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33530oFi rsD�4Jay South ��.���1�6���� � �If�l-1� � PERMIT N0: ISSUED.p05/�.9�
Federal Way, WA 98003 Buildi.ng Inspection Requests 661-4140 BY: FC
651-4000 EXPIRES: 11/15/95
ADDRESS:29613 20TH AVE S
NO. : 367440-0236
PROJECT DESCRIPTION:HVAC - ADDIN6 GAS FURNACE TO 100,000 BTU
�= OMNER ======s==��a�_�=���==�=�aaa=a�a�mea���=a = CONTRACTOR ==-----�=====a=�a=Q�====________=====F� . LENDER =__��_=�_=_��_�=a=�m�a��====��a��=�s�
- FEAZEI NORTHiiEST iIATER HEATER
. 29613 20TH AVE S 8201 DURAN60 ST SN
FEDERAL WAY WA 98003 TACOMA NA 98499
941-8431 984-6404
HORTNMH103R2
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FUEL TYPES.:6AS ? FANS..........: 0 BOILERS/COMPRESSORS fEES:
6AS PIPIN6.: 0 ft HOOD..........: 0 0-3 HP......: 0 MEC PRMT ISSUANCE... 3 20.00
FURN<100K..: 1 DUCT NORK.....: 0 3-15 NP.....: 0 �� � , �, MEC APPLIAHCE FEES.# � 10.00
6AS HNT....: 0 MOOD STOVES...: 0 15-30 HP....: 0
COHV BURNER: 0 FURtI>100K.....: 0 30-50 HP....: 0 �.,
BBQ......... 0 MISC........... 0 5+ HP........ 0 '�
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6AS DRYER..: 0 AIR HANDLIN6 UNITS FUEL TANKS---------
RAN6E......: 0 <=10,000 CFM: 0 ABOVE GROUND: 0
6AS L06S...: 0 > 10,000 CfM: 0 UNDER6ROUND.: 0
TOTAL fEES = 30.00
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Does the uater supply syste� contain a Pressure Reduction Device or Check valve? (} Yes () No (If "Yes" then water expansion tank is required on Hot Water Tank)
Inspection Record Water Line OK __�___�_ Mechanical Inspection Notes: ________________�_______________________
6AS PIPIN6 OK ---------- Date ------ By ------ ------------------------------------------------
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PERMITS EXAIaE 180 DAYS AFTER ISSUANCE IF NO MOR[ IS STIYtTED. RESIDENTIAL ANB �tADIN6 PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSIIANCE.
I CERTIFY TNE INfORMATIO FURN�SHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KN�ilED6E MID TNE APPLIfABL CITY OF FEDERAL UAY REQUIREMEMTS MILL � MET.
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ONNER Q(�AGENT --�-- ; ---�-��5..�------------------------ DATE _� �i.
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� FILE COPY
�ECEIV��
City of Federal Way
CITY OF C_ 33530 First Way South ~
__�_- � Federal Way, wa ssoo3 �AY 1 g 199�
(206)661-4000 �
\�1y' V � Gi�tY OF FEDERAiL 41�A11
E3UILDING I�EPT.
APPL/CA T/ON FOR MECHAN/CAL PERM/T
,
�LDqS- �3� 8'
PARCEL�•_ ���T��-��� � �r�� 0� �� Single Family Multi-Famil ❑
�. Y Commercial ❑
SITE LOCATION:
Tenant/Owner: - �� << ��� � � Phone: � �� � � J
Address/City/State2ip: � � �� � �t�{1 � � �' �� �i��
Nature of work:`�Y�— �� �1�1Y 1't�il,( �
Project Valuation: $ �� ��-� �
APPLICANT:
Name: f` l '. ` _. . ' I
1-
� � ���� � � �G
Address/City/St/Zip:r�iN�7,� � C- ��L' I�'�/'� f C��� �_ `�� (�`,�� �
Contact Person: � ����'�1/�.� �-� ��i1 � Phone:���Z��� ��� �
Fax:
MECHANICAL CONTRACTOR:
Company Name: �� �/�� \���l.t--4-� �' -I_��C��� �
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. ,�
Address/City/St/Zipr- � > � ��1����� C, C�- _ ��(, _�Q �� ����
Contact Person: Phone:��-� �'� /�� � Fax:
State L & I Contractor Registration #: �f� �1.1�.N �1��(/�"_( �I/-;%�������,
(Card must be presented) Exp. Date:�G�.��`'.�—�..,"—.J
MECHANICAL UNIT COUNT:
Fuel Type (gas/other) ; Gas Dryer Air Handling < = 10,OOOcfm Fuel Tanks:
Length of gas piping Range Air Handling > = 10,OOOcfm Above Ground
Furn <100K BTU's Gas Log Unit Heater
Underground
Furn >100K BTU's Fans Boiler BTU/H Miscellaneous
Gas Hwt Hood Boiler BTU/H Other
Conv Burner Duct Work A/C TONS Other
.,. }
DISCLAIMER: I certify under penalty of perjury that the information furnished by me is true and torrect to the beat of my knowledQe and further th�t I am authorized by the owner of the above
premises to perform the work for wMch permit application is made. I further epree to save harmless the Cit of Federal Wa as to sn claim(includi costs,ex ?
incurred in investipation and deferme of such elaiml"which ma be made b an Y Y y ^a P��e and attorneye'fees
Y Y y Perso�,ineludirq the urdereiQned�ar�d}���painst the City of Federay Way but only where euch eleim arises
out of the reliance of the_City,ineludinp ih officros nd employees,upon tfx accurocy of the informetion supplied to the Ciry as a pert o�thia epplicetion.
,� � � � � �.--
Owne Agent; �� � �� ��1 �`_-
: Date:
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