94-100057 • 9�-�aoa �'7
33530OFi rsDEWay South MEC I CAL P E1�;MI T PE�ISSUED- O1 J05/9408
Federal Way, WA 98003 6uilding Inspection Requests 661-4140 BY� FLF
661-4000 EXPIRES: 07/04/94
ADDRESS:29218 20TH AVE S
NO. : 042104-9043
PROJECT DESCRIPTION:HVAC - INSTALL 6AS FURNACE, NOT MATER TANI(, RAN6E, 6 PIPIN6.
OMMER COMTRACTOR LENDER
ROBERT MARD A 6 M HEATIN6 CO
29218 - 20TH AVE S 10512 RUSTIC RD S
EDERAL NAY MA 98003 SfATTLE �IA 98176 '
911-2143 934-9927
AMHEACx081N7
FUEL TYPES.:6AS FANS..........: 0 BOILERS/COMPRESSURS FEES:
6A5 PIPIM6.: 87 ft HOOD..........: 0 0-3 HP......: 0 . , , MfC PRMT ISSUANCE... = 20.00
FURN<100K..: 1 DUCT MORK.....: 0 3-15 HP.....: 0 � � � �� ��� ���� MEC APPIIANCE fEES.x � 26.00
6AS HMT....: 1 MOOD STOVES...: 0 15-30 NP._..: 0 `
;-•_ �-; � ,. ,��� ,
CONY BURNER: 0 FURN>100K.....: 0 3Q-50 NP....: 0 " Y'
BBQ........: 0 IIISC,,........: 0 5+ HP.......: 0 ,�.
6AS DRYER..: 1 AIR NANDLIM6 UNITS FUEL TAiiKS--------- �'` '''
RAN6E......: 0 <=10,000 CFM: 0 A80VE 6ROUMD: 0
6AS L06S...: 0 > 1Q,400 CFM: 0 UMDER6ROUND.: 0
TOTAL FEES s 46.00
Does the rater supply syste� contain a Pressure Reduction Device or Check valve? () Ves () No (If 'Yes' then rater expansion tank is required on Hot Nater Tank)
Inspection Record Mater Line OK Mechanical Inspection Motes:
6AS PIPIN6 OK Date By
PERMITS EXPIRE 180 DAYS AFTER ISSUAIICE IF N MORK STARTED. IDENT AMD 6RADIN6 PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUAMCE.
I CERTIFY THAT THE INFORMATI URN D IS UE AMD CO TO BEST Of MY KNOMLED6E AMD THE APPLICABLE CITIf OF FERERAL MAY REQUIREMENTS NILL Bf MET.
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OWNER OR AGENT ----- - -=- — --------- ---------------------- DATE -----�-�--f
FILE COPY
�
q,,,� � City of Federal Way
-�- F--r,�rzR,
�� � APPLICATION FOR BUILDING PERMIT '
PLEASE PR/NT APPL/CAT/ON #: �������L���
STTE LOCATION addrass a9�,/�f O� ��c �$p- �,p, �Q. ��a�3
Tena�t (if known) Lot# Assessor's Tax #
RD EQ �t/ Q C= Z�'G'�"(C� � �
Building/O�wner Name Address �/
��f 6 r-R G.l�Q l02-/� � i9UE So.
City — � q State (�J-�- Zip �5'/d Q '3 Phone 9�f� � �
Nature of Work r � � F'�,�� — ��
_ _ .
APPLICANT
Name (F,M,L) �
�E� �EC/5�/Qil/IG�L picJ
Address
City State Zip
Contact Person Day Phone Other Phone Fax
BUII,DING CONTRACTOR
Company Name
Address '
City State Zip
Contact Person Phone Fax
Contractor's !1 (card must be presented) Expiration Date Verified � Yes ❑ No
ARc�rECT '
Name
Address
City State Zip
Contact Person Phone Fax
IEGAL DESCRIPTION
Please ComA/ete Reverse Side
CD0492 IRev 4/931
STRUCTURE ting Use posed Use
Permit includes: „uilding ❑ Plumbing Mechanical ❑ Other
� Type of Work: ❑ Residential ❑ New ❑ Remodei ❑ Number of Units ❑ Deck
❑ Commercial ❑ Addition ❑ Garage ❑ Shed ❑ Other
Enter 1 st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement sq ft Oecks sq ft Garage sq ft Proposed Total Area sq ft
Water Availability ❑ Sewer Availability ❑ On-Site Septic System Availability ❑ Project Valuatio� $
Zoning Lot Size F�cisting Bldg Valuation 5
LENDER
Name Address
Ciry State Zip
hIECHANICAL CQNTRACTOR
Contractor Name n � �� T��/ �D AddressO � /�J �/ �� ���
�/� � �r 7
City (�,� �� State �J�- Zip �QQ�
Contact MG��� �• ��/U�
/�/ Phone Fax
�3`�-�9Q'2�7 �3�-- 9��
License # � G ����/ Expiration Date�jZ Verified ❑ Yes ❑ No
PLUMBING CONTRACTOR I � .
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes ❑ No
PLU11�fBING FIXTURE COUNT
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountai�s Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total Fixture Count
NiECHAMCAL i7NIT COUNT
Fuel Type (electric/other) �� Gas Dryer � Air Handling < = 10,000 CFM 15-30 To�s
Length of Gas Piping t� Range Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUs � S� Gas Log Unit Heater 50+ Tons
Furn >100 BTUs Fans Miscellaneous Fuel Tanks
Gas Hwt � Hood Boilers Above Ground
Conv Burner Duct Work 0-3 Tons Underground
BBQ's Wood Stoves 3-15 Tons Totaf Unit Count
DISCLAIMER: I certify under penaky of perjury that the informetion furnished by me ie true and correct to the best of my knowledpe and further thet i am authorized by the owner
of the above premisea to perform the worfc for which permit application is made.I further agree to save harmless the City of Federal Way ae ta eny claim�includinQ costs,expenses,
and attorneys'fees incurred in inveati ation end defe e of such claim), hich may be made by eny person,includi�p the undersigned,and filed againet the City of Federal Way,
but only where such cleim ari s ou f the ianc f tha ' ,inclu g its officers and employees,upon the accurecy of the informetion supplied to the City as a part of this
application.
Owne�/Agent: Date: �j� ,S /�y�