93-102072 `1TY F FEDERAL WAY IVI E C H A IV I CA L P E R IVI I T PERMIT fVO.! �Y�D93 0899
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33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED; 0�/1�/93
Federal Way, WA 98003 BY: F°LF
661-4000
SITE ADDRESS: 927 S 296°1'H PL
PARCEL NO.: 515160�0305
PROJECT DESCRIPTION: HVAC � YN�°I'AIaYa GA3 g°ZJRNACE, Fi0'd° 1FT�iTEIt HEATER, Sc PYP%NGo
OWNER CONTRACTOR LENDER
ROBERT BUTTS NORTHIJEST WATER HEATER
927 S 296TH PL 8201 DURANGO ST SH
FEDERAL 41AY 41A 98003 TACOMA, b1A HA 98499
839-3871 984-6404
NORTHWH103R2
FUEL TYPES.:GAS FANS..........: 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 10 ft NOOD..........: 0 0-3 bP......: 0 MEC PRMT ISSUANCE... S 20.00
FURN<100K..: 1 DUCT LJORK.....: 0 3�15 HP.....: 0 MEC APPLIANCE FEES.* $ 19.50
GAS HNT....: 1 NOOD 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 UNYYS FUEL TANKS------___
RANGE......: 0 <=10,000 CFM: 0 ABOVE GROUND: 0
GAS LOGS...: 0 a 10,000 CfM: 0 UNDERGROUND.: 0 � TOTAL FEES $ 39.50
%1�JSPECTgON RECORD
Water Line OK Mechanical Inspec�ion Notese
� PIPING OK � �I Da�e '��yBy �
ALL PERMITS EXPIRE 1�0 D41Y�AFTER ISSUANCE IF PIO WORK IS STARYED.
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.
fWNER OR AGENT DATE ��'� 1� � � � fJ1'
bld mech 07/01/92 �l �
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. Per -t # �Lp93 'b�9�' .
CITY OF FEDERAL WAY � p
BUILDING PERMIT APPLICATION � I
—Please Print— Y-•}.�.._�..,_..,-'
BOX 1 TENANT NAME: �.�
OWNER c " SITE LOCATION ��).�'i �' . .�,. ) Cl� j 1__
OWNER'S ADDRESS � - � �; �` ' CITY r �-=L � PHONE `�; 3`1•- ��I J
DESCRIBE JOB t�-�` ��<.l � �,� ;�;� � L� l .-1 �.t�.�C C;�� 1 • ,�
THE PROPERTY IS OWNED BY: S�/MA�IED_ � PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME I(�..�( ) l 1� Q �. ��I�],� CONTRACTOR'S REG. # �RTI+U3F� In3R�
Card MUST be presented
CONTRACTOR'S ADDRESS �c�O 1 Q-1,11�� iY1 ) �SL�C►TY �C��Q,. PHONE ���'L.PyO y
EXPIRATION DATE 1����(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 PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON � � PHONE
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST �� I C�C�� EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER �l I c�)I �: C.-` � �,!�;C �
LEGAL DESCRIPTION
(If necessary, piease 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 (N0. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
N0. WATERCLOSETS GAS PIPING, FEET f:�' $
BATHTUBS N0. 1 FURNACE, ELEC. GAS � $
SHOWERS 1 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 EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
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OWNER/AGENT: � ��"-�, �- � ��-� DATE: �_> I�.� ��
ANP-008 3/90