95-101546CITY OF FEDERAL WAY��, PERMIT NO: BLD95-0524
33530 First Way South MECHANICAL !L�.RM IT ISSUED: 07/11/95
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC2
661-4000 EXPIRES: 01/07/96
ADDRESS:31210 41ST PL SW
NO.: 873199-0090
PROJECT DESCRIPTION:MECH - GAS INSERT (2)
OWNER
JOSEE JACKMAN
31210 41ST PL SN
FEDERAL WAY WA 98023
661-0256
CONTRACTOR
G 8 G GAS APPLIANCE INST
27027 316TH AVE SE
RAVENSDALE WA 98051
886-7112
GGGASAI093BZ
LENDER
-- ------------- ----------------------------------------------
#= CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE = 8.25 Ott
FUEL TYPES.:GAS ? FANS..........: 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 0 ft HOOD..........: 0 0-3 HP......: 0 MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 0 DUCT WORK.....: 0 3-15 HP.....: 0 ;;� MEC APPLIANCE FEES.* $ 13.00
GAS HWT....: 0 WOOD STOVES...: 0 15-30 HP....: 0 <.
:..
CONV BURNER: 0 FURN>1OOK.....: 0 30-50 HP....: 0
BBQ......... 0 MISC........... 0 5+ HP........ 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ---------
RANGE ......
--------RANGE......: 0 <:10,000 CFM: 0 ABOVE GROUND: 0
GAS LOGS...: 2 > 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 water expansion tank is required on Hot Water Tank)--- -
Inspection Record Water Line OK --------- Mechanical Inspection Notes: ......................................
GAS PIPING OK ---------- Date ------ By ------ ---------------------------------
L------ _ - __ _..--- -------------- -..- � __----___-_- ____ -__-= z_.aatsaaaaaaxtstsaaaxaaaaxxxxxxxaaaaaxaaaxaxaaaaaaaaaaaaaaasaaaaaa _aaxaaaaaaats
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THE INFORNATIWFURNISHED BYX IS WAND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL HAY REQUIREMENTS WILL BE NET.
OWNER OR AGENT
FILE COPY
DATE --� - i5 -----
• *RECEIVED
City of Federal Way
CITY OF 33530 First Way South JUL 1 1 1995
• Federal Way, WA 98003
(206)661-4000 CITY OF FEDERAL WAY
BUILDING DEPT.
v
APPLICATION FOR MECHANICAL PERMIT �jLp q 5 C) 52q,
PARCEL / 3 01 _— O C)2 0 Single Family 6,"'_ Multi -Family 0 Commercial El
SITE LOCATION: _
Tenant/Owner:
Address/City/State/Zip: i L to 1 G S
Nature of work: Ttn
/la 7�k" e L fe✓g 9':2'5 -�- �'7S-'iAProject Valuation: $ -
APPLICANT:
Name: -
Address/City/St/Zip:
L S 1_Z
J-0 Contact Person:
S {� `�C%���' u Phone: "" / ` C� �C Fax:
MECHANICAL CONTRACTOR:
Company Name:� J
Address/City/St/Zip: -22/0.
Contact Person: k <ly� l ' ''y� Phone: Fax:
State L & I Contractor Registration #:
(s A To � � /S � - Exp. Date: �
(Card must be presented)
MECHANICAL UNIT COUNT:
Fuel Type (gas/other)
Length of gas piping
Furn <100K BTU's
Gas Dryer
Range
Gas Log
Air Handling < = 10,000cfm
Air Handling > = 10,000cfm
Unit Heater
Fuel Tanks:
Above Ground
Underground
Furn > 100K BTU's
Gas Hwt
Fans
I Hood
Boiler BTU/H
Boiler BTU/H
Miscellaneous
Other 45
Conv Burner
Duct Work
A/C TONS
Other v
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 defenseclaimI 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 Cit chiding its o iters and employees, u op-ttt£'aeeuraK-f tyinformation suppli>� the City as a part of this application.
Date:
Owner/Ag
CITY OF FEDERAL WAYPERMIT NO: BLD95•••0524
33530 First Way sout=h MECHANICAL. PERMIT' ISSUED: 07/1.1/9.5
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC2
661-4000 EXPIRES: 01./07/96
ADDRESS:31210 41ST PL SW
NO.: 873199-0090
PROJECT DESCRIPTION : MECH - GAS INSERT (2)
OWNERnmamwaaaaataac
JOSEE JACKMAN
31210 41ST PL SW
FEDERAL WAY WA 98023
661-0256
FUEL TYPES.:GAS
GAS PIPING.: 0
FURN<IOOK..: 0
GAS HWT.... : 0
CONV BURNER: 0
BBQ......... 0
GAS DRYER..: 0
RANGE......: 0
GAS LOGS...: 2
CONTRACTORmwm—...m.. a
G & G GAS APPLIANCE INST
27027 316TH AVE SE
RAVENSDALE WA 98051
886-7112
LENDER
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tts CONTRACTORS, PLEASE USE LOCATION (ON 1732 WIfff PF'PORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY
mGtOffi xaS^awmamr."'aT.. �: a^�:T.[�Saaffiffi^.: t. ..���:`:.am�ttz„ltStID1E�.:onie �amµaibaaaRaaam A'ax."Ft Rasaaat^: maG:.:amax«-amacbCa:u4C camY 3CazA.1TSCLatG 6-
? FANS........... 0 BOR ERS/COMPRESSORS FEES:
ft HOOD..........: 0 0-? NP......: 0 NEC PRMT ISSUANCE... # 20.00
DUCT WORK.....: 6 3-15 HP.....: 0 ME( APPLIANCE FEES.* # 13.00
WOOD STOVES ... ° 0 15-30 HP,,,,: 0
FUR0100K.....: 0 LO 50 HP. ..: 0
MIS(........... 0 5+ HP..,..... 0
AIR HANDLING UNITS Ft9E'. TARKS---------
<:10,000 CFN- 0 ABOVE GROG+ND: 0
> 10,000 CFM 0 UNDERGROUND.: 0
TAX RATE = 8.25 IM
TOTAL FEES
# 33.00
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Does tho water supply system contain a Pressure Reduction Device or Check valve? () Yes () No (If "Yes” then water expansion tank is required on Not Nater Tank)
Inspection Record Water Line OK ........... Mechanical Inspection Notes:
GAS PIPING k-� _____.
__.---------------- —--------- ____---------
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PERMITS EXPIRE 180 DAYS AFTFR ISSUANCE IF NO MORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE Of ISSUANCE.
I CERTIFY THE INFORMATION;FURNISNED IS ND CORRECT TO THE BEST Of MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL Of MET.
OWNER OR AGENT
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FIELD COPY