95-100225C
CITY OF FEDERAL WAY MECHANICAL
P
33530 First Way South
Federal Way, WA 98003 Building Inspection Requests 661-4140
661-4000
ADDRESS:33119 28TH AVE SW
NO.: 894430-0060
PROJECT DESCRIPTION: HVAC - INSTALL 1 GAS FURNACE.
ONNER I CONTRACTOR I LENDER
BETTY MOLES GEORGE BRAZIL 24 HR SERVICE
33119 - 28TH AVE SN 11063 PACIFIC HNY S
FEDERAL NAY NA 98023 TUKNILA NA 98168
661-5660 451-4800
GEORCB2081J1
9 ,5--/0oa�
PERMIT NO: BLD95-0072
ISSUED: 01/25/95
8Y: FC
EXPIRES: 07/24/95
FUEL TYPES.:GAS ?
FANS......,...:
0
BOILERS%COMPRESSQRS
FEES:
GAS PIPING.: 0 ft
HOOD..........:
0
0-3 HP......: 0
NEC PRAT ISSUANCE...
$ 20.00
FURN<100K..: 1
DUCT WORK.....:
0
3-15 HP.,..,: 4
NEC APPLIANCE FEES.
$ 10.00
GAS HMT....: 0
WOOD STOVES_..:
0
15-30 HP....: 0
CONY BURNER: 0
FURN>100K,....:
0
30-50 HP....: 0
BBQ........: 0
MI;.0.......... :
0
5+ HP.......: 0
GAS DRYER..: 0
AIR HANDLING UNITS
FUEL TANKS ---------
RANGE ...... : 0
<:i0,000 CFM:
0
ABOVE GROUND: 0
GAS LOGS...: 0
> 10,000 CFM:
0
UNDERGROUND.: 0
TOTAL FEES
$ 30.00
Does the Nater supply
system contain a
Pressure
Reduction Device or Check valve?
O Yes O No (If 'Yes' then coater expansion tank is required
on Hot Water Tank)
Inspection Record
Water Line OK
Mechanical Inspection Notes:
—.
BAS PIPING OK
Date _ By
1
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO MORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT TH 7ORMATION F SED BY IS AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE C TY Df FERERAL NAY REQUIREMENTS HILL BE MET.
OWNER OR AGENTDAiE
FILE COPY
LILY W I UUCI01 IVdy
Cn v orrl�g(
33530 First Way South
® f=ederal Way, WA 98003� (206)661-4000
APPLICATION FOR MECHANICAL PERMIT
zr'i y 4 �) - oow
PARCEL 1t• Single Family V( Multi -Family 0
SITE LOCATION: I t
Tenant/Owner:
BL E)IS 00_� a
Commercial ❑
Phona: &/,, ( —. 5-1/'00
Address/City/State/Zip: 331
Nature of work: 1-k-lf'&'_ Project Valuation
APPLICANT:
Name
Address/City/St/Zip:
Contact Person: Phone:
MECHANICAL CONTRACTOR:
4
it
Fax:
Company Name: � �� A '& _
Address/City/St/Zip: -tTL LW � S.
Contact Person: Phone: Fax:
State L & I Contractor Registration #:
(Card must be presented)
MECHANICAL UNIT COUNT:
Exp. Date:
Fuel Type (gas/other)
Gas Dryer
Air Handling <
= 10,000cfm
Fuel Tanks:
Length of gas piping
Range
Air Handling >
= 10,000cfm
Above Ground
Furn < 100K BTU's
Gas Log
Unit Heater
Underground
Furn > 100K BTU's
Fans
Boiler
BTU/H
Miscellaneous
Boiler
BTUM
Other
tGHwtHood
Burner
Duct Work
A/C
TONS
Other
DISCLAIMER: 1 certify under penalty of perjury that the Information furnished by me Is true and correct to the beet of my knowledge and (utter dut I am authorized by the owner of the above
premises to perform thewnde
which permit applIcs is made. I further agree to save harmless the City of Federal Way as to any daim fnnduding coats, experves and attorneys' fees
incurred in investigation of such dalml, wfnich may tx made by any person, Including the undersigned, and filed against Una Chy of froderay Way but only where such daim arises
out of the reliance of the Cuding Its officers and employees, upon th 4curyt! 4f- information supplied to tfa City a a part of this application.
Owner/Agent:
Date: `.iLA 24n 0ir
CITY OF FEDERAL WAY MECHANICAL PERMIT33530 First Way South
Federal Way, WA 98003 building Inspection Requests 661-4140
661-4000
ADDRESS:33119 28TH AVE SW
NO.: 1394430-0060
PROJECT DESCRI PT ION : NYAC - INSTALI. I GAS FURNACE.
PERMIT NO:
ISSUED:
BY:
EXPIRES:
BLD95--0072
01/25/95
FC
07/24/95
DOVER - _ _. -s CONTRACTOR LENDER
BETTY MOLES GEORGE BRAZIL. 24 HR SERVICE
33119 28TH AVE SM 11061 PACIFIC MY 5
FEDERAL MAY MA 98023 TUKMILA MA 98168
ate.
661-9660 �I
_. ..._ ._.�.__ _ __ _.. . . ar_^s-.�.s,:sc�.r.-r•a�s�:za�=-'w ... _. .�rr.-...�-".^.�.+s.^.e:^a-...._ea..-a.-.�;-.nc-:s^seryrrax.:�.acc-•.^�^�s c�=..,
FUEL TYPES.:GAS ? FANS.. _ .,.., 0 DIfl-ft- flNPBES FEES:
CAS PIPING.: 0 ft HOOD.....,.:..: ;j 3 V .....w4 SSUANCE... S 20.00
fup"000K..: I DUCT NO". 0 IS '.... i NCE fEES.s 10.00
GAS HMT ....: 0 4i ST"09 : 6
CONN 6ORNER: 0 '.it !4>Innl, ► d �
BOO........: 0 NL!(,— .,n.°
GAS DRYER-: 0 R 11(444W=, IT tUE1. i
RANGE....... 0 < % CTM; 0
GAS LOGS... - 0 �,fo, UNDEROWND.: 0
TOTAL FEES f 30.00
Does the water supply system contain a Pressure Reduction Device or Check valve? Yes () He (it "Yes' then water expansion tank is required on Hot Mater Lank)
luspection Record Mater line ON - ___.. _ __._. Mechanical I�4t;
01
GAS PIPING 69 ._. Date_. By
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO MORK IS STARRED. RFSIDINTIAL AND GRADING PERMIT'S EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY KHAT THE INFORMATION FURNISED 8Y �E ISlnee AND CORRECT TO THE REST OF MY KNOMLEDGE AND THE APPLICABLE/TY C Of FERERAL MAY REQUIREMENTS MILL $E MET.
# 4i'[P J JEra _,�_ .- _- w_ DATE ~
FIELD COPY