93-102215 93- 1oaa1S
CITY OF FEDERAL WAY MECHANICAL F ERM I T PERMIT NO:ISSUED: 09/02/9359
33530 First Way South
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 03/01/94
ADDRESS:31025 26TH AVE S
NO. : 798440-0195
PROJECT DESCRIPTION:HVAC - INSTALL GAS FURNACE.
= OWNER — CONTRACTOR — LENDER
RAYMOND MORTIMER NORTHWEST MATER HEATER
31025 - 26TH AVE S 8201 DURANGO ST SM
FE L MAY NA 98003 TACOMA, WA WA 98499
839-2166 984-6404
NORTHWHIO3R2
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 MORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* = 10.00
GAS HMT 0 MOOD STOVES...: 0 15-30 HP • 0
CONY BURNER: 0 FURN>100K . 0 30-50 HP • 0
880 • 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 $ 30.00
Inspection Record Water Line OK Mechanical Inspection Notes:
GAS PIPING OK Date By
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL 'WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT ��'—�1� �` DATE _?��-3 —
ALE COPY
Pegit #
•
CITY OF FEDERAL WAY A X- E
BUILDING PERMIT APPLICATION CM
—Please Print-
BOX 1 TENANT NAME:
OWNER SCLC 1110r'ct It1Gr-fi6���(�_ SITE LOCATION 3\0a 5 (";k:-
OWNER'S
GOWNER'S ADDRESS 31,0a5 R(o Hu S CITY d Lv PHONE $39
DESCRIBE JOB OcACt,l O(i_`> ,
THE PROPERTY IS OWNED BY: SINGLE/MARRIED V PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME M'W I a)lift C'OP J CONTRACTOR'S REG. # NORT f+U)if In3RQ
_ Card MUST be presented
ryv
CONTRACTOR'S ADDRESS \ Q�l� h^ O S�uCITY I� �0. PHONE qt-f-(.01-l0V
EXPIRATION DATE iaraa c1/43
— OR —
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON 1 AtC10 - Q IiIJ PHONE Q� I - COL-04/
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST \. C 1.`)( EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER 96N-�(yG C.�(`I`.
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET cS $
BATHTUBS NO. I 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: -,(011(.0.
,(011( DATE: 5\'D,-L0 l !3
ANP-008 3/90