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95-101253OFCITY FEDERALPER56 Way South MECHANICAL. ICA L. .. I `�"ISSUED: 06/12/95 33530Firs Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC 661-4000 EXPIRES: 12/09/95 ADDRESS:33104 30TH AVE SW NO.: 954280-1930 PROJECT DESCRIPTION: HVAC - INSTALL GAS FURNACE AND GAS PIPE. OWNERaxxaxaaaaasaaaaaa==a====aaaxaxx==aa =_______==xxxtx CONTRACTOR LENDER=aaxaaaaaaaa======a=====_____ aaaa__aaxaaaaxaaa DAMON KEENER NATIONAL CONSTRUCTION SERVICES 33104 30TH AVE SN 25432 74TH AVE S FEDERAL WAY WA 98023 KENT WA 98031 874-2957 850-1616 MATIOCS0606M asxaxxaaxaxxsxssxxxxssxxaasxssasasaasaxsxassssssxsxssaasas_aaaaxssaaaxassxsassascasaaazxssssaaaa� saassxsaasaaaaaxxx_xxxxcxaxxxzaaassxxaaaaasxxaxassaxsssxxassasasssssasassas *** CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL MY. TAX RATE = 8.25 Fa_.asaaaaasasaaaasssascccccaazxasxxccxcxcxasxsxxxxxxxxsxxxxsxxasxaaasxxxxxsssaaaassxr _sssxxsxaaasssaxsaasasxsxaaasxz aaaaaaaaszxazasxssxaaxxsxa:xsxxaaxxs:saaxsaaaaaxsassaaa FUEL TYPES.:GAS ? FANS..........: 0 BOILERS/COMPRESSORS FEES: GAS PIPING.: 15 ft HOOD..........: 0 0-3 HP......: 0 NEC PRMT ISSUANCE... $ 20.00 FURN<IOOK..: 1 DUCT WORK.....: 0 3-15 HP.....: 0 NEC APPLIANCE FEES.* $ 19.50 GAS HWT....: 1 WOOD STOVES...: 0 15-30 HP....: 0 CONV BURNER: 0 FURN>100K.....: 0 30-50 HP....: 0 BBQ......... 0 MISC........... 0 5+ HP........ 0 GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS --------- RANGE ...... : 0 <:10,000 CFM: 0 ABOVE GROUND: 0 GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0 TOTAL FEES $ 39.50 sxxxsssaaaaasssscasassccsasasssxxxxxxxxxccxxxxsxcxxxxxxsxxssxaaaassxsxaaassxxaxcscxxxxxxxxcxxsxxxxxxxxsxssaaxxaxxxa_xaaaaasaacxxxaxxsxxaasaaaasasssssaxxcxxczcaaxcxxcsxxsxcx Does the water supply system 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: ---------------------------- ----------- GAS PIPING OK ---------- Date ------ By ------ ------------------------------------------------ sxsxxxsssxssxssxaaasxxxxxxxxaxsxsssssssxxxxasssssascssccacxcxaxxxcsxcxsxacxxxcxcccscsxsxxsxsssaxxxxxsccsscsxsxxxxxxxxxcxxsxxxxsxsxxssssxsssc=xcccxxxcxsxxxaxxxxxxxxxaxsaasxscc PERMITS EXPIRE 180 DAY AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE. I CERTIFY THE INFORMION FURNISHED BY ME A,TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL HAY REQUIREMENTS WILL BE NET. OWNER OR AGENT ----------- DATEOF % FILE COPY ti ; R'' °r G City of Federal Way 0 ` ��L APPLICATION FOR BUILDING PERMIT PLEASE PRINT APPLICAI'.'T Name (F LI A rests . Ci Conta Person DqV Phone_ BUILDING CONTRACTOR Company Name T 1V yt. Address City _ Contact Person ---�" ContracAtto��r's # (card must be presented) ARCHITECT Name Address City Contact Person LEGAL DESCRIPTION Assessor's Tax # State Zip ` 4i O er P one Fax pQy 1 L State Zip — C, Phone Fax S-0 3 Expiration Date Verified El Yes _no Please Complete Reverse Side State Zip Phone Fax CD0492 (Rev 4/93) IILENDER IName City MECHANICAL CONTRACTOR Contractor Name City Contact License # Address State Address State Phone Expiration Date Zip Zip Fax Verified ❑ Yes ❑ No Si PLUMBING FIXTURE COUNT Gas Dryer Air Handling < = 10,000 CFM Water Closets Sinks Range Bathtubs STRUCTURE Furn <100K BTUs Existing Use Electric Water Heaters Proposed Use Lavatories Washing Machine Miscellaneous Permit includes: Gas Hwt / ❑ Building ❑ Plumbing ❑ Mechanical ❑ Other 0-3 Tons Type of Work: ❑ Residential ❑ Commercial ❑ New ❑ Addition ❑ Remodel ❑ Garage ❑ Number of Units ❑ Shed ❑ ❑ Deck Other Enter 1st Floor Area Basement sq ft sq ft 2nd Floor Decks sq ft 3rd Floor sq ft sq ft Garage sq ft Existing Floor Area Proposed Total Area sq ft sq ft Water Availability ❑ Sewer Availability ❑ On -Site Septic System Availability ❑ Project Valuation $ Zoning I Lot Size Existing Bldg Valuation I $ IILENDER IName City MECHANICAL CONTRACTOR Contractor Name City Contact License # Address State Address State Phone Expiration Date Zip Zip Fax Verified ❑ Yes ❑ No Si PLUMBING FIXTURE COUNT Gas Dryer Air Handling < = 10,000 CFM Water Closets Sinks Range Bathtubs Dish Washers Furn <100K BTUs Showers Electric Water Heaters 50+ Tons Lavatories Washing Machine MECHANICAL UNIT COUNT Urinals Drinking Fountains Sumps Drains Lawn Sprinklers Other Total Fixtur Fuel Type (electric/other) Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons Length of Gas Piping j Range Air Handling > = 10,000 CFM 30-50 Tons Furn <100K BTUs Gas Log Unit Heater 50+ Tons Furn > 100 BTUs 7 Fans Miscellaneous Fuel Tanks Gas Hwt / Hood Boilers Above Ground Conv Burner Duct Work 0-3 Tons Underground BBQ's Wood Stoves 3-15 Tons Total Unit Count 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 Federal Way, but only where such clai 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. y� % Owner/Agent: Date: 0 0 f CITY OF FEDERAL WAY PERMIT NO: BLD95-0456 3'530 First Way South MECHANICAL PERMIT ISSUED: 06/12/95 Fleral Way, WA 9800-4 Building Inspection R<�questS 661-4111+0 BY: FC 6)1-4000 EXPIRES: 12/09/95 ADDRESS:33104 30TVI AVE SW NO.: 954280-1930 PROJECT DESCRIPTION: NVAC - INSTALL GAS FURNACE AND GAS PIPE. OWNERW.m=mft ...... DAMON KEENER 33104 30TH AVE SW FEDERAL WAY WA 98023 4-2957 *n CONTRACTORS, Paw USE FUEL TYPES.:GAS ? FANS..........: 0 GAS PIPING.: 15 ft HOOD— ........ : 0 FURN<1OOK..: I DUCT WORK--: 0 GAS NWT....: I WOOD STOVES...: A CONY BURNER: 0 FURN�100r.....: 0 BBO ........ : 0 MIS(.. .......: 0 GAS DRYER..: 0 AIS HANDLING UNITS RANGE......: 0 ":10,000 CFM. 0 GAS LOGS...: 0 > 10,000 (Fm: C CONTRACTOR . ..... . ...... an .... .... O'n ...... I' LENDER ....... NATIONAL CONSTRU(TION SERVICES 25432 74TH AVE S KENT WA 98031 850-1616 #ATIOCS064M CONE 1732 VIEN REPORTING SALES TAX FOR PROJECTS WITNIN THE CITY OF FEDERAL MAY. TAX RATE : 8.25 US , ... ... m- ............... ........ 0-3 HP ...... : 0 3-15 HP...... 0 1510 0....: 0 30-50 HP. ..: 0 5+ Hp. ...... : 0 FUEL TANKS --------- ABOVE GROUND: 0 UNDERGROUND.: 0 FEES: NtL PRNT ISSUANCE... S 20.00 ML( APPIAN,-( FEES.* $ 19.50 TOTAL FEES S 39.50 pm.=--�m .... ............ mmr ...a ..... = ............ = .... .... ........ . . =..w ..... :y=-. Does the water supply systes contain a Pressure Reduction Device or Check valve? () Yes () No (If 'Yes" then water expansion tank is required on Not Water Tank) Inspection Record Water Line OK GAS PIPING OK Mechanical Inspection Notes: Date ...... By ...... ... a ........... F mcc=saaaccamamccamaaacaaazoamuamm6aaCmaammsrcnmaa.�aaaS:CaIItamSamaaan PERMITS EXPIRE 180 DAY' AFTER ISSUANCE If NO WORK IS STARTED. RESIDENTIAL AND GRADING KITS EXPIRE ONE YEAR AFTER 0411 Of ISSUANCE. CERTIFY IRE INfOR ION FURNISKI NY NE�! TRUE AND CORkECT TO TIN: BEST OF Mt rNOOLEDGE AND INE APPLI(A�L[ CITY OF FEDERAL NAY REQUIRENENTS MILL BE KI OWNER 00 AGENT71.1-�/ DATE FIELD COPY