99-103744f I A
C11 -Y OF FEDERAL WAY
33530 First Way Soutli t4E:CV1PNH1CML FAUAMIT
Feder -Al, Way, WA 98003 Mechati:i.r�al 1rv_:;f)e)cfJon Requests -2-53-661-41.40
253--661-4000
APDRESS:32241 16 FH AVE SW
t4O.: 010450-0250
PROJECT DESCRIPTI011:HVAC - GAS TO GAS FURNACE CHARGEOUT
PERMIT NO: MEC99-0329
ISSUED, 09/28/99
BY: FC2
LXPIRES- 03/25/00
1, OWNER, ...& z ....... ..=. = CONTRACTOR :.•.:•#a ... II LF11DER. = .... ...
ELLEN SCHERER WASHINGTON ENERGY SERVICES CO
32241 16TH AVE SW 41800 THORHDYKE AVE V
FEDERAL WAY RA 98023 SEATTLE WA 98199
4
mmrsair
N 11
. ................ ....... ...
its fiff I KA11" fm il*rl Vfff IrMT11M SALES IAX FOR PWfCIS VIfH1V TIE CIIY OF f[KRAL MAY.
PROJECT VALUATION 1700
FEES.
FUEL TYP[S.:GAS ELE FARS—_., 1141"1 PUIMIT"FEE
GAS PIPING.: 0 ft
TURN' i Atli, A TdIrf 11.nf'Y A
99 — I
TAX RATE : 8.25 M
60.10
$ 60.10
Does the water supply system :ontain a Pressure Reduction Device or Check valve? Yes No (if "Yes' then water expansion tank is required on Hot Water Tank)
Inspection Record: hechanical Rough -in
MECHANICAL FINAL
Date Gas Piping
I
A
/Z# glDateef'l
__ Date.-____ -
.......... =... ....... .. . .......
PERNITS EXPIRE 180 HAYSAFTERIS%Wf If NO W;RK IS StM119.
I CERTIFY in OPMTION' PONISHID Irf ME is -001 AND Comm 10 THE KSf Of MY lowtact Ate III APPLICABLE (11Y Of RKMI. VAY REQUIREMENTS RILL K KI.
OWNER ; AGEN171.1-1-1-1 DATE
FIELD COPY
1— ki
"x1 11-11, . . . . :
GAS
I
WO"R S'T!)VLS* ... : 0
15-310, T:A_.:
0
(00V BURNER:
0
F VR N". I , Jul ...... 0
30 - SO ,, 0.
BBQ.........
0
HIS(_ ........ : 9
501 Tflit ...
0'
GAS DRYER—:
0
AIR HANDLING UNITS
FUEL TAOS ---------
RANGE ...... :
0
/:10,000 CFM: 0
ABOVE GROUND:
0
GAS LOGS—:
0
) 10,000 (fM: 0
UNDERGROUND.:
0
TOTAL FEES
60.10
$ 60.10
Does the water supply system :ontain a Pressure Reduction Device or Check valve? Yes No (if "Yes' then water expansion tank is required on Hot Water Tank)
Inspection Record: hechanical Rough -in
MECHANICAL FINAL
Date Gas Piping
I
A
/Z# glDateef'l
__ Date.-____ -
.......... =... ....... .. . .......
PERNITS EXPIRE 180 HAYSAFTERIS%Wf If NO W;RK IS StM119.
I CERTIFY in OPMTION' PONISHID Irf ME is -001 AND Comm 10 THE KSf Of MY lowtact Ate III APPLICABLE (11Y Of RKMI. VAY REQUIREMENTS RILL K KI.
OWNER ; AGEN171.1-1-1-1 DATE
FIELD COPY
v
CITY OF F=EDERAL WAY
33530 First Way SoutYi
Federal Way, WA 98003
253-661-4000
ADDRESS:32241 16TI-1 AVE
NO-: 010450-0250
PROJECT DESCRIPTION: HVAC
�= OWNER
ELLEN SCHERER WASHINGTON ENERGY SERVICES CO
32241 16TH AVE SW 2800 THORNDYKE AVE W
FEDERAL WAY WA 98023 SEATTLE WA 98199
i
s
:s: CONTRACTORS, PLEASE USE LOCATIOk CODE '_•732 NHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE : 8.25 ;*_
PROJECT VALUATION 1700 �EtS
i FUEL TYPES.:GAS ELE FANS.........,: 0 0"_I L L C RCS,L,�S ,-;:- PiRlIT
IGT
Mechanical Inspection Requests 25`1 661-4140
SW
- GAS TO GAS FURNACE CHANGEOUT
PERMIT NO: MEC99-0329
ISSUED: O9/28/99
BY: FC2
EXPIRES: 03/25/OO
60.10
AS PIP.NG..
0 ft
HOOD. ..... j0
QN.
FURN<100K..:
0
DUCT O
3-15 TCN....:„<..
... �`
GAS HWT....:
1
WOOD STOVES...: 0
15-30 TON...:
O �
{ CONV BURNER:
0
FURN>lOOK.....: 0
30-50 TON...:
0
BBQ.........
0
MISC........... 0
50+ TON,.....
0
GAS DRYER..:
0
AIR HANDLING 'N TS
FUEL TANKS ---------
RANGE ...... :
0
<:10,000 CFM: 0
ABOVE GROUND:
0 r
GAS LOGS...:
0
> 10,000 CFM: 0
UNDERGROUND.:
0 TOTAL FEES $ 60.10
y
----------------
r------ -- ------=------------= --________==_=-_____________--------------- ... - ---__ ---------
------ ------------------- -------
1 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 NFOR ON RNISHED BY ME UE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER AGENT - --__ ----'YZ----------------------------- DAT t
FILE COPY
DEPARTMENT OF LABOR AND INDUSTRIES
REGISTERED AS PROVIDED BY LAW AS
CONST CONT GENERAL
REGIST:.# EXP. DATE
CCO1' .WASHIE807403 06/24/2000
,EFF.ECTIVE•:.,DATE ;= =:;.:09/23/1993
WASHINGTON ENERGY SERVICES CO
2800 THORNDYKE AVE W
SEATTLE WA 98199
t6:5 -05e -Ma (SX7)
Detach And Display Ccitiriccce
rREGISTERED AS PROVIDED BY LAW AS
CONST CONT GENERAL
REGIST. # EXP. DATE
CC01 WASHIES07403 06/24/2000
EFFECTIVE DATE 09/23/1993
WASHINGTON ENERGY SERVICES CO
2800 THORNDYKE AVE,W.
SEATTLE . WA..: 98199 ' • .: .
Signature ) A, -40
Issued by DEPAR EN -r OF LABOR D INDUSTRIES
j+625.0.4200 iSN7j
State of Washington
County of King
Please Remove
And Sign
Identification
Card Before
Placing In
Billfold
I certify that this is a true and correct copy of the original document presented to me by Angela
Aldrich of Washington Energy Services c
Notary Public in and for the State of Washington
My Commission Expires 09/09/99
L-7 - �wN=
GrY of G Bun.Dow DIvrsioN
AED 33530 First Way South
ARy Federal Way, WA 98003
�p 2 a 1999 (253)6614000
Fax (253) 6614129
6r F' C)OIAPPLICATION FOR MECHANICAL PERMIT
Federal Way Business License number:
MEC
PARCEL # (� « S Single Family Multi -Family ❑ Commercial ❑
SITE LOCATION
Tenant/Owner ! `'uji jC H � � r' Phone �S -:3
Address/City/State/Zip )�_ 2 C/ I I b k A—u,,e
Nature of Work
APPLICANT
cz-
Project Valuation: $ % 7C)U ' Cm
Name -t , J
Address/City/St/Zip -( h 2 J2i Z - a-i�
Contact Person 144 Phone 11 �� 7d� Fax
MECHANICAL CONTRACTOR
Company Name
Address/City/St/Zip
ContactPerson ��/� Phone ��j?�'�%� Fax
State L & I Contractor Registration # dc-) cp Exp. Date
(Card must be presented)
MECHANICAL UNIT COUNT
Fuel T Lhs/other
Gas Dryer
Air Handlin < = 10 000cftn
Fuel Tanks:
berigth ofwpiping
Range
Air Handlin > = 10 000eftn
Above Ground
Furn <100K BTUs
Gas Log
Unit Heater
Underground
Fum >100K BTUs
Fans
Boiler BTU/H
Miscellaneous
Gas Hwt
Hood
Boiler BTU/H
Other
Conv Burner
Duct Work
A/C TONS
Other
_qaQ:s_
Wood qtovLs
A/C TONS
.1m
DISCLAIMER 1 certify, under penalty of perjury, that the information furnished by me is true and correct to the best of my knowledge and fiatha that 1 unauthorized by the owner of the above premises toperform the work
for which permit application is made. 1 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 employees, upon the accuracy of the
information supplied to the city as a part of this application.
Owner/Agent
ME".APP
Reyes® In/99
L C
Date l