99-103891ITY,()F FEDEPAL WAY f I
335'-40 Fli-st, Way Soiji-,h M C K: " ri Pf 1. IC P4 L M C r% K4 3: T
F pde ral Way, WA 9800*3 Mechanical Inspecti.i3n Pequests '253-661.- 4140
253-661-4000
ODDRE)S:34503 9TH AVE S
NO.: 750451--0050
PRO,JE(_"r DESCRIFITION:0VAC - TO FINAL NE(97-0212, HER DIFFUSERS AND MICT WORK
OWNER CONTRACTOR - .....
NEDAtIA HEALTHCARE MACDONALD HILLER
34503 qTH AVE S 7717 DETROIT SW
FIDERAl. WAY WA 98003 SEATTLE #A 98106
838-5000
#A(
It IW10% PLEAS Cm 1732
Is SALES TAX
PROJECT VALUATION 54051
FUEL TYPES.:GAS FANS......... €v/(o ESSORS
GAS PIPING.: 0 HOOD.......
FURN<100K..: 0 DUCT WOR.V,.. _.: I T011f 0
S
GAS HWT .... : 0 MOOD SIOVL'5
'.. 1 *Jo 14,m_: 0
fONV 10RER: 0 FURN)IOR.... O 30,5o I01 ..: A,
81(0........: 0 11: 1 504 101'. 0
GK DRYER—: 0 Alp A LING U#111S RIEL TaNt".
RANGE....... 0 IO,00 (M 0
GAS LOGS...: 0 > 10,000 crfl.' 0 IPRDEKROUNP.:
Does the water supply systeo contain a Pressure
Inspection Record: mechanical Rough -in
MECHANICAL FINAL
LENDER
CITY Of I
i
PERMIT NO: "EC94-0340
ISSIJED: 10/05/99
BY: FC
I
LXPIRF'..- w1,,I.qj/oo
Rq -I anel
TOTAL FEES
$ 50.00
$ 50.00
evice or Check valve? ( ) Yes No (If *Yes* then water expansion tank is required on Not Water Tank)
Date _.____'_ Gr' Piping Date
Date
=..... .. Y*Irmm. .... A.
PERMITS EXPIRE 180 DAYS AFTER,ISSWM If NO 0ORt IS STARRED.
I CERTIFY IR INFONATION FUMSIED MY NE IS 0% AD CORRECT 10 IN[ BEST Of AY INWIKE AND IK APPLICABLE CITY Of tENM NAY At0IREKINIS gilt K ftt.
OWNER OR AGENT``NTI — -
- - - - - - - - - - — — ____ -.-- /� -
FIELD COPY
Page No. 1
12/27/99
FEES FOR CASE NO.: MEC99-0340
MEDALIA HEALTHCARE
34503 9TH AVE S
(This is NOT a receipt)
Case Fee Fee Account Fee Amount Receipt Check Date Rcd
# Description Type Number Amount Paid # # Paid By
---------- -------------------- ------------------------------ ----------------- ------ -------- ---
MEC99-0340 MECH PERMIT FEE 8004 001-0000-0000-032 50.00 50.00 02-39812 6759 1OIn°•99 KLC rce'70
Total
2-0010-0001 _-- __
Total fees:......... $ 50.00 it 1
- Payments: ......... $ 50.00 iiIInn
Balance due: ........ $ 0.00
CITY ,OF FEDERAL WAY
33530 F i rs t Way South P r,: r., u;::,, rR ;iii 10.1, ,' �,, ' .,.,. "�' C., rµ 1,4 .,.T,
Federal Way, WA 93003 Mechanical Inspection Requests 253-661-4140
253-661-4000
ADDRESS:34503 9TH AVE S
NO.: 750451-0050
PROJECT DESCRIPTION: HVAC - TO FINAL MEC97-O212, NEW DIFFUSERS AND DUCT WORK
OWNER=_______.___________________________________________�= CONTRACTOR
MEDALIA HEALTHCARE MACDONALD MILLER
34503 9TH AVE S 7717 DETROIT SW
FEDERAL WAY WA 98003 i SEATTLE WA 98106
838-9000
PROJECT VALUATION
FUEL TYPES.:GAS
GAS PIPING.: 0
FURN<10OK..: 0
GAS HWT....: 0
CONV BURNER: 0
BBQ......... 0
GAS DRYER..: 0
RANGE....... 0
GAS LOGS...: 0
206-763-9400
MACDOM*248J9
LENDER
PERMIT NO: MEC99-0340
ISSUED:. 10/05/9'9
BY: FC
EXPIRES: 04/01/00
Sts CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL MAY.
TAX RATE : 8.25 M
54051 FEES:
? FANS.........,' 3 ILEFS COMPRESSORS MECH PERMIT FEE
ft HOOD........... 0 0 ON...... 0
DUCT WORK.....:1 TCti...
WOOD SIOVES...; 0 15 T L
FURN>100K. 0 30-5i
MISC..........: 1 50- TOP.....: 0
AIR HANDLING UNITS FUEL TANKS--------- i
<:10,GOO CFM: 0 ABOVEGROUND: 0
> 10,000 CFM: 0 UNDERGROUND.: D TOTAL FEES
$ 50.00
$ 50.00
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 WORK IS STARTED.
I CERTIFY THE INfORMATiC, r'"4"'S — BY xF IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CIIY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT
FILE COPY
DATE
Federal Way, WA 98003 �'
(2061661-4000
APPLICATION FOR MECHANICAL PERMIT Y -
M a I
9,FGEIVED
Single Family 0 Multi -Family G Commercial
re2w-,)
SITE LOCATION:
/�
l G(fYFEuLRAL VHY ,
Tenant/Owner: r0WMU Qha� Haz-A-1j'A"PT.
Address/Ci ty/State/Lip�
Nature of work:-HY2��, � 'f Cr�') 1Jf-�W VAY project Valuation: $ If45
XIS' • , Ci.,jG'fAZ) rl-Y- �L- d 11frQ%�-f
APPLICANT
=iddress;City/St/Zip: --21-7 I[2'� ri— �W �✓S��l.� �,•i�c `1�j� � `jqb�
Contact Person: � �� Phcne:��`���� Fax-7�2P 403-7
MECHANICAL CONTRACTOR:
Company Nar„e: 1 L�jzN1w — �_l IUB'
Address/City/St2ip:
Contact Person: ��� Phone:
State L & I Contractor Registration M L� Svl Exp. Date:' f z_L=(C
(Card mus: be presented)
%IECHANICAL UNIT COUNT:
Fuei Typa (gas/atha r)
Gas Cryer
Air Handling <
= 10,0C4cfm
I Fuel Tanks:
Length of -gas piping
I Range
I Air Handling >
= 10,000cfm
I ., Above Ground
=urn < 100K BTU's
Gas [.ag
Unit Heater
Underground
Furn >I 00K BTU's
Fans
Boiler
STUN
Miscellaneous
Gas Hwt
Hood
Bailer
BTU/H
Other
Conv Burner
Duct Work
A/C
TONS
Other
I Wnn St - v-
0ISC1,AJMEF_ I certify candor P—watY of parry that aw hionn.don hmi.hod by rrw k try and corset to &m b.at e( my krv.v .{ and turttw that 1 .rtt .cad} tzod by d• owner & tho above -
prami.e. to parfam th. work for _Kch p.rrtwt .Opac.tion k :nada. I ftrthor .tree to ..ve hamt _ the Cty of Fd.r.f.W.y — to arty d.im Gnd+sfinQ ,—U, .xp.— and .ttoirayi f-
kw.d {n kw.dc.don and d.fer-+a of aueh d.iml, wNdt may b4 made by any person, k1dW4-V the undarsicr+.d. —a Mod aQ.iM *A Cty of F.dwr y Way but wly whey. audt d.:m .ri.-
out of tha «fi.nca .f the Gtr ktdud cc R. ojf-, a tsd r on th- �Y of the Wonn.don aWpried to tho Gty ar • part at tAi..ptric.d-u '- -
F l t fi
:-Owner(A ent. - C4 - Dates .a
- raw 6