99-1038650, 1 TY
QF FEDERAL WAY
3-3530 First Way Soutt'i P4CC"P4F4,Z*-F4L F%CnP4]ET
rederal Way, WA 98003 Mechanical, Inspection R(-)(4ijests 253-661-4140
253-661-4,000
ADDRLSS:34503 9TH AVE S
NO.: 750451 0050
PROJECT DESCR I pTr ION:HVAC - TO FINAL REC97-0214, 1 COMPUTER RM UNIT, VAV BOX, DUCT/DIFFUSERS_
OWNER
ST FRANCIS CO"HUH11Y HOSPTAL
34505 9TH AVE S
FIDERA! WAY WA 98003
m (0T9Aff%S1 tWA V
CONTRACIOR ---a-
MACDONALD MILLER
7717 DETROIT OR
SEATTLAPWA 981A
--ff t[NDER .—
PERMIT NO: MEC99-0338
1',5<SULI)-. r3/05,199
BY: FC
EXPIRES: 04/01/00
01. 61 - I 0?5y (05;
ININ TK CITY Of FEKLK NAY. TAX Lill : 8.25 nt
PROJECT VALU
00
331T.1
FUEL TYPES.:
?
FAN. .......
0
GAS PIPING.:
0 ft
W)
0
FURK/1100K..:
DIK
GAS HNT.....
NOC'•D liYLS....:
CONY PURKIR:
0
FURN t.....:
0
8b0.........
0
MISC. .......
I
WS DRYER—:
0
OWTS
RANGE......:
0
'10,000 CFM:
0
GAS LOGS...:
0
10,000 (fh.
0
CONTRACIOR ---a-
MACDONALD MILLER
7717 DETROIT OR
SEATTLAPWA 981A
--ff t[NDER .—
PERMIT NO: MEC99-0338
1',5<SULI)-. r3/05,199
BY: FC
EXPIRES: 04/01/00
01. 61 - I 0?5y (05;
ININ TK CITY Of FEKLK NAY. TAX Lill : 8.25 nt
FEES:
KCH PERMIT FEE i 50.00
TOTAL FEES $ 50.00
Does the water supply systea contair, a Pressure Reduction Device i)r Check valve? Yes No (If 'Yes' then water expansion tank is required on Not Rater Tank)
Inspection Record: mechanical Rough -in ----------- Date _—_„M, --_ Gas Piping . ....... .__ Date
MECHANICAL FINAL Date
P[RNIIS EXPIRE 180 MYS Afffj IS4;UWf if No VW( IS SIARI[P.
I CERTIFY TK 11FORNA1191 FURNISHED BY Ot IS TRUE AND CORRECT 10 lK KSI Of NY KNORILIGE M INE fWRICAUtL CITY FUM VAT KOUREMENIS VILt K NET.
NRER 0 AGEIT Pot
— ----- — ------
FIELD COPY
50+ TOO...
FUEL
A8011 GROUND:
0
UNDERGROUND.:
0
FEES:
KCH PERMIT FEE i 50.00
TOTAL FEES $ 50.00
Does the water supply systea contair, a Pressure Reduction Device i)r Check valve? Yes No (If 'Yes' then water expansion tank is required on Not Rater Tank)
Inspection Record: mechanical Rough -in ----------- Date _—_„M, --_ Gas Piping . ....... .__ Date
MECHANICAL FINAL Date
P[RNIIS EXPIRE 180 MYS Afffj IS4;UWf if No VW( IS SIARI[P.
I CERTIFY TK 11FORNA1191 FURNISHED BY Ot IS TRUE AND CORRECT 10 lK KSI Of NY KNORILIGE M INE fWRICAUtL CITY FUM VAT KOUREMENIS VILt K NET.
NRER 0 AGEIT Pot
— ----- — ------
FIELD COPY
Page No. 1
12/27/99
FEES FOR CASE NO.: MEC99-0338
ST FRANCIS COMMUNITY HOSPTAL
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
---------- -------------------- --------------------- -------------------------- -------------- ---
MEC99-0338 MECH PERMIT FEE 8004 001-0000-0000-032 50.00 50.00 02-39812 6759 10/05/99 KLC
2-0010-0001
Total fees: ......... S 50.00
- Payments: ......... $ 50.00
Balance due: ........ $ 0.00
SU '
�c
01,
CITY OF - FEDERAL WAY
33530 F i rs t Way South A ....,
Federal Way, WA 93003 Mechanical Inspectioh Requests 1'53 661-4140
253-661--4000
ADDRESS:34503 9TH AVE S
NO.: 750451.-0050
PROJECT DESCRIPTION:HVAC - TO FINAL MEC97-0214, 1 COMPUTER RM UNIT, VAV 80X, DUCT/DIFFUSERS
OWNER
ST FRANCIS COMMUNITY HOSPTAL
34505 9TH AVE S
FEDERAL WAY WA 98003
CONTRACTOR
MACDONALD MILLER
7717 DETROIT SW
SEATTLE WA 98106
206-163=9400
MACDOM*248J9
M CONTRACTORS, PLEASE USE LOCATION CODE 1732.YHEN REPORTING SALES TAX FOR PROJECTS
PROJECT VALUATION 33198
FUEL TYPES.:GAS ?
FANS.........,:
0
3^ILERS/COMPRESSORS
GAS PIPING.:
0 ft
HOOD....... .
0
a_0 'ON......
1
FURN<100K..:
0
DUCT WORK.....:
0
3_'5 TON,. .:
0
GAS HWT....:
0
WOOD STOVES...:
0
15 -?0 T'r',
CONV BURNER:
0
FURN>100K _ _ :
0
30-50 T^N',_.,:
C
BBQ........:
0
MIS'...,......:
1
50+ TDN..
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
Does the water
supply
system contain a
Pressure
Reduction Device
or
Check valve? ( ) Yes () No (If
1
I runrn
PERMIT NO: MEC99-0338
ISSUED: 1.0/05/99
F3,".: FC
EXPIRES: 04/01/00
WITHIN THE CITY OF FEDERAL NAY. TAX RATE : 8.25 =*;
50.00
50.00
"Yes" then water expansion tank is required on Hot Water Tank)
Inspection Record: Mechanical Rough -in________________ Date __________ Gas Piping ______________�_ Date
i
MECHANICAL FINAL Date
i
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 WILL BE NET.
OWNER OR AGENT
FILE COPY
DATE `c9 f % %
Ly ui i uuu .:,y
-. 33530 F rsi Way South
Federal Way, WA 98003
(206)661-4000
,APPLICATION FOR MECHANICAL PERMIT
7 EC EIV E U,
'AP.CEL Sincie Family ❑f amity ❑ Commercial
()CTs
<<�• MSL. �1�- obi, �via� �� ��+��� �� ,
SITE LOCATION: CITY OF FEDERAL WAY
BUILDING DEPT.
Phone:
Address/City/State/Zip
V
Nature of work: �U%�� — Z TD►J Project aluatil "2
on: S 2
Cfl rj �y Yeic ►zl • Lj oil) J) V,c►,�( P� -s , c ?w�z.K �,,�r)
V1 r2S .
";PPLICA1%T:
Name: M A-'�h I1�` 1�% — f✓I I LL1✓�
Add ress/City/St/, ip: -7 % 1 :7, -:� ! -�_ -5,� LE— r l -JA, �?r 7I iq& -" 141n-7,
ContaOl P2fsOn:ph0ne:f�'��
v1ECH^NIC AL CONTPnCTOR:
Company Name: �Xo M I l,L�jZ
Address/City/St/Zip: -7-71:7
�2 J
Contact Person: *_ ����I�" � Phone:1�2a-40-7 ; ax-7��-4o17
State L & I Contractor Registration : � C '�i Exp. Date:
(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 >
= 10,000cfnn
I .. Above Ground
Furn <100K BTU's
Gas Log
Unit Heater
Underground
Furn >I OOK BTU's
Fans
Boiler
BTU/H
Miscellaneous
Gas Hwt
Hood
Boiler
STUN
Other
Conv Burner
Duct Work
A/C f
TONS
Other
V
Wood Stnynn
A IC
TONS
OISCLAIMM 1 certify under pte-fry e( perjury that the Information furnished by me b true and correct to the beat of my trhowladCe and ftx-dw that 1 am aut hortzad by tfw owner of the above
premises to perform the work for which permit appUcatdn N made. I fu dw agree to save harmleet the Chy of Fsdwai.Way se to any claim Grdudrip costa, a:npenaes and attomeyi tees
khcanred in Inwestication and defe-ea of such daunt, wNch may be made bry eny person. khdudkhp the udwaipned, and (Rad agairwt rw Chy of Fedway Way but only where audh claim "e,s
out of the reliance of the City, hdudl q he officers and omplayeea, upon the accuracy of the Wornation supplied to the City ss a part of this apgCcadon. -
Owner/Agent: �' Date: