94-100510 . R
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33530�First��Way South 1VIECHAN�CAL PEF:MIT �'�RISSUED= 03J96/940V
Federal Way, WA 98003 8uiiding Inspection Requests 661-4140 8Y: FC
661-4000 EXPIRES. 09/12/94
ADQRESS:2240 S 285TH PL
NO. : 422220-0234
PROJECT DESCRIPTION:NVAC - INSTALL 6AS HOT OIATER NEATER 6 FURNACE.
� O�ONER CONTRACTOR LENDER
UN6AR MUN6RA ENVIRONMENTAL DESI6N, IMC.
240 5 285TH PL 25328 SE 200TH 5T.
EDERAL IOAY NA 98003 MAPLE VALLEY MA 98038
432-4241 �
ENYIRDI�98K1
FUEL TYPES.:6AS fANS..........: 4 SOILEpSjCQP9PRESSORS FEES:
6AS PIPIN6.: 0 ft HOOD.........,; 0 Q-3 NP......: 0 MEC PRPSI ISSUANCE... t 20.OQ
FURN<100K..: 1 DUCT ECORK....,: 0 3-15�� HP....�: 0 �`�� � ����`� � �� �' � � � ;,�� � �EC Ai�PiTAMCE FEES.Y t 16.50
6AS HbdT,...: 1 EQOOD��SFOYES..�.: 0 i5-3Q HP....: 0 ` � �� '�°,}''��"� �, � - � ��� -
CONV BURNER: 0 FURN>100K....�.: f� � �30-5�} HP....��� 0 � � '� � �� �
86a........: 0 MISC..........: 0 5� NP... ..: 4
.,
6AS DR1fER..: 0 AIR HAkDLIN6 UMITS FUEL TAi4KS ------ �
RAN6E......: 0 <=10,QOQ CFM: 0 ABDVE 6ROUND: 0
6AS 106S...: 4 > 10,000 CFM: 0 Ut�DER6R0UND.: 0
TOTAL FEES = 36.50
Does the pater supply syste� contain a Pressure Reduction Device or Check valve? {) res () !90 (If 'Yes' then rater expansion tank is required on Hot I�ater Tank)
Inspection Record I�ater Line OK Mechanical Inspection Notes:
6AS PIPIN6 OK Date 8y
P�RM:TS EXPIRE lE0 �AYS fTER ISSUANCE TF NO OIORX IS STARTED. RESIDENTIAL AND 6RADIN6 PERMITS EXPIRE D8E YEAR AFTER DATE OF ISSUANCE.
I CERTIfY THAT HE INFORM TIOM FURM D Blf M IS TRUE AND CORRECT TO THE BEST OF MY KNONLED6E AND THE APPLICABLE CITY OF FERERAL NAY REQUIREMENTS fi�ILL 8E ME?.
OWNER OR AGENT _ _ � _________ DATE _�__� G
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CITY OF FEDERAL WAY .
BUILDING PERMIT APPLICATION
—Please Print—
BOX 1 TENANT NAME:
OWNER `� SITE LOCATION 1� 11�''��(") 2�-j�•C.
OWNER'S ADDRES 2 2 L/�:r `��`, "��/-a�_CITY�,� � PHONE ���
DESCRIBE JOB f�l`�,r [1 �F'�!?�Ur9��' , �� � i /¢l�-!< ,
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME — � � CONTRACTOR'S REG. #E�IUi��/L�9BKl
.y� Card MUST be presented
CONTRACTOR'S ADDRE � � •2 � ��'" CITY�/l PHONE `j��� ��y7
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 �LCCL/� PHONE /�L��� 5l��7
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER � Z- ��-C-, �- � J
LEGAL DESCRIPTION
(If necessary, please 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) MECHANI�APPLIANCES— BASIC FEE$
N0. WATERCLOSETS GAS PIPING, FEET " c� $
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 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 AGAIN E CITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY,INCLUDING ITS
OFFICERS AND E PLO EES, UPON THE URAC THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: DATE:
�� � � — � �
ANP-008 3/90