92-102209 CITY OF FEDERAL WAY M ECHAIV I CAL PERM IT r���aa a�f ,
PERMIT NO.: BLD92�25�15
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 12/11/92
Federal Way, WA 98003 BY: FLF {
661-4000
SITE ADDRESS: 167 S 295TH PL
PARCEL NO.: 54372100090
PROJECT DESCRIPTION: INSTAI,L GAS PIPYNG, HOZ° WATEIt HE�ITER, G�i� RAIJGE, AND I�°IREPI,�iCEB
OWNER CONTRACTOR LENDER
CRO ASSOCIATED HTG/SHT METAL INC
29813 164TH AVE SE P.O. BOX 309
KENT 1JA MONROE YA 98272
4866 206-825-5000
ASSOCI*238R7
FUEL TYPES.:GAS FANS..........: 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 100 ft HOOD..........: 0 0-3 HP......: 0 MEC PRMT ISSUANCE... f 20.00
FURN<100K..: 1 DUCT NORK.....: 0 3-15 HP.....: 0 MEC APPLIANCE fEES.* E 39.50
GAS HWT....: 1 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......: 1 <=10,000 CFM: 0 ABOVE GROUND: 0
GAS LOGS...: 2 > 10,000 CFM: 0 UNDERGRWND.: 0 TOTAL FEES f 59.50
INSPECTIOI�i RECORD
T•'-ter Line OK Mechanical Inspection Notes: /� /,v /Z�/b���r���
vAS PIPING OK /b Date By
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THAT THE INFORMATIO�I FURNISHED Y ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
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OWNER OR AGENT � DATE �,�-c —�� ��--
bld mech 07/01/92 :
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DE �92 �EC 1 �I�OF FEDERAL WAY
�� oT� �����RMIT APPLICATION _
—Please Print—
BOX 1 TENANT NAME: '
OWNER S TE LOCATIO
OWNER'S ADDRESS — CITY � PHONE • ^
DESCRIBE JOB
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME S / CONTRACTOR'S REG. # - SvC;l, Z 3� '�
' Card MUST be presented
CONTRACTOR'S ADDRESS � CITY D � C ' PHONE �a3 L`r'�C�?
EXPIRATION DATE —
— 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��'�D�ff"�
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
(If necessary, please submit sD�rate pa e with the legal description.)
K.C. Plat Recording # �� /��— �� � �
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/P opose 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEM / DECK / GARAGE /
BOX 8 ( SINGLE FAMILY ( NEW CONSTRUCTION
( ) MULTIFAMILY (N0. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAVINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES(including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$
N0. WATERCLOSETS GAS PIPING, FEET � / $
BATHTUBS NO.�_FURNACE, ELEC. GAS ✓ $
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 COMMER�AL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER C��� � � G $
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 EMPLO S, UPON TH AC URACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: � DATE: � �'
ANP-008 3/90