99-104307Y
L v
r
O T"Y UTA' FEDERAL WAY
s X1530 F i r moi: Way Sc)Rjtth MECHANICAL L P IT
Federal Way, WA 9E 003 '253-661-4140
253--661--4000
ADDREE 3:2628 SW J20TI-I PL..
NO.: 873190-0100
PROJECT DESCRIPTION:MEC - FURNACE RETROFIT (GAS FURNACE CHANGEOUT)
OWNER=.x =--..
HELEN TROTTER
26''28 SW 320TH PL
FEDERAL WAY WA "023
253/874-4514
*it C09114(10s PtIASL O
CONTRACTOR=c..a:=.r=
GLENDALE HEATING I A/C
12462 DES MOINES NAY S
SEATTLE WA 98168-2266
206-243.7700
LENDER
PERMIT NO: MEC99-0j'j" ;
ISSULD: 11/00/99
BY: TQC
EXPIRES: 05/05/O0
�.:.t�-r^s axis:xscam�•«wrw:sex»c:x:.e.:pr::c:c^::e�.as::xcw;.._mSssx.x �:c a:��:zs.�:ec; :.s;.:�:axa. xr2iaases:xzaN az+:ao-mzmrs3
NG SALES TAIL FOR PROJECTS MITIIIN INE CITY Of f£DIRAL PAY. 1AX NATE : 8.25 sts
PROJECT VALUATION
2080
FEES:
FUEL TYPES.:GAS
?
FPKS........�..*'
EE S 83.25
GAS PIPING.:
0 #t
MD.
0
0 Fri.
,, ..s
GAS HNT.....
0
WOOD STOPS....
0
1`
CUNV MINER:
0
FUNK -Or.....;
T
,0 -SO 1134.,.:
0
BOO.,..,....
0
MISC...........
0
5;it 10tl..... .
it
GAS DRYER-:
0
AIR HARROIG U#IIS
FUEL T«ifllS-- -
RANGE ...... :
RANGE......:
0
<.10,000 CFM:
`l
ABOVE GROUND:
0
GAS LOGS...:
0
> 10,000 (FM:
0
UNDERGROUND.:
0
TOTAL FEES 3 83.25
uDoesatersupply
~thk wePsystem contain a Pressure Reduction Device or Check valve? () Yes () No (If "Yes" then eater expansion tank is required on Sot Water Tank)
Inspection Record: Mechanical Rough -in Date Gas Piping Date
MECHANICAL f INAI _ _ _ Date--_----.__--
gust:va:mtnaanra..::.ssrcuccsxn:::�Paar:rtr.u....,.,,.:..:a....,..g:....«----..,.-w.....w-....,::...-------- »..---------- -...----___--.--
PU MITS EXPIRE 130 DAYS K IER ISSWE IF NO YINtt IS STARTED.
I CERTIFY THE INFORMATION Tun!,SMED Oft, ME is TRUE AI® CORRECT TO TME ICST OF NY KIME09 AIIM TIN: APPLICABLE CITY OF FEDERAL NAY REQUIREMEMTS MILT. K MLT.
OWNER OR AGFItT _..__ -- -_____-,._....----_—_ DATf
FIELD COPY
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PUBLIC WoAKS..FiN�iL....
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BUiLDING1:PlNAE.`:
_✓
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CDO193 (Rev 4/97)
CITY OF FEDERAL WAY
�p
33 530 F i i -s t Way South
u..,.,. d,,,,�.• I �,,,, ° .,. �,�.,,. �, 9..,.. �•„ !1;;;:;,. I ,. II
Fedet-al Way,, WA 9£3000 Mechanical Inspection Requests 253-661-4140
253-661-4000
ADDRESS:262£3 SW 32OT1-I PL
NO.: 873190--0100
PROJECT DESCRIPTION:MEC - FURNACE RETROFIT (GAS FURNACE CHANGEOUT)
PERMIT NO: MEC99-0395
ISSUED.: 11/093/99
F3Y : F C
EXPIRES: 05/05/00
;= OWNER =______ _________________________:::_________________= CONTRACTOR =________-________= _____==____:_=______= LENDER
HELEN TROTTER ; GLENDALE HEATING & A/C
t 2628 SW 320TH PL 1 12462 DES MOINES WAY S
FEDERAL WAY WA 98023 SEATTLE WA 98168-2266 j
253/874-4514 206-243-7700
i
GLENAHA----------------
01
xx: CONTRACTORS, PLEASE USE LOCATION CODE 1732 WT9 REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL NAY
PROJECT VALUATION 2080
FUEL TYPES.:GAS
?
FANS..........:
0
BOILERS/C0MPRESSG
GAS PIPING.:
0 ft
HOOD.........,..
0
0-3 TON.....:
FURN<100K..:
1
DUCT 'WORK ..... :
0-
3-15 TON....:
2
GAS HWT.... :
0
WOOD STOVES...:
0
15-0 TON...:
0
CONV BURNER:
0
FURN>10K.....:
0
30-50 TON...:
0
BBQ.........
0
MISC...........
0
50+ %N......
0
GAS DRYER..:
0
AIR HANDLING UNITS
FUEL TANKS ---------
RANGE ...... :
0
<:10,000 CFM:
0
ABOVE GROUND:
0
GAS LOGS...:
0
> 10,000 CFM:
0
UNDERGROUND.:
0
Does the water supply system contain a Pressure Reduction Device or Check valve?
TAX RATE : 8.25 M
FEES:
MECH PERMIT FEE $ 83.25
TOTAL FEES $ 83.25
( ) 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 EMUHE4iB1} 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 _
FILE COPY
DATE
City of Federal Way
a
33530 First Way South
Federal Way, WA 98003
�� (206)661-4000
APPL ICA TION FOR MECHAN/CAL
PARCEL
SITE LOCATION:
Single Family K
liE7 �,q-Dsg5
RECEIVED
NOV 0 9 1999
PERMIT
, _,3/,L WAY
BUiLDIN_ DEPT.
Multi -Family 0 Commercial 1:1
Tenant/Owner: � -,� r✓�- Phone:
Address/City/State/Zip:
Nature of work:
APPLICANT:
Name:
Project Valuation: $
,;7 oe
Address/City/St/Zip: 1-2,16,5" Z)e-
Contact Person: "��r"` (f0nN S -Phone: -Z'/3- Fax:
f
MECHANICAL CONTRACTOR:
Company Name:
GLe���le
v
Address/City/St/Zip: 12- '16 2,✓•g.
Contact Person: /P`''0 Phone: Fax:
Date:
State L & I Contractor Registration #: GZ_sx/D y.Q U S" -?Q a Exp
(Card must be presented)
MECHANICAL UNIT COUNT:
Fuel Type (gas/other)
Gas Dryer
Air Handling < = 10,000cfm
Fuel Tanks:
Length of gas piping
Range
Air Handling > = 10,000cfm
Above Ground
Furn <100K BTU's
Gas Log
Unit Heater
Underground
Furn > 100K BTU's
Fans
Boiler BTU/H
Miscellaneous
Gas Hwt
Hood
Boiler BTU/H
Other
Conv Burner
Duct Work
A/C TONS
Other
RRO's
Wood Stoves
A/C TONS
X.
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 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 qTployees, upon the accuracy of the information supplied to the City as a part of this application.
Owner/Agent: ��� Date: —_11416r -.12i