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CITY OF FEDERAL WAY MECHANIC/64AL PERMIT NO:
12/14/9431
33530 First Way South
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: KLC
661-4000 EXPIRES: 06/12/95
ADDRESS:4222 SW 323RD ST
NO. : 873202-0770
PROJECT DESCRI PT ION:HVAC - INSTALL 2 GAS TOGS & 65' PIPING.
BRUCE IRk°T NORTHWEST WATER HEATER
4722 SN ;;73RD ST R201 DURANGO Si SW
FEDERAL WAY WA 98023 TACOMA WA 98499
984-6404
ItIRINWHi03A7
FUEL TYPES.:GAS ? FANS - 0 BoTaricriipPT°tSfIP' FEES:
GAS PIPING.: 65 ft HOOD. .-_..... 0 0-3' HP.-..... 0 "t"':'''''�; I55UAMCE.,. $ 20.00
FURNt100K..: 0 DUCT WO!... 0 i-15 HP ' a -_ a
DANCE FEES. t 9.50
GAS HNT.. .: 0 HOOD .101 a,... 0 15-30 HP.. .0 e,, ,�w aoa
CONY BURNER: 0 iiURM>iiN?K.....: .0-50 IIP,,
880 • 0 MISC......: • 5t HP.. - 0
GAS DRYER..: 0 AIR IA UNITS FUEL TANIIS---------
RANGE • 0 <:10,000w CF1 t ABOVti GROUND: 0
GAS LOGS...: 1 > 10,E 01PN: UNDERGROUND.: 0
TOTAL FEES $ 29.50
_ _._ ..
Does the water supply syster contain a Pressure Reduction Device or Check valve? () Yes () No (If 'Yes' then eater expansion tank is re0oired on Hot Water Tank)
Inspection Record Water Line OK _ _..._____ Mechanical Inspection Notes: ____ __—,,,___ __.___ ___._ I
1
GAS PIPING OK _ _ Date ._--.. _. Ay _._. 1
PERMITS EXPIRE 1S0 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE Of ISSUANCE.
I CERTIFY THAT THE-4i1FORMATION FURNISED BY NE IS TRUE AND CORRECT TO THE BEST OF MY KNONIEDGF AND THE APPLICABLE CITY OF FERERAI. NAY REQUIREMENTS WILL RE MET.
f
OWNER OfAGENT _ j/. ..L4 -_.:. L... t !( ._..__ DATE i �. , ____
t j(\
FIELD COPY
1111 City of Federal Way '
CITY OF #0^ ' 33530 First Way South •
0 il
Federal Way, WA 98003 �� ���
(206)661-4000
V>Fr ,
APPLICATION FOR MECHANICAL PERMIT
PARCEL it• S Z `J 2_0-7-7D I Single Family*. Multi-Family LI Commercial
SITE LOCATION:
Tenant/Owner: ia-- -i-if'it &4 Phone:
Address/City/State/Zip: for _ r , - A ifs,
4,
Nature of work: 4 s j Jf ?yJbt I hid -k---,- ied Project Valuation: $ j/40 ?)
0-
APPLICANT: -T `
Name:
.,)( (' �IC 5-Mau 4
Address/City/St/Zip: � OZ ( ' AQl,lcA'I 3C.fi t / 1s ���
Contact Person: &tC�� ��rG2cPhone: � )�/ Fax: u' -%� ��
MECHANICAL CONTR/A�CTOR: , f�
Company Name: N"v� I A - �it /'t"�f V
Address/City/St/Zip: ' �i V7) f J IQ// f/U sit,„.4ff Q `/ 7
Contact Person: - Phone ? r`'I `G)( Fax:
State L & I Contractor Registration #:)(0 , �A--`�1` e-� Exp. Date:r�
(Card must be presented)
MECHANICAL UNIT COUNT:
z
Fuel Type (gas/other) (,2 Gas Dryer Air Handling < = 10,000cfm Fuel Tanks:
Length of gas piping (1 Range Air Handling > = 10,000cfm Above Ground
Furn <100K BTU's Gas Log OS/v-1 ( Unit Heater Underground
Furn >100K BTU's Fans Boiler BTU/H Miscellaneous
Gas Hwt Hood Boiler BTU/H Other
Cony Burner Duct Work A/C TONS Other
BBQ's Wood od Stoves
A/C TONS :'>::�> ::::::::::::::>:: «:. <> >
>`I'+itf U nt t:6klflC
DISCLAIMER: 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 Federay Way but only where such claim arises
out of the reliance oft :City,includi its 'fivers and em oyees,upon the accuracy of the information supplied to the City as a part of this application.
Owne A ant' P` Date: C
9 /104 ,�