94-1018009q-/a 18106
CITY OF FEDERAL WAY MECHANICAL P PERISSUED: 09/19/9400
33530 First Way South
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 03/18/95
ADDRESS:35308 19TH AVE SW
NO.: 926975-0510
PROJECT DESCRIPTION: HVAC - INSTALL 2 GAS HOT MATER HEATERS.
OWNER I CONTRACTOR LENDER
DEANNA KOTILA;; OWNER IS CONTRACTOR
35308 - 19TH AVE SW
FEDERAL WAY WA 98023
838-8008
_$$ NONE *$$
FUEL TYPES.:GAS ?
FANS..........:
0
BOILERS/COMPRESSORS
FEES:
GAS PIPING.: 0 ft
HOOD..........:
0
0-3 HP......: 0
NEC PRNT ISSUANCE...
: 20.00
FURNO OOK..: 0
DUCT WORK.....:
0
3-15 HP.....: 0
NEC APPLIANCE FEES.$
13.00
GAS NMT....: 2
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
= 33.00
Does the water supply
system contain a
Pressure
Reduction Device or Check valve? () Yes ()
No (If 'Yes' then rater expansion tank is required
on Hot Water Tank)
Inspection Record
Water Line OK
Mechanical Inspection Notes:
GAS PIPING OK
Date By
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT -JHE .INFORMATION FURNISED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENTDATE
________ G _ C
-----`-=-_=--�==
FILE COPY
• City of Federal Way •
C':"1"Y OF 33530 First Way South
_as— Federal Way, WA 98003 (�
(206)661-4000�'�
�fTY D(0 CD
APPLICATION FOR MECHANICAL PERMIT
PARCEL A Single Family ® Multi -Family 0 Commercial o
SITE LOCATION:
Tenant/Owner: +0 ( I r"1 C� �ci / (� F r l �1C� `�c� l ct. Phone: ALL iiGO W
Address/City/State/Zip: .350 i� u-� 5 U i r0cLurn-1 WL, j LSI A Ci$'C) 2 1
Nature of work: -Li 1"'I u -t rt c' ( n 0", r'-JG'e-L S Ii -,(I ix V- 111-46t�'�r ject Valuation: $
APPLICANT:
Name: 1cc)d Cx_o cl eG .V L ✓tCt - c,4 1 C^
Address/City/St/Zip:
Contact Person: I 'Ir -1 kcA-L Phone: X 2U S11 -7X j Fax:
MECHANICAL CONTRACTOR:
Company Name: L0f(L ✓ A0 r'1 0.0 �S r
Address/City/St/Zip:
Contact Person:
State L & I Contractor Registration #:
(Card must be presented)
MECHANICAL UNIT COUNT:
Phone:
Fax:
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
Gas Hwt 12-
Hood
Boiler
BTU/H
Other
Conv Burner
Duct Work
A/C
TONS
Other
BBQ's
Wood Stoves
TONS
...T.QgWi
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 of the City, including its officers and employees, upon the accuracy of the information supplied to the City ss a part of this application.
Owner/Agent: Date:
CITY OF FEDERAL_ WAY MECHANICAL P PERIISSUED: 09/19/9400
33530 First Way South
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 03/18/95
ADDRESS:35308 19TH AVE SW
NO.: 926975-0510
PROJECT DESCR I PT ION : HVAC INSTALL 2 GAS HOT MATER HEATERS.
OWNER-
DEANNA KOTILA
35308 - 19TH AVE SW
FEDERAL MAY MA 98023
838-8008
CONTRACTOR _
its OWNER IS CONTRACTOR
L'
:ss NONE ss•
LENDER
FUEL TYPES.:GAS ?
FANS.—
K Itips VAIPRFSiORS
FFF"
GAS PIPING.:
0 ft
40' ,,
�i �3 iIP..., `"
NFC PvVT.'ISSUANCE... { 20.00
EURN<100K..:
0
MC CC`s',..,..
15 ". ,...° 0
MEC A P1,IANCF FEFS.2 1 133.00
GAS HMT....:
2
CONV BURNER:
O
FtRfi'
0
BBQ.........
0
1iIC.,.,,. 0
5 0
GAS DRYER...
0
'AlR 10 UMTS
rOEL r"WS---
RANGE...... .
0
<=101,#00"CFM. `"W
A80*41OUND: 0
GAS LOGS...:
0
> 10,�1b1: O ,.`
' UNDERGROUND.: 0
TOTAL FEES 33.00
Does the .rater supply systen contain a Pressure Reduction Device or Check valve? () Yes () No (it 'Yes" then Water expansion tank is required on Not Mater Tank)
Inspection Record Water line OK
GAS PIPING
ianical Inspectio,
11 es: -
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RFSIDENTIAL AND GRAPING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
i CERTI! THAT THE INFOgMATION FURNISED BY ME IS TRUE AND CORREC. n THE BFST OF MY "UN17— 9D THE APPLICABLE CITY OF FERERAL WAY REQUIREMFI47 W'" ar V
OWN -'.R OR AGENT_ - )/
FIELD COPY