99-103713(ITY OF FFI)ERAL WAY
33530 First Way outfi
Fe Mechanical Inspec.biort 253-661-4140
_qeral Way, WA 98003
�30-661-4000
A-DDRESS:618 SW '2194TH ST
NO. : 119600-1791
PROJECT DESCRIPrION:HVAC - FLE TO GAS CHARGE Of FURNACE, HINT, f/P INSERT WI-ASSO(IATED GAS PIPE
OWNER
GEORGE HORSHAM
618 SW 294TH ST
FEDERAL RAY WA 98023
Us CONTRACTORS, nf#$t ft L(KA
=—= .4 '- s ,. -
PROJECT VALUATION 4500
FULL TYPES.:GAS ?
FANS,.....
0
GAS PIPING.:
50 ft
HOOD........:.:
FUR4<100K..:
I
Duct WOR14....
GAS HWI... .:
I
Wool S"VF11. . ,
CONV BURNER:
0
fURH*11qVr--*
HBO.........
0
MISC— . ...... :
GAS DRYER..:
0
AIR HANDLING 0011("
RANGE.......
0
<:10,000 +Fm:
0
GUS LOGS...:
I
s 10,000 (FM:
P
CONTRACTOR LENDER
WASHINGTON ENERGY SERVICES CO
2000 THORNDYtf AVE W
SEATTLE WA 98199
WAS11007403
I t.; , 1 , : / con PR t Ssof S
0-3 10"N'
f9EL
ABOVE GROUND:
UNDERGROUND.. 0
X, 'F164
PERMIT NO: MUC99-U329
09/28/99
RY, KL.0
EXPIRES: 03/25/00
ING SALES TAX FOR PK031(15 NIININ IRE CITY Of f[KRAL NAY. TAX RATE :: 8.25 Wt
FEES:
M101 PERMIT FEE $ 111.25
TOTAL FEES $ 111.25
Does the cater supply systes contain a Pressure Reduction Device or Check valve? Yes RA f1f *Yes' then eater PxDansbn tank is required on Rot Water TaO)
Inspection Record: Mechanical Rough -in Date us Piping Date
MECHANICAL rINAL -A)0__M_. ,. Date ,/z7/Q�
.. 4 ... = ... I- i VA.- .. . B W .1 -�� . T, . A >k . ra — . m �1- M, . QC 4 . . = . m a; r. . .1. z —..v. , t. 4. �:t..
PfRNITS EXPIRI 180 DAYS Mltk ISSUAKE It 10 IM IS STARTED.
I CERTIFY IKL INIOR"ON fURNISN10 Ff- NLJS IM AND COWCT III THL )QST Of R14" KH(WLLPGL AND INE #PPLILAULL CITY Of f[DEM NAY AEQUIRININI� HILL RL ML).
OWNER A(,(HT DAIE
-*Yz?
1
FIELD COPY
CITY OF FEDERAL WAY
33530 F i rs t Way S o u t h � r»�}� � ,: 4 , � '1# F11 F4 M' L., NF"T, 1r,` n P4 .1 "'1
Federal Way, WA 98003 Mechanical Irispection Requests 253-661-4140
253--661--4000
ADDRESS:613 SW 294TH ST
NO.: 1.19600--1791
PROJECT DESCRIPTION: HVAC - ELE TO GAS CHANGE OF FURNACE, HWT, F/P INSERT W/ASSOCIATED GAS PIPE
== OWNER == _______-__=___________________________________== CONTRACTOR = __=__-__= ______________________= ______-= LENDER=========
GEORGE HORSHAM s WASHINGTON ENERGY SERVICES CO
618 SW 294TH ST ° 2800 THORNDYKE AVE W
FEDERAL WAY WA 98023 SEATTLE WA 98199
I
t
WASHIES07403 I
M CONTRACTORS, PLEASE USE LOCATION CODE 1732 VREN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY-
- - - - - - - - - - - - - -
AY__________ -____
PERMIT NO: MEC99-0323
ISSUED. 09/23/9"?
BY: KL_C
EXPIRES: 03/25/00
TAX RATE : 5.25 Us
PROJECT VALUATION 4500 FEES:
FUEL TYPES.:GAS ? FANS....... _: 0 S`11 1?S/COJ PRESSORS I MECH PERMIT FEE
°
GAS PIPING.:
50 ft
HOOD. ...: 0
0 Ok
FURN<100K..:
GAS NWT....:
1
1
DUCT WORK,,..
WOAD STOVE S...: 0
3 .
15
`m
CONV BURNER:
0
FURN>100K. ...' "
30-53 '...: n
BBQ........: 0 MISC..........: 0 53+ TO......: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS---------
RANGE......: 0 <:10,000 CFM: 0 ABOVE GROUND: 0
GAS LOGS...: 1 > 10,000 CFM: 0 UNDERGROUND.: 0 TOTAL FEES $ 111.25
Fc=:r_•_==zc:_=a=cc==c_m=cc=sc=c-ar.======ccc.--=c:ccc:::cc::�=cc=:cz=c=•_.cv==••_=c:_::=___=::==ns=a=====co=ccc=====_=_===:=n=cca_::a==cca=}-=::=c======r.:=o===c'====n'====-----=====r_c:.=aa:a=_.c_
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
MECHANICAL FINAL
Date
Date
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THE INFOR FURNISHED BY S TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
00ER �, ------------------- �-------- - DATE
------------------------------ --- -asp---
FILE COPY
txrr or X --
SEEP
SEP 2 9199'
Bua nnvG DiVMON
33530 First Way South
Federal Way, WA 98003
(253)6614000
Fax (253) 661-4129
G17SU°uoNr.DtO ►PPLICATION FOR MECHANICAL PERMIT
Federal Way Business License number:
MEC
PARCEL # �� �' Single Fame Multi -Family ❑ Commercial O
SITE LOCATION
Tenant/Owner f " r" �S ` ' Phone
Address/City/State/Zip
Nature of Work 4
APPLICANT
Project Valuation: $ '52������
Name
Address/City/St/Zip 4 42 1121' 2 - a-V.�t�/�`
Contact Person -����� G�f /-�/'� Phone LL LZ2Y2-�7�D Fax
MECHANICAL CONTRACTOR
Company Name
• .. - . Z�lrlls�////////!///.�J•ill.��/Is��i'..l�Jfi7l•L�
Contact Person —Phone --X /72C ) Fax
State L &I Contractor Registration # �� iA�fLr�� �� 7��� Exp. Date
(Card must be presented)
MECHANICAL UNIT COUNT
Fuel T as/6ther
Gas Dryer
Air Handlin < = 10 000cfm
Fuel Tanks:
((
Lengthof gas piping 1 (�j i
Range
Air Handlin > = 10 000cfm
Above Ground
Fum <100K BTUs T
Gas Log
Unit Heater
Underground
Fum >100K BTUs
Fans
Boiler BTU/H
Miscellaneous
Gas Hwt
Hood
I Boiler BTU/H
Other
Conv Burner
Dud Work
A/C TONS
Other
Wood Stovo—
TONS
DISCLAIMER I certify, under penalty of perjury, that the information furnished by me is titre and correct to the best of my knowledge and further that 1 am authorized by the owner of the above premises to perform 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' tees 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
Mecu.App
Revtsen In/99
i
Date
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