99-100868CS TY OF FEDERAL. WAY
33530 First Way South MCC "I" H I CML f4 C f"% M I T
Federal Way, WA.98011-1 Mechanical Inspection Requests 253-661 -4140
253-661-4000
ADDRESS:1.137 S 299TI-I PL
NO.: 515160-0435
PROJECT DESCRIPTION: INSTALL GAS INSERT AND PIPING
OWNER... all = ... V ... =:=i
ROGER GILDERISIN
FEDERAL WAY WA 980
PROJUT VALUATION
FUEL TYPES.:GhS
GAS PIPING.: 20
FUR0,10": 0
GAS NWT....: 0
CORV BURNER: 0
PRO........: 0
GAS DRYER..: 0
RANGE....... 0
GAS LOGS...: I
CONTRACTOR
WASHINGTON ENERGY SERVICES CO
ONE UNION SO 9TH FL
PO BOX 91060
SEATTLE WA 99111-9160
WASHIESO7403
LENDER
PERMIT NO: MEC99-0064
ISSUED: 03/01/99
BY: FC2
IXPIRL�,,, 0 /-27/9'3
q1 — 100 Wo 9
M CONTRACIM. PtfASf (Al. 10CA1101 COO 1737 N!# REPORTING SALES TAX FOR ftWfCTS 1111911 Ifff CITY Of FEKIAL KY. TAX RATE = 8.25 M
2500
FEES:
? FANS.......,...
10ILEF'
MECH PERMIT FEE S 83.1115
DUCT WORK,
OP,(1
WOOD SIOVt 0
0
HMO. fi
'0
JO's ON--
o",
106's "a
.......
AIR HANDtIRC UHTT�
FIJI I TA#K'.'
-10,000
10.0ou (Fm. 0
0
TOTAL FEES 83.25
=.V.-M.um ... , I .. .......z..4 ..
Does the eater supply systes contaiA a Pressure Reduction Device or (heck valve? Yes ( ) No (if "Yes* then crater expansion tank is required on Not Water link)
Inspection Record: mechanical Rough -in 57- Date Gas Piping -fct Date
MECHANICAL FINAL Date
..........
FERNIIS EXPIRE too IIAYS AFTER ISSONCE if 0 m Is StAR(fV
I CERTIFY IM. 11117OPM110V [UNNISNED V K IS TAK AND CORRI(f 10 IM REST Of BY INDKENE All TK AMICAILE CITY OF IFENAAL WAY P.LQUIRLAVIS MILL K NLI.
DAR
OWNER OR AGENT
FIELD COPY
CITY OF FEDERAL_ WAY
33530 F i rs t Way South 1,11 N;,",;,,: M',„„ I "I ih 4, 11"''N Fs L.. M, .„ �,,,
Federal Way, WA 98003 Mechanical Inspection Requests 253-661-4140
253-661-4000 - y
{ADDRESS:1137 S 299TH PL_
NO.: 51.5160-0435
PROJECT DESCRIPTION: INSTALL GAS INSERT AND PIPING
= OWNER
t ROGER GILBERTSEN
i
FEDERAL WAY WA 980
i
CONTRACTOR
WASHINGTON ENERGY SERVICE
ONE UNION SQ 9TH FL
PO BOX 91060
SEATTLE WA 98111-9160
WASHIES07409
LENDER
US CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL HAY
PROJECT VALUATION 2500
FUEL TYPES.:GAS ?
FANS..........: 0
GAS PIPING.:
20 ft
HOOD..........: O
FURN<100K..:
0
DUCT WORK.....: 0
GAS HWT....:
0
WOOD STOVES...: 0
CONV BURNER:
0
FURN>1OOK.....: 0
BBQ.........
0
MISC........... 0
GAS DRYER..:
0
AIR HANDLING UNITS
RANGE......:
0
<:10,000 CFM: 0
GAS LOGS...:
1
> 10,000 CFM: 0
BOILERS/COMPRESSORS
0-3 TON..,.,: 0
3-15 TON....: 0
15-30 TON...: 0
30-50 TON...: 0
50+ TON...... 0
FUEL TANKS ---------
ABOVE GROUND: 0
UNDERGROUND.: 0
PERMIT NO: MEC99-0064
ISSUED: 03/01/99
BY: FC2
EXPIRES: 08/27/99
(
f
)
i
TAX RATE = 8.25 :t:
FEES:
MECH PERMIT FEE $ 83.25
TOTAL FEES $ 83.25
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 ---v----- Gas Piping ---------------- Date
MECHANICAL FINAL Date
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THE INFORMATION F'RNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT _ r
-----------------
DATEl
FILE COPY
CrrYOF G
VV AY
BAR o� 11999
BUIIAIIVG DIVISION
33530 First Way South
Federal Way, WA 98003
(253) 6614000
Fax(253)661-4129
APPLICATION FOR MEC NJCAI,,,FERMIT
UILDING DEPT,
Federal Way Business License number:
MEC 4.4 - D� _
PARCEL # Single Family Multi -Family ❑ Commercial 11
SITE LOCATION
Tenant/Owner
Phone (-) D 1
Name 0t U 'N ��
Address/City/St/Zip
Contact Person
MECHANICAL CONTRACTOR
Phone
Company Name e C_ O
Address/City/St/ZipG � ' l�
Contact Person
State L & I Contractor Registration #
(Card must be presented)
MECHANICAL UNIT COUNT
Fax
Phone zo(c) ?WL 47k -)o Fax Q
K, AS H (x��6 __--'> Exp. Date
Fuel T as/other
Gas Dryer
Air Handling
< = 10 000cftn
Fuel Tanks:
Length of as piping
Range
Air Handlin
> = 10 000c&n
Above Ground
Fum <100K BTUs
Gas Log
Unit Heater
Undereround
Fum>100KBTUs
Fans
Boiler
BTU/H
Miscellane us
Gas HvA
Hood
Boiler
BTU/H
Other 1
Conv Burner
Dud Work
A/C
TONS
Other
BRO's
Wood Stoves
A/C
TONS
DISCLAIMER I certify, under penalty of perjury, that the information famished by me is trite 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, expanses, 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 arise out of the reliance of the city, including its officers and employees, upon the accuracy of the
;nfnrmatinn snnnhed to the city as a nart of this immticatiom
Owner/Agent
Mecm.Are
Rl!vurD 7129/98
Date