACT PERSON ��_ _ 41. _ la A # ' PHONE CI c�y — CDL(O
Lli
SEWER DISTRICT WATER DISTRICT
ESTIMATED PROJECT COST lq 5C3 cc EXISTING BUILDING VALUATION
•
PROPERTY TAX ACCOUNT NUMBER fR-cN (-1*c)on" )-co
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR_____/ 2ND FLOOR /
3RD FLOOR_____/ BASEMENT_____/ DECK / GARAGE__________/
( ) SiNGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET 5 / $
BATHTUBS NO. i FURNACE, ELEC. GAS .1-/ $
SHOWERS 1 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 $
URINALSAIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS COMMERCIAL HOOD S
SUMPS, SPRINKLER VACUUM BREAKERS OTHER $
DRAINS $
OTHER $
TOTAL FIXTURES $
TOTAL MECHANICAL FEE $
TIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
:URTHER THAT I AM AUTHORIZED BY THE OWNER OFTHE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APPLICATION IS
E.I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(INCLUDING COSTS,EXPENSES,AND ATTORNEYS'
INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM),WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
=ILED AGAINST THE CITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY,INCLUDING ITS
;ERS AND EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
ER/AGENT: /. f J 11 _91 DATE: (J' / I /
A/N.OW LW