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33530oF i rst�EWay Sout h M E C H A N I C A L P E R M I T PERMSSUED: OS/09/9382
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4400 EXPIRES: 02/05/94
ADDRESS: 34926 28TH AVE S
NO. : 219060-0230
PROJ ECT DESCR I PT I ON:HYAC
ONNER CONTRACTOR IENDER
DEBBIE CONNEII AWERICAN HEATING SERYICES INC.
34926 28TH AYE S 1503 POATlANO AYE S1E.#9
FEDERaI W�IY NA 98003 TACOMA MA 984b4
539-1702
A�IERIHS0831d5
EL TYPES.:GAS ? FANS........,.: 0 84ILERSiC011PAESS4AS FEES:
GAS FIPIN6,: 0 ft H06D..........: 0 0-3 HP......: 4 ��,; qEC PRI�T ISSUANCE... : 20.00
�.: � __
FURN<100K..: 1 DUCT NORK.....: 0 3-15 HP...,.: 0 ,�� � �� � �� � .s GEC APPITANCE FEES.+ f 10,00
GAS NNT.,,.: 0 MOOD STOYES...: 0 15-30 HP....: 0 F �,� �,��� _ „ �,.�� ������
CONV BURNER: 6 FURN>1QOK.....: 0 30-5d HP.,..: 0 s ` �#
� BBQ.,......: d MISC,.........: 0 6+ HP..,,.,,: 0 �
GAS ORYER.,: 0 AIR HANDLING UNITS FUEL TANKS--------- '
-RAN�E..,,.,: Q <=10,000 CFR; 0 A68VE GR6UND: b
GAS L06S...: 0 > 10,000 CFtd: 0 UNDERGRBUND.: 0
TOTAL FEES � 30.00
Inspaction Record Mater line OK ______ tlechanical Inspection Notes: _� __________���_^_—�_�
GAS PIPING OK � _ Date ----- 9y ----- ------- ---------------____��_�
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO MdRK IS STARTED. RESIDENTIAL ANQ 6AADIN6 PERNITS EXPIRE ONE YEAR AFTER DATE OF ISSUItNCE.
I CfRTIFY THAT THE INFORWATION FUANISED BT ME IS TR AND CORRECT TO THE BEST 8F MY KNOMLED6E AND THE APPlICABLE CITI' OF FERERAL NAY REGUIREMENTS MILL BE MET.
�-,
OYINER OR AGENT _ ___ _ �_ __
- ���� ------- ------ -------- DATE _�_ `� '" ���-
FILE COPY
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:.�0 �irst Way South �.Yl���� � �.✓�� �.L�� �� I�iUE�D: 01,�24/44
,.�4�ra1 Wa�y, YdA 98Ua3 Bui.lding Insp�ction Reque�sts b61--�dI4C? EiY: Ft:
b�.,l-A�00 EX�If�;ES: t�7/23/44
AGDRESS:28T01 EbTH AVE �
NO. : 7d6b90-�030
PROJ�CT nE�CRI PT IDN:NYAC - INSTAi.I 6AS I�T MAiER NE�iER (C�IIK6EWT).,
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:�TED MASNIN6TOM iMITURAL �AS
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6AS tNIT....: 1 I����i�9.�� � �,� �� 3�`HP � � � -� �
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RAN6E......, 0 f.l�i , Q
6Ag t06S.... 0 > i4,0 f 4 �' ��ER6 � .. 0
iOTWI FEfS # 2b.59
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Does the �ater supply syst� contain a Pre�sure Redection Device or Check yalve? () '1es () No {If 'Yes� LIICR IN�Bf Bl(�fl510A kank is tequired on tlot Mater Tank�
i�rspection Record if�tet Line Olt ._.___._,_ � �'" .�__. ..�.
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6A5 PIPIN6 0!( _. __._._..__. ���� � __...__
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;a EXPiRE 1$0 DAVS AfTElt tSSURNCE IF i10 ICORX IS 5TARTED. RESIDEIlTIA! ANl/ &(t�IM6 PEItliCiS fl6PIRE ONf 1(EAR AFTER URTE 4F 1CSIIAiK:F..
�IF11 TNAT TN� I!lfORNATIQ fURMiJE� 8Y f f� RUE AND CORRfCT IO TNf BEST Qf MY KIIOMLED6E AND tHE AFPLTCABLE CltY fff F-' •
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FIELD COP'Y
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CITY OF FED��iAi��WAY
.RECEIVED BY
CQMMUNITY DEVELOPMENT DEPARTM�6d U I L D 1 N G P E R M I T p P P L 1 C AT I O N
—Please Print—
BOX 1 T NA E: � �
OWNER �i SITE LOCATION � ' , lZ�
OWNER'S ADDRESS 'f�` ' • ' CITY . PH NE
DESCRIBE JOB
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME � '' �� ' � � � CONTRACTOR'S REG. # ��'�L� ''�'� �_��
/� `-C,�d UST be presenled
. : f�
CONTRACTOR'S ADDRES ��c/ � • � ��C)• CITY � ��
� �11��� PHONE -�_`� , � IC'�
EXPIRATION DATE - — �
— OR—
I HAVE READ CHAPTER 18.27.010 RELATIN6 TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WfaICH PROHlBlTS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. �
BOX 3 CONTACT PERSON PHONE
BOX 4 SEWER DISTRIC7 WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER ' oZ L-
LEGAL DESCRIPTION �
(If necessary, please submit a separale page with the legal description.)
K.C. Plat Recording# �
BOX 7 BUILDIN6 S�UARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK I GARAGE__J
BOX 8 �-}SINGLE FAMIIY O NEW CONSTRUCTION
( ) MULTIFAMILY(N0. OF UNITS = ) ( ) EXISTIN�STRUCTURE
( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES(including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$
N0. � WATERCLOSETS GAS PIPING, FEET �' $
BATNTUBS NO.�_FURNACE, ELEC. GA� $
SNOWERS GAS HOT WATER NEATER $
LAVATORIES CONVERSION BURNER $
S1hKS BOILER, SIZE BTU $
DISHWASIIERS AIR HANDLING UNITS $
ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $
LAUNDRY WASNER OUTLET UNIT HEATERS $
� URINALS AIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS COMMERCIAL N000 $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER $
DRAINS $
OTHER $ I
70TAL 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 KNOWLED6E
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 70 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 SUCN CLAIM ARISES OUT OF THE RELIANCE OF THE CITY,INCLUDING ITS
OFFICERS AND EMPL YEES, UPON 7HE ACCU CY OF TIiE INFORMATION SUPPLIED TO 7HE CITY AS A PART OF THIS APPLICATION.
4/ / t � � � �
OWNER/AGENT:� � .i� � � � �� DATE: �^
. ANP-00!p/pD