99-10454433�30OFi. r st WzlY Scauth ME0,..I( NICAL fr" ERM I
May, Wil 98003 r1oct*r riical .fr)sF;c�c-t ir)n REgUt-�Sts 253-661 .41.40
253--661- 4000
ADDRESS:2117 SW
NO.: 416770--0290
PROJECT DESCRIPTION:GAS HOT EATER NEATER CHANGEOUf
OWNERm—U—as.m:=:,.�����
RITA KUCKLATK
2117 SN 3071H ST
FEDERAL HAY IFA 98023
253838-2980
sx.a:arttc:.mr.:e arsttr�saxr::ax:cs�:aacm:rmsfk�u�r.:a�:rq�Tv:aytlpc�Kl::r.m«�R,p9Yk'�
M rllMillAriiNkf bte tOf
PROJECT VALUATION
105'
FUEL TYPES.:GAS ?
FANS..........,'
GAS PIPING.:
0 ft
HOOD.;
0
FURN(1001..:
0
,v
D+ICT`NOE,, ,
G
GAS HNT.....
1
MOOD STOVES.,,
U
CONV OURNER:
0
FUR MOOK'.....:
6
880.........
0
HIS(...........
0
GAS DRYER..:
0
AIR HANDLING UNITS
RANGE......:
0
<40,000 CfH
O
GAS LOGS...:
0
) 10,000 CFM:
0
CONTRACTOR M$Qma=*mitt=s=:=n.-
ACTION NATER HEATERS ONLY INC
12704 HE 124TH ST, SUITE 43
KIRKLAND MA 98034
425-820-8848
LENDER
ffn -1 1 04,51H
PERMIT NO: MEC990416
ISSUED. 11/30/99
13Y: FL.F
EXPIRES: 05/27/00
SKES TAX FOR PROJECTS NITNIN THE CITY OF FEDERAL WAY. IM RATE = 8.25 M
Does the water supply system contain a Pressure Reduction Device or Check valve? ( ) Yes ( ) No (If "Yes" then water expansion taut! is required on Hot Mater Tank)
Inspection Record: Mechanical RoughAn __. ._ Bate .__--_____- Gas Piping __---------- — Date
MECHANICAL FINAL ..._... _v _ Date ._.� ?_ 7 qj
.: nbta]YI:/d¢aV*A.WC:CTG.... ... a:L.s�&Wu
PENMITS EXPIRE 180 EATS At ER ISSUANCE If ND VORI IS STARTED.
T CER11fY INE MORMATIUN FURNiSHLO by Ni IS HK ANN CORRECT 10 INt REST Of MY KNil I DGE AND THE APPLICANLE CITY Of FEOERM NAY REQUIREMIS Mitt BL illi.
OWNER OR MOT �Ar r � :Il� �r?/ _ __.. _. _._ _- _ - DATE
FIELD COPY
FEES:
Q ; TOH. .:
0
v L
y6
LIN
vvv;
iF;1
5 30Cr'�
50+ 'TCN.....:
0
FULL TAt;KS.... .
.
ABOVE GROUND:
0
ONDERGROUND.:
0
TOTAL FEES
Does the water supply system contain a Pressure Reduction Device or Check valve? ( ) Yes ( ) No (If "Yes" then water expansion taut! is required on Hot Mater Tank)
Inspection Record: Mechanical RoughAn __. ._ Bate .__--_____- Gas Piping __---------- — Date
MECHANICAL FINAL ..._... _v _ Date ._.� ?_ 7 qj
.: nbta]YI:/d¢aV*A.WC:CTG.... ... a:L.s�&Wu
PENMITS EXPIRE 180 EATS At ER ISSUANCE If ND VORI IS STARTED.
T CER11fY INE MORMATIUN FURNiSHLO by Ni IS HK ANN CORRECT 10 INt REST Of MY KNil I DGE AND THE APPLICANLE CITY Of FEOERM NAY REQUIREMIS Mitt BL illi.
OWNER OR MOT �Ar r � :Il� �r?/ _ __.. _. _._ _- _ - DATE
FIELD COPY
-CITY OF FEDERAL WAY p �� y �
33.530 F i. rs t Wad' South � � ;;,. �,,,. �.. � �:.,,� ��'' .;,II... �,..... �:,,,�' �. IF"!I;,;;... I�'�.
Federal Waxy WA 98003 Mechanical Inspection Requests 253-661_.4140
2.53--661--4000
ADDRESS:2117 SW 307TH ST
NO.- 416770--0290
PROJECT DESCRIPTION:GAS HOT WATER HEATER CHANGEOUT
OWNERCONTRACTOR
RITA KUCKLATK ACTION WATER HEATERS ONLY INC
2117 SW 307TH ST 12704 NE 124TH ST, SUITE 43
' FEDERAL WAY WA 98023 KIRKLAND WA 98034
i
253-838-2980 425-820-8848
ACTIOW# Ot *
t
CONTRACTORS, PLEISE 'OSE LOCA ION CODE 1132 FIPII%,•'' REPURTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY.
PROJECT VALUATION 1055 FEES:
FUEL TYPES.:GAS ? FANS. ., 0 3JIL �� 'ESaOnS,� FEE $
�,
GAS PIPING.: 0 ft HOOD.....,.f"l.
FURN<100K. : 0 DULY �v,, 3 ��''' �m� ,
GAS HWT..... 1 WOOD STOVc...... u 15-30 TON...; 3 '
CONV BURNER: 0 FURN>100K.....: 30-50'`TON ... : 0
BBQ........: 0 MISC..........: 0 50+ TON.....: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ---------
RANGE ......
--------RANGE......: 0 <:10,000 CFM: 0 ABOVE GROUND: 0
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0 TOTAL FEES $
PERMIT NO: MEC99-0416
ISSUED: 11/30/99
BY: FLF
EXPIRES: 05/27/00
TAX RATE : 8.25 stt
41.80
41.80
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 INFORMATII00%N FURNISHED 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_.----------------------------------- ---------
DATE
FILE COPY
F,
/C4 of- ' BUILDING Dry uwK
) 33530 First Way South
-W � Federal Wa53WA� 9�
NOV 3 0 1999 Fax (253) 661-4129
APPLICATION FOR MECHANICAVB i SAY
MEC qJ - (�
PARCEL # Single Family Multi -Family 0 Commercial 0
SITE LOCATION (v2- p q p
TenandOwner /`! 1-7,/� ►�L� la T/� - Phone 5-3 "o?
/Oy
//
AddrAddress/City/State/Zip7 SkJ -30 <
/) A �' C S Ll ��(c G�
Nature of Work ' Project Valuation:y$
r
APPLICANT
Name
FT
� 3
Address/city/St/zip /'z . 2o y /v' & /� �14-t, Ir
i y
Contact Person 1� rp:ff A� eJ t1-` J Phone
MECHANICAL CONTRACTOR
'.Z D -Y Fax C` -1A 1 -
Company Name IJV,', ' --P IL ' V
Address/City/Sdzip
N4:,-7 is � � 3 '►-1�(L� ��
�/ �� (� �o Fax
Contact Person „Y� N�e CL �1 Phone
State 1. & I Contractor Registration # 0 Exp. Date
(Card mullt be prw ritod)
MECHANICAL UNIT COUNT
Duel T e as/othcr
Gas Dr ver
Air I Luidling
< = 10 OOOorm
Nuel Tunis:
Len gtlr of gas piping
Range
Air Handlin
> = 10 OOOclin
Above Ground
Furs <I OOK BTUs
Gas LA)g
Unit beater
Undertzround
Fur it>100KBTUs
Farts
Boiler
BTU/II
Misecllalcous
Gas Hwt
Hood
Boiler
BTLY11
Otlier
Conv Burner
Dud Work
A/C
TONS
Oilier
Wood
I
DISCLAIMER: 1 ..Wily, under penalty of perj.y, aut ae urf—owion fwiuslwd by um is true and coned to ac Lest of my knowledge mid lurtlicr awl I ion auaton=d by the owner or ac above prenuses to pedurm ata wodr
for Much pcniul appuation is made. I rivaiu agree to suvc hanidas ac City of fcdcral Way as to miy clauu (mclwluig costs, experiscs, mid attorneys' lees uicwrcd in utvesugation mid dc(ensc of such claim), which Inay be
nude by any person, biclwluig the imd—ipmd, mid tiled eguuua are City of Fcderay Way but wdy where such clurn mu" out ofala rebuoce ofale city, ulcluduig its olbcers mid enipluyees, upon tho accuracy Orae
urlornuttion supplied to tho city u • pmt of application.
Owner/Agent � — Date c2-3— 9
Wca.Ape
iucvmw gPwO .
I