99-103504c:ITY OF FEDERAL WAY
3353U Fir.st Way South
Federal Way, WA 98(. 03
L53-661--4000
ADDRES13:34503 9TH AVE S
NO.: 750451-0050
PROJECT' T)ESCPTPT10N.-.HVAC
llechao.i�.al Inspectiovi 2b3-661, 4140
Uni f: 211
- 2 VAV BOXES AND DUCTING - ALL INTIRIOR
OWNER
JEFFERY BwGus, DR.
34503 4T11 AVE S
FEDERAL WAY WA 90003
425-889-9019
sts camuoks. ntw u�t wfinop
CONTRACTOR =---
MKDORALD MILLER
7717 DEIROIT SW
SEATTLE 4A 98106
206-163-9400
MA(DOM3248J9
LENDER
PERMIT NO: MEC99-0-301
ISSUE I.),- 09/10/99
BY: FC2
r:-"f1'frLS-. 0,110,7100
9q— I red350ii
KONG SALES TAX FOR PROJECTS VITNIN IR CITY N ftKIAL VAY. TU RATE : 9.25 M
-
PROJECT VALUATION 10000 NA
FEES:
FUEL TYPES--?
FANS. 00 R NECH PERMIT FEE 181.25
....
GAS PIPING.: 0 R HOOD........:
, X
h�
FURNIOOK, . : 0 DUCT NMI
GAS HWT....: 0 WOO -3 ON
(ORV BURNER: 0 FURNI 100f. 0 0 ")'lH,..:
H",......... 0 MISS',... ;w TOP ..... 0
GAS DRYER..: 0 AIR HANDL!HG UNITS HiEt r0l`
-a----
RAKE....... 0 /40,090 1!'M- 0 ;,i0q RaRQUND: 0
GAS LOGS...: 0 > 10,0011 Cite 0 UNDERGROUND.: 0 TOTAL FEES 181.25
Does the water supply system contain a Pressure Reduction Devire or Check valve? Yes No (It *Yes* then water expansion tank is required on Not water lank)
- ?
Inspection Record: mechanical Rough Dat. 5cGas Piping Date
MECHANICAL HN0, ole Datt le—Aa-7il ov`� i e{ �-H— `��22 f Ct�
—
PENNIFS EXPINE 100 DAYS At[[R ll's-SUAKI If NO V091 IS STARTED.
I ("Tif Y INE INFORMATION It NISKV By K is IRK AW (OR QCT to THE Nsl of MY twwl I PG1 AND Rf APPI. ILAOLI (Py Of FEKHL MY REQUIALRENIS WILL IF NLT.
OWNER OR AGENT DA) L
or
FIELD COPY
CITY OF FEDERAL_ WAY PERMIT NO: MEC99-0301
33530 F i rs t Way South �'r.:�� ,.,; ,,..p iW,'$ �,;!''M :,�,: µ' »,,;: iW'�i �....... ;,,+n ";;:.: " I, �'r„`� :, ,,: ” ISSUED: 09/10/99
Federal Way, WA 98003 Mechanical Inspection R,!.quests 253-661-4140 BY: FC2
253-661-4000 EXPIRES: 03/07/00
ADDRESS:34503 9TH AVE S
NO.: 750451--0050
PROJECT DESCRIPTION:HVAC
Unit: 210
- 2 VAV BOXES AND DUCTING - ALL INTERIOR
OWNER=________________________________ ___________ _______ CONTRACTOR
JEFFERY BURGESS, DR. MACDONALD MILLER
34503 9TH AVE S 7717 DETROIT SW
FEDERAL WAY WA 98003 SEATTLE WA 98106
425-889-9099 206-763-9400
MACDOM*248J9
LENDER
__= CONTRACTORS, PLEASE USE LOCAT:ON CODE 1732 RHEA REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL HAY. TAX RATE : 8.25 s**
PROJECT VALUATION
10000
F FEES:
FUEL TYPES.:?
?
FANS...........
0
30ILERS/COMnQFccn0c
MECH PERMIT FEE
GAS PIPING.:
0 ft
HOOD. .......:
0
0'ON ..... ,
0
FURN<100K..:
0
DUCT +WORK..... :
?
3 TC°+....:
GAS HWT....:
0
WOOD STOVES_:
0
IS 3 T,N
CONV BURNER:
0
FURN>100K.....:
0
30-5.3 TON....
BBO........ .
0
MISC...........
2
50+ TON......
O
GAS DRYER..:
0
AIR HANDLING UNITS
FUEL TANKS---------
RANGE......:
0
c:10,000 CFM:
0
ABOVE GROUND:
0
GAS LOGS...:
0
> 10,000 CFM:
0
UNDERGROUND.:
0
TOTAL FEES
7
Does the water supply system contain a Pressure Reduction Device or Check valve? ( ) Yes ( ) No (If "Yes" then water expansion tank is required
Inspection Record: Mechanical Rough -in ---------------- Date ---------.. Gas Piping ---------------- Date
MECHANICAL FINAL Date
$ 181.25
181.25
on Hot Water Tank)
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THE INFORMATION FURNISHED BY ME IS TRUE AND COR CT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CI Y OF FEDERAL WAY REQUIREMENTS WILL BE MLT.
OWNER OR AGENT � f /o G /
------ --- --------------------------------------
DATE
FILE COPY
crrr of
A
: -
PARCEL #
BUII DING DMSION
33530 First Way South
Federal Way, WA 98003
(253) 6614000
Fax (253) 6614129
DEQ 1 � 1041
,,PLICATION FOR MECHANICAL PERMIT
BUiI_0_u pEP'TFederal Way Business License number: ;
MECC161 b 3C A
Single Family ❑ Multi -Family ❑ Commercial )<
SITE LOCATION r 3,1 fol
Tenant/Owner f RA 42 1 L C :l V %Z / �% -^� Phone
L •�
Address/City/State/'Zipc'
` xL/ �
Nature of Work �/ C 01 Aol/
APPLICANT
Project Valuation: $
Name y///1& c �Dr,,y 41 lt-_� _ 2 -1',
Address/City/St/Zip
�7 / f m it-�,1 -F,4 ,, S(_1\_1'Ji � � 477C
Contact Person � %� Phone 2-,C�16 — 16 9 2VS9 Fax � c
MECHANICAL CONTRACTOR
Company Name 1�Y ��-),A14-L 1 > ` ��% L � /L'
Address/City/St/Zip -� 1 -�� i T A U r ("u ;4 C) ,;
Contact Person ,/�'4 /�/ Phone �6-4 ,c 8 %h "L Fax W6 46 4110'?
State L & I Contractor Registration # �✓� /' �� �� cj Exp. Date 61/4
(Card must be presented)
MECHANICAL UNIT COUNT
Fuel Type as/other
Gas Dryer
Air Handlin < = 10 000cf n
Fuel Tanks:
Length of gas piping
Range
Air Handling > = 10 000cfm
Above Ground
Fum <100K BTUs
Gas Log
Unit Heater
Under ound
Fum > 100K BTUs
Fans
Boiler BTU/H
11
Miscellaneous V
Gas Hwt
I Hood
I Boiler BTU/H
Other
Conv Burner
Duct Work
A/C TONS
Other
Wood Stoves
DISCLAIMER I certify, under penalty of perjury, that the information famished by me is true 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. I further agree to save harmless the City of Federal Way as to any claim Cmcluding 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.
_fes i
Owner/Agent �� 'Z, /�� -"�`Z Date 4b,
Mrcn.APP
REv m 1/7/99