99-104563(,-,ITY OF F-EDERAL SAY
.33530 Fi.rst. Way outh MECHANICAL PERMIT
,Fcnder�ql Way, WA 98003 Mechardcal Inspection Requests '214,153-661,4140
253-661-4000
ADDRESS:1911 SW 35JRD PL
NO.: 926975--0070
PROJECT' DESCRIPTION:11EC - ELECTRIC TO GAS FKKA(E CHAHGEOUT
OWNER
DICK POULSEN
1911 SW 353RD PL
fEDIPAL WAY WA 98023
PPOJECI VALUATION
FUEL TYPLS.:GAS
GAS PIPING.: 30
FURN(loor..: I
GAS OT..... I
COP BURNER: 0
BBV......... 0
GAS DRYER,.: 0
RANGE......: 0
CAS LOGS...: I
CONTRACTOR .... . ....... ..... LENDER
NORPAC HEATING L A/C INC
3414' *A* ST SE SUITE #102
408URH WA 980021
R 1-1045
3
PERMIT NO: MEC99--0419
ISSUED: 12/01/99
BY: FC2
EXPIRES: 05/28/00
3tt (6111RACTUS, 0116L 141' lili.4160 C40t 17r,, V!1,4 fALES TAX FOR PRDJICFS V11`11111 IK CITY Of tfKRAI VAY. TAX PATE : 8.25 Its
Does the water supply system contain a Pressure Reduction Device or (heck valve? Yes No (If "Yes' then water expansion tank is required on Hot Water Tank)
Inspection Record: Nechanical Rough -in D.1 t e Gas Piping _]/—!7 Date
MECHANICAL FINAL Dat:
�F51Y2-."lY:r:+:Fr:CGFC r:.:axs.nc»r.c«sxr::f.ra:ncx�.:'�anes:c: _,.-. ."„:.. :::::, .. ...._.•., :: ._..r-.::.:..: �"... �1�' _:.s xwa:..::r.:lzc...wax:.::.:uc4xtarwc,;:.:wy�«.+..x:rax"�.:>ramn'::m'Xan,�.y�xmarF-.s..::.1 f .. _ .... ... ...
PERMITS EXPIRE ISO SAYS Affilt ISS01(f IF No W1 is STARR).
CERTIFY fill INfORMTION fuRNISK-D la rk is Ira AND CORRECT to In VIST of. NY Kit"trw AND INE APNICARE CITY Of FtKI-At WAY 111001)(011IS WILL 1 liti.
OWNER OR AGENT -.t '4DATE
FIELD COPY
1000
FEES:
FANS...
FEE 83.25
ft HOOD.....
M M
WOOD myn
Ia i,f.w
:v-
m
0
TOR......
AIR 000LIRG QNITS
FIJI[[ 11'vRS - ------
IQ,000 (Fh: 0
A80L GROUND:
0
I 10,D00 CFO: 0
UNDER(IROUND.:
0
TOTAL FEES 83.25
Does the water supply system contain a Pressure Reduction Device or (heck valve? Yes No (If "Yes' then water expansion tank is required on Hot Water Tank)
Inspection Record: Nechanical Rough -in D.1 t e Gas Piping _]/—!7 Date
MECHANICAL FINAL Dat:
�F51Y2-."lY:r:+:Fr:CGFC r:.:axs.nc»r.c«sxr::f.ra:ncx�.:'�anes:c: _,.-. ."„:.. :::::, .. ...._.•., :: ._..r-.::.:..: �"... �1�' _:.s xwa:..::r.:lzc...wax:.::.:uc4xtarwc,;:.:wy�«.+..x:rax"�.:>ramn'::m'Xan,�.y�xmarF-.s..::.1 f .. _ .... ... ...
PERMITS EXPIRE ISO SAYS Affilt ISS01(f IF No W1 is STARR).
CERTIFY fill INfORMTION fuRNISK-D la rk is Ira AND CORRECT to In VIST of. NY Kit"trw AND INE APNICARE CITY Of FtKI-At WAY 111001)(011IS WILL 1 liti.
OWNER OR AGENT -.t '4DATE
FIELD COPY
CITY OF FEDERAL WAY
33530 First Way South
II SII !I.» » � ... �� . � i��°��i_��''I� .Il. � �.• i�""' � N� il'°"� !I;;�:• �'' � it � II ,..�..
Federal Way, WA 98003 Mechanical Inspection Requests 253--661 4140
253-661-4000
ADDRESS:1911 SW 353RD PL
NO.: 926975-0070
PROJECT DESCRIPTION:MEC - ELECTRIC TO GAS FURNACE CHANGEOUT
OWNER
DICK POULSEN
1911 SW 353RD PL
FEDERAL WAY WA 98023
CONTRACTOR
NORPAC HEATING & ASC INC
3414 "A" ST SE SUITE #102
AUBURN WA 98002
931-0608
LENDER
PERMIT NO: MEC99-0419
ISSUED: 12/01/99
BY: FC2
EXPIRES: 05/28/00
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
�i; CONTRACTORS, PLEASE USE LLCA.iIO
BODE 1732
'WHEN REPORTING SALES TAX FOR
_----------------------------------------------------------
PROJECTS WITHIN THE CITY OF FEDERAL NAY. TAX RATE = 8.25
PROJECT VALUATION
3000
OWNER OR AGENT
_ .-
FEES:
FUEL TYPES.:GAS
? FANS....
MECH PERMI. FEE
GAS PIPING.: 30
ft. HOOD..........:
FURN<100K..: 1
DUCT WORK--: O
GAS HWT.... : 1
WOOD STOVES,..: 0
15-30
( CONV BURNER: 0
TURN>100K.....: 0
30-50;TON ... :
BBQ......... 0
MISC........... 0
50+ TSN.....:
O
GAS DRYER..: 0
AIR HANDLING UNITS
FUEL TANKS ---------
--------RANGE......:
RANGE ...... 0
<:10,000 CFM: C.
ABOVE GROUND:
0
! GAS LOGS...: 1
> 10,000 CFM: O
UNDERGROUND.:
0
TOTAL FEES
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 WORK IS STARTED.
I CERTIFY THE
INFORMATION FURNISHED
BY ME IS TRUE AND CORRECT
TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS HILL BE MET.
OWNER OR AGENT
_ .-
,..__.----_____.-..-----._------------------__.__
DATE
FILE COPY
CRY OF G
DEC 0 11999
c. APPLICATION FOR MECHANICAL PERMIT
Bute Federal Way Business License number:
PARCEL #
SITE LOCATION r
Tenant/Owner '
Address/City/State/Zip
Nature of Work
APPLICANT
Single Family
Multi -Family ❑
Phone
BunDiNG DIV7sioN
33530 First Way South
Federal Way, WA 98003
(253) 66111000
Fax (253) 6614129
11
MEC" -D140
Commercial ❑
fs G O��J Project Valuation: $ C CC
Name c �'
Address/City/S,I�CL
� A �� `� ul A
Contact Person
Phone �7 ' rl 3 / C C ,Fax
MECHANICAL CONTRACTOR
Company Name P NL S— t �-- I II
Address/City/St/Zi �4 i `'A�
Contact Person Phone • .SA-t,`� Fax
State L & I Contractor Registration # �! �` T��` '7s M. <S Exp. Date
(Card must be presented)
MECHANICAL UNIT COUNT
Fuel Type as/other
_ Gas Dryer
Air Handlin <
= 10 000cfm
Fuel Tanks:
Len of gas piping
Range
Air Handlin >
= 10 000cfm
Above Ground
Fum <100K BTUs
Gas Lo
Unit Heater
Underground
Fum>100KBTUs
Fans
Boiler
BTU/H
Miscellaneous
Gas Hwt
Hood
Boiler
BTU/H
Other
Conv Burner
Duct Work
A/C
TONS
Other
BBO'.-
Wood Stoyes
A/C
TONS
DISCLAIMER: I certify, under penally of perjury, that the information famished 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 hamiless 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 tothe city as a part of this application.
Owner/Agent
Mrcu.Arr
REvrsm 7/29/98
Date �' ~�