93-100795 CITY OF FEDERAL WAY MECHANICAL PERMIT PERMIT NO.: BLD93-0351
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 03/31/93
Federal Way, WA 98003 BY: FC
661-4000
SITE ADDRESS: 625 SW 297TH ST
PARCEL NO.: 720520-0030
PROJECT DESCRIPTION: HVAC - INSTALL GAS PIPING & GAS LOG (CC-125)
OWNER CONTRACTOR — LENDER
MARILYS DOLNEY GOLDEN FIRE INSTALLATIONS
625 SW 297TH ST 1006 W MAIN
FEDERAL WAY WA 98023 PUYALLUP WA 98371
839-7648 838-6113 841-9379 839-0998
GOLDEFI088KQ
FUEL TYPES.:GAS FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 25 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.* $ 9.50
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 $ 29.50
INSPECTION RECORD
Water Line OK Mechanical Inspection Notes:
41,S PIPING OK Date By
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 AGENT7/://ff DATE ������
bld mech 07/01/92 / ' 6 /--/ 747
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EC,EIVPPLICION FOR DEVELOPME IIIPPERMIT
PLEASE PRINMAR 3 1 1993
� � L —( `,LJAPPLlCA7/ON # �- / � J 7_
IL. SITE I CL�'W Y Address C�"(.3� -- a-� (
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Tenant Lot # Assessor's Tax #
Budding Owner Name Phone
(//, /2/2/-o' I ) 1/ )/ / .-U7— ay
City -- State . ? Zip
G,�L g1 r% te)o-y , -(/,/e--.2 �f4S
)C APPLICANT
Name ,M,Li _ _
�C0' L-l�F.1 fin& ._../,/'us f 14/i--//6 4C)
Address
if/ i'G al, /. 7/9-7--
City ��`j ��" State�� Zip /' -) 2j
Day Phone Other Phone Fax
--9a‘ 6$Y-179
BUILDING CONTRACTOR
Company NameA/'/14
Address
City State Zip
tl
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date Verified
❑ Yes ❑ No
ARCHITECT
Name
Address
A, //14—
City State Zip
Contact Person Phone Fax
STRUCTURE Existing Use Proposed Use
Permit includes: 0 Building 0 Plumbing Mechanical ❑ Other
Type of Work: 0 Residential ❑ New 0 Remodel 0 Number of Units ❑ Deck
❑ Commercial ❑ Addition ❑ Garage ❑ Shed ❑ Other
Enter 1st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area sq ft
Water Availability ❑ Sewer Approval ❑ Project Valuation $
Please Complete Reverse Side
CDOC 32(Rev 2/9?
LENDER410
•
Name
I
Address
7/1?
City /1/1/ State Zip
Contact Phone Fax
Y MECHANICAL CONTRACTOR
Contractor Name _
L.- J/JC`/z'J/:–.2111/::: -tic 74 (Z w Ti8,t)
Address
_ /E/ ,/7%.7- .7. ;
City , State / Zip
Contact Phone //, Fax
License # �! r/ Expiration Datt Verified
•C't-e& /= /occ1/xa y//�/J? ❑ Yes ❑ No
PLUriBLNG CONTRACTOR
Contractor Name
Address
City /'V,
State Zip
Contact Phone Fax
License # Expiration Date Verified
❑ Yes ❑ No
PLUMBING FIXTURE COUNT /AVY
4
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total Fixture Count
MECHANICAL UNIT COUNT
Fuel Type (electric/other) Gas Dryer Air Handling < = 10,000 CFM 1 5-30 Tons
Length of Gas Piping / f— Range Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUs Gas Log Unit Heater 50+ Tons
Furn >100 BTUs Fans Miscellaneous Fuel Tanks
Gas Hwt Hood Boilers Above Ground
Cony Burner Duct Work 0-3 Tons Underground
BBQ's Wood Stoves 3-15 Tons Total Unit Count
DISCLAIMER: 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. U :/::(/..."
X Owner/Agent: e��l/ -" 6L%� ;�:/- /�7//--Sl
Date: