97-103358CITY OF FEDERAL_ WAY� pp ll � �r y
33530 F i rs t; Ways South il , l 11;;;;;. �..,.. II,,.,.11 it;`„; �K' ..II,,. � •... !i�„. ..,,,� ll:.,.•. �;;;�, I� ii ., . ,,,�,..
Federal Way, WA 98003 Mechanical-1r)spection Requests 25:3--661-4140
253-661-4000
ADDRESS:33702 21ST AVE SW
NO.: 242103-9099
PROJECT DESCRIPTION. HVAC - GAS PIPING AND DUCTWORK
PERMIT NO: MEC97-0261
ISSUED: 10/08/97
BY: FC
EXPIRES: 04/05
4
p= OWNER _______________________________________________= -==r= CONTRACTOR =_________________________________-__________.
LENDER
FRED MEYER
UNITED SYSTEMS INC
33702 - 21ST AVE SW
1021 SW KLICKITAT WAY, STE 104
FEDERAL WAY WA 98023
SEATTLE WA 98134
503-797-3529
g�
a
; 654-3340
UNITESI176RB
=is
CONTRACTORS, PLEASE USE
LOCATION CODE 1132 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY
OF FEDERAL MAY. TAX RATE
= 8.25
PROJECT VALUATION
17500
`
FEES:
FUEL TYPES.:GAS GAS
FANS..........: 0
BOILERS/COMPRESSORS
MECH PLAN CHECK FEE
$
47.25
GAS PIPING.: 580 ft
HOOD..........: 0
0-3 TON.....: 0
MEC PRMT ISSUANCE...
$
20.00
FURN<100K..: 0
DUCT WORK.....; 1
3-15 TON,...: 0 ;
Mechanical Permit*
$
189.00
I GAS HWT....: 0
WOOD STOVES...; 0
15-30 TON...: 0
CONV BURNER: 0
FURN>100K.....: 0
30-50 TON...: 0
BBQ........: 0
MISC..........: 0
50+ TON.....: 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
TOTAL FEES
$
256.25
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 INFORMATION WISHED BY ME S TRUE D CORRECT TO TIE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT __--------- - --� - -- (I —------------------------- DATE ... !_v -1--_ 1i 2 -
FILE COPY
. ,
.
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cllY OF FEDERAL WAY PERMIT NO: MEC97-0261
93530 First Way South. MECHANICAL PERMIT P".;SUED: 10/08/97
Federal Way. WA 9$3003 Mechanical Inc4Dection Peque-as 233-661-4140 BY: EC
25.3-661-4000 ,.....'' EXPIRES: 04/05/98
(
`'ADDRESS:33702 21ST AVE SW
NO. : 242109-9099,v .
.PROjECT DESC1PTION:MMC - WPIPINGANDIMOWAk
it
- oNN0 .......................................... . CONTRACTOR wm,A.AantomNstm.aessm..===u=sat,sm7==mmiumwrommmatommtvg . LENDER ..........................................:,
IFRED MEYER UNITED SYSTEMS INC
33702 - 21ST AVE SN 1021 SN KLICTITAT NAY, STE 104
IFEDERAL WAY WA 98023 1 SEATTLE NA 98134
I 503-797-3529 654-3340 \
UM TE441,74,8,
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Its CONTRACTOC, PILAU USt EOCAI100 C1)( 1737 MP REPOPTINC SALES TAX FOR PROJECTS WINTOE CITY Of MERU NAL fAX SATE : 8.25 tss
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1 PROJECT VALUATION 17500 - , FEES:
1 MEL TYPES.:GAS GAS FANS.... -,:s 0 Eo!LEP..!COMPPi]seEt MECH PUN CHE4 FEE i 47.25
GAS PIPING.: 580 ft HOOD : 0 n-3 i* ..: - tiSIGACE... $ 20.00
FURC100f..: 0
IRI CONY 108 ,. .. 1
WOoD HAqs.,.- 0
FUROW .. : ',) 3.15 TOP n
1Sy30 40#...: 0
a-50 TON...: e I ti,--,hnica, Pertitt $ 189.00
BOO • 0 DISC..........: 0 504 TON ....: 0
GAS DRYER..: 0 AIR NANDLIi UNITFUR l .----..
RANGE 0 e.:10,000 OM' 0 alt GBOUID: 0
GAS LOGS...: 0 ; 10,000 , tti. 0 OTTiHD.: 0 TOTAL TEES $ 256.25
,c.Peic,mt,.Q1.1.01 7.A 1:-1,..,=a r7-ade.V.....,=.z..,,,...........,11.4....-X.,87.1.70,4ana.0.ma.X... xottratow assass;r:obsmwe t,..=:.mc.:ISR”ta 4.11.12=0,Jr....it;=......r1 CM 4=WISIC.3.14-4,1142T W.V a= AIIMM .41111.0=St 7S:29=V:
Does the water supply systei contain a Pressure Reduction Device or Check valve? ( ) Yes ( ) No (If 'Yes' then water expansion tank is required on Hot Water Tank)
1 Inspection Record: Mechanical Rough-in Date Gas Pipin Olc... (9 ..--. Date .4.:70.-..7.?" --
......,......___
MECHANICAL FINAL ,45.k.....,_All„__ Date 12„74, 7!-913
121M.Tin.YX.,.....lael,.:2==¢=SA Y al 4.4ffir,,11[1.44 Wit; V.Ar.ES IC=X'ATVIM WIlliOLAC V9VOIM,MS IMI.VIEWiti021W&A UMZ.X.4 ViaP*=ARA 2.9 AD.==UV Mta xi...... . . , ,......,4.14.2 Saltrit20 X.CIMIZIMat 0.401:10:1,21112:VAMMi.PZ SI,..%iSinlia.S*4114310.4.S4,2MSA TeC2,23(MAU k,X=412,:=an.. .
PERMS EXPIRE 188 DAYS All IN ISSUANCE IF NO YORK IS STARTED.
I-CERTIFY THE INFOINIATION NISNED Y $1 iS TRUE ,N10 CORRECT TO Ilk NISI 01 MY 1NOWEEDGE A114 1111 APPLICANc1 CITY OF FtlfRAt WAY REORRENINIS VIII RE NET.
VOW oB AGENT 4.."
.C.1,A1
(......- DATE 0 *Vfl
FIELD COPY
City of Federal Way
CITY OFG 33530 First Way South
_ Federal Way, WA 98003
(206)661-4000�,v� D„
WY
uv FA'L� /
APPLICATION FOR MECHAN/CA,41PERM/T /►�l .
A- �4� r%'
PARCEL �U o`�l ii Single Family 0 X6V Multi -Family Commercia'/
3 \ �
SITE LOCATION:
Tenant/Owner: ��P' Phone:3J
Address/City/State2ip: ` 60%� ( f0A;(raan 0�,
.a ��j 0 ( )(r0 - 41 Project J'�� Pro ect Valuation: $
Nature of work: �� 1
APPLICANT:
Name:
Address/City/St2ip:
Contact Person: Phone: Fax:
MECHANICAL CONTRACTOR:
. . _, n
Company Name: I,t `KI -4
.E �.W• Kkt�1�,t We d( ICO
Address/City/St/Zip:
01 I
Contact Person: t? i "("' S� Phone: b5l`� 3340 Fax: WtU n
State L & I Contractor Registration #: �IZTL�� �y� Exp. Date:
(Card must be presented)
MECHANICAL UNIT COUNT:
Fuel Type 6a /other)
Gas Dryer
Air Handling < = 10,000cfm
Fuel Tanks:
Length of gas piping 5�6
Range
Air Handling > =
10,000cfm
Above Ground
Furn <10oK BTU's
Gas Log
Unit Heater
Underground
Furn >1o0K BTU's
Fans
Boiler
BTU/H
Miscellaneous
Gas Hwt
Hood
Boiler
BTU/H
Other
Conv Burner
Duct y1(ork
A/C
TONS
Other
Wood Stoves
A IC
TONS
DISCLAIMER: I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge and further that I 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 (including costa, 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, includiryl'i s officers and employeesf, upon ^he accuracy of the information supplied to the City as a part of this application.
Owner/Agent:
Date: U