92-102340°"` r' IN A___ PFS I T
,G INSF�,�; ION - c ii 4140
Federal Way, WA 98003
661-4000
SITE ADDRESS: 29644 9TH PL S
PARCEL NO.: 515160-0335
PROJECT DESCRIPTION:
�—TALL
GAS
PIPING ONLY
ROBERT CARTER
GOLDEN FIRE INSTALLATI[:NS
29644 - 9TH PL S
1006 W MAIN
FEDERAL WAY WA 98003
PUYALLUP WA 98371
941-8073
841-9379 839-0998
GOLDEFI088KO
II FUEL TYPES.:GAS
FANS.. ...:
0
BOILERS/COMPRESSORS
GAS PIPING.: 30 ft
HOOD..........:
0
0-3 HP..... 0
FURN<100K..: 0
DUCT WORK.....:
0
3-15 hP.....: 2
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......:
RANGE ...... 0
c10,000 CFM:
0
ABOVE GROUND: 0
GAS LOGS...: 0
> 10,000 CFM:
0
UNDERGROUND.: 0
Water Line OK
WS PIPING OK /'S5} , iii✓
INSPECTION RECORD
Mechanical Inspection
Date/ -S-K F, By
Notes:
LENDER =
PERMIT NO.: BLD92-2611
ISSUED: 12/29/S27
BY: FLF
FEES:
MEC PRMT ISSUANCE... $ 20.00
MEC APPLIANCE FEES.* $ 2.00
TOTAL FEES $ 22.00
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
bld mech 07/01/92
DATE
L
SET BACKS AND FOOTINGS
DATE_ ____ ---BY -
PLUMBING ROUGH IN
DATE _ _- _ ___._BY,___
O.K.
_._BY._-
O.K. TO ENCLOSE FRAMING
DATE _ -- BY
FINAL O.K. TO OCCUPY
DATELy� �B/l/1 �. --- __
OX TO POUR FOUNDATION WALLS
DATE _..._ __.__BY
.._.-
WATER LINE O.K.
GAS PIPING O.K.__.. .....
INSULATION
DATE _ .--__BY ... _......
...
DCD
PSD
PLUMBING GROUNDWORK
DATE _- __ - __._...BY ......
MECHANICAL INSPECTION
DATE - .--._- ___BY
WALL BOARD AND FIRE WALL
DATE _ _ _ _ __ _ BY
FMOSIVED
DEC 2 9 1992
*TV
M AY
8=
Permit # P2L — 2- /l
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME:
OWNERSITE LOCATION yid
OWNER'S ADDRESS 16� CITY PHONE — ' 7
DESCRIBE JOB
THE PROPERTY IS OWNE BY: N E/MARRIED PARTNERSHIP�2 CORPORATION
BOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG.
Card MUST be presented
CONTRACTOR'S ADDRESS�O�� /,//< �ElA! _CITY PHONE EW -
EXPIRATION DATE
1'
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS I§SUING PERMITS WITHOUT PROOF OF REGISTRATION. _
BOX 4 SEWER DISTRICT
'� WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
(It necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR—/-
3RD
LOOR/3RD FLOOR-------/— BASEMENT / DECK /
2ND FLOOR /
GARAGE_____J
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIALANDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
N0. WATERCLOSETS
BATHTUBS
SHOWERS
LAVATORIES
SINKS
DISHWASHERS
ELECTRIC HOT WATER HEATER
LAUNDRY WASHER OUTLET
URINALS
DRINKING FOUNTAINS
SUMPS, SPRINKLER VACUUM BREAKERS
DRAINS
OTHER
TOTAL FIXTURES
MECHANICAL APPLIANCES —
BASIC FEE S
GAS PIPING, FEET __C 36
S
N0. FURNACE, ELEC. GAS
S
GAS HOT WATER HEATER
S
CONVERSION BURNER
$
BOILER, SIZE BTU
S
AIR HANDLING UNITS
S
HEAT PUMPS, SIZE
S
UNIT HEATERS
S
AIR COOLING UNITS, SIZE
S
COMMERCIAL HOOD
S
OTHER
g
_S
S
TOTAL MECHANICAL FEE
S
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 CLAINI 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:n�_ &- c�
ANP 0-38 3,5G