97-103923(_11'Y OV FEDLRAL WAY
3a5a0 Fir-st Way �3cmtl,i
Feder -al Way, WA 9800=3
253--661. .4000
AI)LfiESS:5233 SW 3261'11 `31
t4O. : 189830-02*140
PROJECT DESCRIP'FT,0N:G/G REPLACE FURNACE
OWNER
11E GRAVES
5233 SW 32610 ST
FE14RAL WAY WA 99023-1932
246-51108 204_2800
4.0 ... ... -2..
PROJECT VALUATION 3100
fU(i TYPES.:46 GAS 0
GAS PIPING.: 0 ft 0000.. .
F OR H,: 100k . . : I DY(f *wk
GAS 0 WOOD Sfevll.
CORV BURNER: 0 fup*100r....
BOO......... 0 MIS(..... ... 0
AAO DRYER : 0 Alp RAN,; tv 4)) :
I
I HECthelNlCeIL PLAHl ,f
tleclhariical Tw7,pc�(_J.1r_)n ReqUeSts 253-661-4140
is -it, T"t,
CONTRACTOR
C I N REFRIGERATION
1090S 25TH ST (I
EDGEWOOD WA 48372
253-841-3134
PERMIT NO: ME C97
ISSOEID: 10/22/97
11Y. FC2
EXPIRES: 04/19/98
SALES TAX FOR PROJECTS V11111 INE CITY OF F[Im NAY. TAX RAff = 8.25
wchaqikl-.l Perlitt 63.00
20.00
RANGE....... 0 -16,000 (ffl: - 0 AbOVE GROUND: 0
GAS LOGS...: 0 > 10,001) (rltt, 0 UNDERGROUND.: 0
.......... ="=.= ......
Does the water supply systes contain a Pressure Reduceion Device or Check vax., Yes No
TOTAL I[LS $ 83.00
(if 'Yes' then eater expansion tank is required on Hot Water lank)
Inspection Record: mechanical Rough -in Date .... . - __ Gas Pipiqq Date _
MECHANICAL FINAL Date - ___-____
........... W. -m --a
P(mils LXPIRI 140 DAYS AIRR 1ISS10(f If NO WORK is STARTED.
I CERTIFY thi liff mi ON VURVIS"
RE is iRtK An CME( 10 THE Kst of MY Kimuttea An In AMICARE CITY OF 11DIPAL NAY 11"llums Vill K Kj.
OWN(p, Of, AGENT DATE
FIELD COPY
CITY OF FEDERAL WAY PERMIT NO: MEC97-0304
33530 F i rs t way South
i N _ �;-O, 0,4 1, , " ISSUED: 10/22/97
Federal Way, WA 98005 Mecharnic,,�l Insp<�ct:ioIn Requests 253 661-4140 BY: FC2
253--661-4000 EXPIRES: 04/19/98
ADDRESS:5233 SW 326TH ST
NO.: 189830-0240
PROJECT DESCRIPTION:G/G REPLACE FURNACE
- OOWNERLENDER
GRAVES ______________________==__- ___-___= ________-= CONTRACTOR=__________________=__________________=====T=
LEE
C K N REFRIGERATION
5233 SW 326TH ST 10905 25TH ST CT E i
FEDERAL WAY WA 98023-1932 ` EDGEWOOD WA 98372
6 �
246-5208 209-2800 253-841-3134
- ! CNREF**055RN
::: CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE : 8.25 ix;
PROJECT VALUATION 3100
FUEL TYPES.:GAS GAS
FANS..........:
0
BOILERS/COMPRESSORS
GAS PIPING.:
0 ft
HOOD..........:
0
0-3 TCN.....:
0
FURN<100K..:
1
DUCT WORK.....:
0
3-15 TON....:
0
GAS HWT.... :
0
WOOD STOVES...:
0
15-30 TON...:
0
CONV BURNER:
0
FURN>lOOK.....:
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...:
i
1..---------------------------------
0
> 10,000 CFM:
--------------------.------_
0
UNDERGROUND.:
_ -------------
0
FEES:
Mechanical Permit, $ 63.00
MEC PRMT ISSUANCE... $ 20.00
TOTAL FEES $ 83.00
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)
i
Inspection Record: Mechanical Rough -in ----------------- Date ---------- Gas Piping ---------------- Date --__----__
1
MECHANICAL FINAL Date
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THE INFORMATION FURNISH ME IS TRUE AND CORREC TO THE BEST OF MY
OWNER OR AGENT -------------------------
KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL NAY REQUIREMENTS WILL BE NET.
---- DATE _._.....---------------
FILE COPY
PARCEL #:
SITE LOCATION:
Tenant/Owner:
City of Federal Way
33530 First Way South
Federal Way, WA 98003-6210
(253)661-4000
APPLICATION FOR MECHANICAL PERMIT
Single Family ❑
OCT 2 2 1997
(;it Y OF FEUERAL WAY
BUILDING DEPT.
Multi -Family ❑ Commercial ❑
Phone(2L 1) qZ s - l 6 S
Address/City/State/Zip: -<
Nature of work: .v.ca �` } c -'lb "5c- -> _�utv\, c 1eL"Project Valuation: $
APPLICANT:
Name:
�C- eLet`CAel:ti
Address/City/St/Zip: 1 C 20 Z St -y- S -f- <1 ��c� � �- :pc c� �— .� 6f � Z
d l e .�zs 3� gl(1 313`(
Contact Person: S C CU \ Phone Fax: ,
MECHANICAL CONTRACTOR:
Company Name: - U"~ CK
Address/City/St/Zip:
Contact Person:
Phone:
Fax:
State L & I Contractor Registration #: �- E dsS �l Exp. Date:
(Card must be presented)
MECHANICAL UNIT COUNT:
Fuel Type as oth
- Gas Dryer
Air Handlin
< = 10,000cfm
FuelTanks-,
Lenath of ass
an
Air Handring.>
= 1 0,000cfmGround
Furn < 1 OOK BTU's
t Gas LouUnit
Heater
Underaround
Furn > 100K BTU's
Fans
Boiler
T H
Miscellaneous
Hood
it
Conv Burner
Duct Work
C
TONS
Other
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. 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 Naim arises out of the
reliance of the City, including its officers and employees, upiM the accuracy of the information supptiedlo the City as a part of this application.
( \-7
.
Owner/Agent: L,/ Date:—