99-100957C11'Y OF FEDERAL WAY
7
,.Q530 First Way South MECHANICAL
' PERMIT
re(.10 ml May, WA 99000 Mechanical Inspection Requests 253-'661--4140
253 4000
AD T,
rZCSS: 1515 SW 3201-1-1 CT
NO.: 0104'_' -AJ- 0700
PROJE'C I DF SCR I P] ION' retro 93S togas furnace
000
ARtEKE HELDREATH
1515 SN 3201H CT
FEDERAL WAY WA 98023
874-0839
PROJECT VA��ATION
FUEL TYPtS.:GAS ?
GAS PIPING.- `0 ft
FuRN4100K..: I
GAS NUT.... 0
CORV OURNER: Q
®110........, Q
GAS MYER_: 0
RANGE......: 0
GAS LOGS...: 0
CONTRACTOR ----
PUYALLUP HVAC IK
130 1510 ST SE
PUYALLUP WA 98372
645-0.581
LENDER
PERMIT NO: MEC99-0071
ISSUED: 03/08/99
BY : HTS
LXPIRES: 09/03/99
SALES TAX FOR PROTECTS NIMN THE CITY or FEKK PAY. TAX "K = 9.25 ns
1500
FEES.
'71AM AW '_T1% glak CE 54.00
I S.,
HOOD
T
�5' Rol
FANS.. �:,
IN
HU 4 , -
. ....... ds P11, '4,
kFf
"'A
j
FURVION. 0
RISC. I
011S
AIR HANDLING 01k4mail,
�--10,000 "(10, '661 GROUND: 0
10,000 Crk: 0 0 TOTAL FEES 54.00
Does the nater supply systew contain a Pressure Reduction Device or Check valve? ( ) Yes ( ) No (If "Yes" then eater expansion tank is required on Not Water Tank)
Inspection Record: Rechanical Rough -in Date ____ Gas Piping Date
KCWICAL FINAL 49r-JA11-- Date Ll. ;) _4*4
5r.__J I
VEMITS EXPIRE 180 MYS AFTER ISSUM IF 0 VOK IS STARTED.
CERTIFY THE INF OWTION FMISKD BY RE IS TIME W CffiKCT To JK ZEST OF NY MftM #0 Iff WKI(M CITY OF fEDEW VAY RILL K K1.
_VNER OR AG'ENT XIL , __ DATE a� ., � � a__
m
FIELD COPY
I
a
CITY OF FEDERAL WAY
33530 First Way South
Federal Way, WA 98003
253-661-4000
.0b. 4
MECHANICAL PERMIT
Mechanical Inspection Requests 253-661-4140
ADDRESS:1515 SW 320TH CT
NO.: 010450-0700
PROJECT DESCRIPTION: retro gas to gas furnace
OWNER === ======
ARLENE HELDREATH
1515 SW 320TH CT
FEDERAL WAY WA 98023
874-0839
CONTRACTOR =—
PUYALLUP HVAC INC
130 15TH ST SE
PUYALLUP WA 98372
845-0581
LENDER
PERMIT NO: MEC99-0071
ISSUED: 03/08/99
BY: HTS
EXPIRES: 09/03/99
aai CONTRACTORS. P EAS`> U5E i TIdQN CODE 17 t,IINF �IRT SALES TAX FOR PROJECTS BITHIN THE CITY OF FEDERAL BAY. TAX RATE = 8.25 _
. a
:mom= eaammaaammsmmmammmaamammmamammmamat�epa�mammommmammamarmamaammm-aa -----^---^^mammmmammmmmmmaom�mmmmmamammmmm-mma�--�-mcmmmsmmmmam-^--�mmmammmmmmmmmmm.
PROJECT VALUATION 1500 �_'`�� FEES:
FUEL TYPES.:GAS ? FANS.. 0 BOIRS��OMPI� e, „� g ; EE $ 54.00
GAS PIPING.: 0 ft HOOD,;,0 0 TOS'.. �» w $�m�
FURN<100K..: 1 DUCyf'� 081.
GAS HWT....: 0 WOOD Sfkii. k.. 15 30
CONV BURNER: 0 FURN>10QK....: 0 30 50,,FON...: -0
BBQ........: 0 MISC..........: 0 50+ TOR....,: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ---------
RANGE......: 0 r-10,000 CFM: 0 ABOVE GROUND: 0
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0 TOTAL FEES $ 54.00
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: Mechanical Rough -in Date Gas Piping Date
MECHANICAL FINAL Date
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO NORK IS STARTED.
I CERTIFY THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF NY KNONLEDGE AND THE APPLICABLE CITY OF FEDERAL MAY REQUIREMENTS BILL BE NET.
OWNER OR AGENT Vnaiawl DATE me
FILE COPY
M
WesNurGTCIN SHORT -FORM INDIVIDUAL ACKNOWLEDGMENT (ROW 42..44.1001
State of Wa inglon
County of
I rtify that I know or have satislactory evil eince that
(.,.7.71 to 'or N f%
0,41A./.11AA,�tr- Z�tJC�� (name of •sigw) is the
person who appeared before me• and said person acknowledged that
/ (he/she) signed this instrument and acknowledged it to be
(his/her) tree and voluntary act for the uses and purposes
mentioned in the instrument.
(rated:9—U'-404
V
(Signature) Title (su as nNotapPublicl
My appointment expires
(SEAL OR STAMP)
OPTIONAL SECTION
THIS CERTIFICATE MUST BE ATTACHED TO
DOCUWNT DESCRIBED AT RIGHT:
Ttrough Ute data requested here is nol required by W.
it coin prevent fraudulent reallachrnerd ol this loan.
W A)
M" 4dz4W OM)
TITLE OR TYPE OF DOCUMENT
NUMBER OF PAGES
SIGNER(S) OTKERTIUtN NAMED ABOVE
DATE OF DOCUMENT
DEPARTMENT OF LABOR AND INDUSTRIES
REGISTERED AS PROVIDED BY LAW AS
CONST CONT SPECIALTY
;:.• :;REGIST # :::..: FJ[P: 'OATS-
:CCAACG:PUYALHI066MIC 07/01/199;9'.
.EFFECTIVE• DATE:,::. -.07/12/19991:
WYOF G BUII DING DIMON
• 33530 First Way South
via
Federal Way, WA 98003 -
(253) 66113000
Fax(253)66113129
MAR ® 4 'J999
APPLICATION FOR�,Mg,Cf-IJAffl'KL PERMIT
Federal Way Business Licens 75
ii
MEC - O(�+
PARCEL # Single Family Multi -Family ❑ Commercial ❑
SITE LOCATION�} Q
Tenant/Owner01AUUfl�-d� �" `^� Phone 917
Address/City/State0p I 6 O
Nature of WorkCQJ-10IdAAAAttProject Valuation: w TZO
APPLICANT
Name
Address/City/St/Zip
Contact Person Phone Fax
MECHANICAL CONTRACTOR
Company Name 1
Address/City/St/Zip :•J
7
U
Contact Person Phone(95 t�i 5 O�o I Fax
State L & I Contractor Registration # IAV q L ' :Moto LU Exp
(Card must be presented)
MECHANICAL UNIT COUNT
Fuel T other
Gas Dryer
Air Han
< =10 000cfn
Fuel Tanits:
Lengthof as piping
Range
Air Handlin
> =10 000cf n
Above Ground
Furn <l00K BTU's
Gas Log
Unit Heater
Underground
Fum>100KBTU's
Fans
Boiler
BTU/H
Miscellaneous
Gas Hwt
Hood
Boiler
BTU/H
Other
Conv B �
Dud Work
A/C
TONS
Other
W.M Stov.
A/C
TONS
_ v
DISCLAIMER: I oe *, under penally ofpaM. thatthe kfoaaation 5mriahed by ma is t w and coned to the best ofmy knowledge and flat)tor that I am wftnzed by the owns ofthe above promises to perform the wodr
for which permit application is made. 19Mher agree to cave bamilas Ste aty ofFederal Way as to any claim (mduding c-ts, expensm and attomeye fees matured in investigation and deface ofsuch claim), Wbichmay be
made by any person, htdm&%the undersigned, and fled egahtst the C4 ofFedeW Way but only where such claim ansa art ofthe radiance ofthe city, fitchW tg its offices and employee, Won die accmary ofdw
infounation mWHed to the city as a part ofNs application.
Owner/Agent
Meca.Arr
Ravmw 7r19/99
ow Date CQ .