93-102421 9 - roV /
CITY OF FEDERAL WAY MECHANICAL PERMIT PERISSUED: 09/21/93 1
33530 First Way South
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 03/20/94
ADDRESS:2126 SW 339TH ST
NO. : 330620-0210
PROJECT DESCRIPTION:HVA - INSTALL GAS FURNACE
OWNER — CONTRACTOR — LENDER
OKEEMAH RECORD NORTHWEST WATER HEATER
126 SW 339TH ST 8201 DURANGO ST SW
DERAL WAY NA 98023 TACOMA, WA WA 98499
952-6119 984-6404
NORTHWH103R2
FUEL TYPES.:GAS FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 NEC PRMT ISSUANCE... $ 20.00
FURN<IOOK..: 1 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 10.00
GAS HNT • 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...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
TOTAL FEES $ 30.00
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Inspection Record Water line OK Mechanical Inspection Notes:
GAS PIPING OK Date By
1 1
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 ,/ DATE ! --5)
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CITY OF FEDERAL WAY CA
BUILDING PERMIT APPLICATION Wm ID
—Please Print—
BOX 1 TENANT NAME:
OWNER 0: Ply Y()}h amid SITE LOCATION 3 . • Lu 3 3c
OWNER'S ADDRESS of iC LU ,3:39 cS-t , CITY 1:-,(..1-.) - PHONE q. - Cot
DESCRIBE JOB t0-C1 D _ f00
THE PROPERTY IS OWNED BY: SING
/MARRIE,11D Y PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME NI t.,1_.) I. )(1DJ1 J CONTRACTOR'S REG. # NOR.d MUSTH-P-) RQ
CCONTRACTOR'S ADDRESS Sa)1 Q_-U 10, SnCCC) S+SL-LICITY ToCCIY\o PHONE c-it-f'Lv`-I07
EXPIRATION DATE 1a 10a CI 3
— 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 PERMITSWITHOUT PROOF OF REGISTRATION.
n
BOX 3 CONTACT PERSON C� Qf� 1 �/ LPHONE q — C01-10Y
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST _��I() EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER 3,7n((1:X) - i O
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 J�� N $
BATHTUBS NO. t FURNACE, ELEC. GASY._.____
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 EMPLOYE1 S, UPO THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: , tli DATE: 9 X. 1
ANP-008 3/90