93-102219 93-���� 9
CITY OF FEDERAL WAY ME� ICAL PEI�:MIT PERISSUED- 09/02/9356
33530 First Way South
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
6fi1-4000 EXPIRES: 03/O1/94
ADDRESS:34251 18TH PL S
NO. : 412960-0050
PROJECT DESCRIPTION:HVAC - INSTALL 6AS FURNACE,RAM6E,(2) DR�ERS, i PIPIM6.
OMNER COMTRACTOR LENDER
RANDY ROBERTS MORTiAIEST MATER HEATER
34251 - 18TH PL S 8201 DURAN60 ST SM
FI . MAY MA 98003 TACOMA, NA MA 98494
�
87�-4147 984-6404
NQRTHMN1A3R2
FUEL TYPES.:6AS FAMS..........: 0 BOILERS/COMPRESSORS FEES:
6AS PIPIN6.: 99 ft IIOOD..........: 0 0-3 HP......: 0 _ __ MEC PRMT ISSUANCE... = 20.00
FURN<100K..: 1 DUCT IIORK.....: 0 3-15 NP.....: 0 �� � , � ,, MEC APPLIANCE FEES.� � 32.50
6AS NMT....: 0 NOOD STOYES...: 0 I5-30 HP....: 0 ; �`
� . b
CONV BURNER: 0 FURN>100K.....: 0 30-54 RP....: 0 �` �t ' '
� . ��� � ,�, �
BBQ........: 0 MISC---.......: 0 5+ HP.......: 0 ° �
6AS DRYER..: 2 AIR NANDLIN6 UNITS FUEL TAMKS--------- �
RAM6E......: 1 <=10,000 CFM: 0 A$OVE 6RONMD: 0 -
6AS L06S...: O > 10,000 CFM: 0 UIIDER6R�IMD.: 0
TOTAI FEES = 52.50
Inspection Record Mater line Olt Il�hanical Inspection Notes:
6AS PIPIM6 OK Date By
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO MORK IS STARTED. RESIDEMTIAL AMD 6RADIN6 PERMITS EXPIRE OME YEAR AFTER DATE OF ISSUAMCE.
[ CERTIF7 THAT THE INFORMATIDN FURNISED BY ME IS TRUE AMD CORRECT TO TNE BEST Of MY KNOMLED6E AMD TNE APPLICABLE CITY OF FERERAL MAIf REQUIREMENTS MILL BE MET.
DWNER OR AGENT �� __ DATE _�T�"���,�
i
FIIE COPY
�
Per--=t # � � q�`�D�l � �
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CITY OF FEDERAL WAY � ��
B ILDI : D
U NG PERMIT APPLICATION
—Please Print— `
BOX 1 TENANT NAME:
OWNER � ���a�� ��' � � '1 SITE LOCATION �=�,�`� � I� (�''�— J ,
OWNER'S ADDRESS '��-{�`` 1 i� k i- �� CITY '-�_r-cl �L��_�� PHONE �`'�'-i -�-tl�)'%
; . . _ -
DESCRIBE JOB ;�` �:� ��l�t � i ,�, � .t � ; L11S��i. � f � i � �- ;,;�-_ , ���� _ �_;?�t�i �C
THE PROPERTY IS OWNED BY: S GLE/MARRIED _..,X� PAR NERSHIP CORPORATI N
BOX 2 CONTRACTOR'S NAME �I[,1> l 1�Q�O �{�I� CONTRACTOR'S REG. # �RT F�I,�F� I[Z3I��
Card MUST be presented
CONTRACTOR'S ADDRESS ��� C�('� �Su'CITY fC��Q PHONE GF�{�L.�L-IO 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 � CU
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST ���C C , EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER L�����L��- ` ��L_�` )C_.
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) ME�HANIC�IL APPLIANCES— BASIC FEE$
N0. WATERCLOSETS 6AS PIPING, FEET `"� `7 $
BATHTUBS NO.�_FURNACE, ELEC. GAS X $
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, ` L ,!1 i — � $
DRAINS . ����I"; - I ; CU►'�Ct� $
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 OFTHE 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.
OWNER/AGENT: � � �:_.�. l- �_� � DATE: _ � l
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SETBACKS & FOOTINGS'
Date By
FOUNDATION WALLS
Date By
PtUMBING'GROUNDWORK
Date By
UNDERFI.QOR FRAMiNG '
Date By
SHEAR WALLS
Date By
PLUMBING ROUGH-IN
Date By
GAS'PIPING>
Date By
MECHANICAL ROUGH-IN
Date By
MECHANICAL (OTHER)
Date By
FRAMING '
Date By
INSU LATION
Date By
GWB - 1 ST LAYER
Date By
GWB - ZND IAYER'
Date By
SUSPENDED'CEILING
Date By
PLANNING FINAL
Date By
ENGINEERING FINAL
Date By
FIRE FINAL
Date By
BUILDING FINAI
Date By
OTHER
Date By
OTHER
Date By
CD0193