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CITY OF FEDERAL W,4Y IVI E C H A N I C A L P E R M I T PERIVIIT NO.: BLD92-2 3 02
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 10/19/92
�ederal Way, WA 98003 BY: FLF
661-4000
SITE ADDRESS: 917 S 294TH PL
PARCEL NO.: 515240-0120
PROJECT DESCRIPTION: HAVC
OWNER CONTRACTOR LENDER
JENNIFER DAVEY NORTHWEST WATER HEATER
917 S. 294TH PL 8201 DURANGO ST SW
FEDERAL WAY WA 98003 TACOMA, uA 41A 98499
2255 984-6404
NORTHLJH103R2
FUEL TYPES.:GAS ? FANS..........: 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 25 ft HOOD..........: 0 0-3 HP......: 0 MEC PRMT ISSUANCE... $ 20.00
fURN<100K..: 1 DUCT WORK.....: 0 3-15 HP.....: 0 MEC APPLIANCE FEES.* $ 18.50
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 UNdTS FUEL TANKS---------
RANGE......: 0 <=10,000 CFM: 0 ABOVE GROUND: 0
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0 TOTAL fEES f 38.50
INSPECTION RECORD
ter Line OK Mechanical Inspection PTo�ese
GAS PIPING OK�/-�-4�� �u;/ Date=-�� By G�i
AlL PERMITS EXPIRE 980 DAYS AFYER ISSUANCE IF WO WORK IS STARTED.
I CERTIFY THAT THE INFORMATION FURNISFiED �Y iV1E IS TVRUE AND ORRECl"�O THE BEST OF MY KNOWLEDGE AND TWE APPLICABLE CITY OF FEDERAL WAY REQUIREMEIVTS WILL BE MET.
OWNER OR AGENT DATE ��C' ) �� � —( �
bld mech 07/01/92 �L �
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Permi' �` ��� I� t�2 �- ��v ` ,
CITY OF FEDERAL WAY ,
BUILDING PERMIT APPLICATION
—Please Print—
BOX 1 TENANT NAME:
OWNER � '�-Y SITE LOCATIO �-11'l � • �;�-E`�'� 1��-.
OWNER'S AODRESS �' � �``�f`°' 'Pl- CI� ����- � PHONE �3�- ;3���5l
DESCRIBE JOB � � � � f� �--
THE PROPERTY IS OWNED BY: SINGLE/M RIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAM�-� ��-k-� �A-� :�`-�-� CONTRACTOR'S REG. #N��C}�N(U3�-
Card MUST be presented
CONTRACTOR'S ADDRESS � � �
� � �--' CITY (L�-;�vi�:. PHONE � �(-Cr?`�F(1'--{
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 G�'�-���-- PHONE `i��1� (n4 c��-T_
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST - <� � �1�-{vl EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER S�� �-`i (� - c�I �'O
LEGAL DESCRIPTION
(if necessary, please submit a separate page with the lega7 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 �
( ) COMMERCIAVINDUSTRIAt TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MEC A ICAL APPLIANCES— BASIC FEE$
N0. WATERCLOSETS GAS PIPICG, FEET - $
BATHTUBS N0. 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 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 ASTO ANY CLAIM(INCLUDIN6 COSTS,EXPENSES,AND ATTORNEYS'
FEES INCURRED IN INVESTtGATION 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.
� p Q,�- �
OWNER/AGENT: �L- �'"�--' / -�"` DATE: G C C '
� ANP-00!3/90