97-101421v�
(..ITY (J1- [t'N.PCil Wt -'-1 PERM11 NO: ML("/ --(.)1,/`(
W('k Vf.100-'
661 -4000 1" 'J 112* L,
0 I)f)R E '218 tit 1 t 1 0 V E
tI5296 -02"'JO
1- R03 I* r)I--' -X'PfPi L01N:HVAC GAS TO GAS FURNACE REPLAUNINT.
OWNEP ......Sats-. CONTRACTOR .......... LENDER
RON KLIPPING Ey
28635 11TH AVE S
FEDERAL WAH WA '48003
0 F
V,
cl -
**a CONTRACTORS, P11FAS!"U" !Af-0.11bn COW IM MR RfWfflfl#6 50.11-S TAX FOR KOJECIS VIIIIIN 19 CITY Of FEDERAL 11AY. TAX RATE = 8.25 nt
A01,
PROJECT VALUATION 1515
FUEL TYPIS.:GAS ? F BO PS on NCE... 40.00
GAS PIPING.: 0 It H ....... MeCQ 31 44.00
GAS HWT .... : 0
CONY BURNER: 0 FURN>1 0
HBO ........ : 0 "is HP........ 0
IX DRYER—: 0 AIR HANDII is IL TANKS---------
RANGE...
MS---------
RANGE... —.: 0 '10,000 Cfm: 0 ABOVE GROUND: 0
GAS LOGS—: 0 > 10,000 U": 0 UNDERGROUND.: 0 TOTAL fIt", S 64.00
4—r ........... .......
........
Does the water supply system contain a Pressure Reduction Device or Check valve? Yes. No (If "Yes" than water expansion tank is required on Hot Water lank)
7 ....
Inspection Record Water Line Of Mechanical Inspection Notes:
GAS PIPING OK Date By ------
PfIt"lls MIR[ 180 LAYS Affig ISSUAKE It NO VOPt Is SIARIM KfSom!lv UANG nails EXP19f, OK YfAR Al I[R DAff Of ISSON(l.
I CERTIFY 19t, IN "MA111911 FUPHIS&D BY N1 IS TRUI. AND t:ORR£CT lq,
'W'KVeNW1K1 NO T111- APKICAILF (jjY Of I'LDIEM MAY RUNIKEMINTS WILI, K Nil.
FIELD COPY
SETBACKS & FOOTINGS
Date By
FOUNDATION WALLS
Date By
PLUMBING GROUNDWORK
Date By
UNDERFLOOR FRAMING
Date By
SHEAR WALLS
Date By
PLUMBING ROUGH -IN
Date By
GAS PIPING
Date By
MECHANICAL ROUGH -IN
Date By
7AN1AL=(oTHER
Date�^ `�C� ^ By
FRAMING
Date By
INSULATION
Date By
GWB - 1ST LAYER
Date By
GWB - 2ND LAYER
Date By
SUSPENDED CEILING
Date By
PLANNING FINAL
Date By
ENGINEERINGFINAL
Date By
FIRE FINAL
Date By
BUILDING FINAL,
Date By
OTHER
Date By
OTHER
Date By
CDO193
CITY O F FEDERAL WAY w, ,.,.. I d ;;r, �t:; a P1...�,..,,�,.,.
33530 First Way South '. II -111 "'ti .. ��.,.1� �i ....... �
Federal Way, WA 98003 Building Inspection Requests 661-4140
661-4000
ADDRESS:28635 11TH AVE S
NO.: 515296-0250
PROJECT DESCRIPTION: HVAC - GAS TO GAS FURNACE REPLACEMENT.
¢= OWNER =___________________________________________________ CONTRACTOR
J RON KLIPPING
28635 11TH AVE S
FEDERAL WAH WA 98003
( 941-8032
LENDER
PERMIT NO: MEC97-0140
ISSUED: 04/24/97
BY: KLC
EXPIRES: 10/20/97
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 Water Line OK ---------- Mechanical Inspection Notes: ..........................................
GAS PIPING OK ---------- Date ------ By
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO MORK IS STARTED.
I CERTIFY THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT
PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
DGE AND THE APPLICABLE CIT! OF FEDERAL MAY REQUIREMENTS WILL BE NET.
-____-- DATE
FILE COPY
=t= CONTRACTORS, PLEASE USE
LOCATION CODE 1732
WHEN
-----------------------------
REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE =
8.25
=xi
PROJECT VALUATION 1515
FEES:
FUEL TYPES.:GAS
? FANS..........: 0
BOILERS/COMPRESSORS
MEC PRMT ISSUANCE...
$
20.00
GAS PIPING.: 0
ft HOOD..........: 0
0-3 HP......:
0
Mechanical Permit*
$
44.00
FURN<100K..: 1
DUCT WORK.....: 0
3-15 HP.....:
0
GAS HWT.... : 0
WOOD STOVES...: 0
15-30 HP....:
0
CONV- BURNER: 0
FURN>100K.....: 0
30-50 HP....:
0
BBQ......... 0
MISC.........,: 0
5+ HP........
0
GAS DRYER..: 0
AIR HANDLING UNITS
FUEL TANKS ---------
RANGE ...... : 0
<=10,000 CFM: 0
ABOVE GROUND:
0
GAS LOGS...: 0
> 10,000 CFM: 0
UNDERGROUND.:
0
TOTAL FEES
$
64.00
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)
Inspection Record Water Line OK ---------- Mechanical Inspection Notes: ..........................................
GAS PIPING OK ---------- Date ------ By
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO MORK IS STARTED.
I CERTIFY THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT
PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
DGE AND THE APPLICABLE CIT! OF FEDERAL MAY REQUIREMENTS WILL BE NET.
-____-- DATE
FILE COPY
City of Federal Way t
cfTv of 33530 First Way South
_ - -
Eopp
Federal Way, WA 98003��
(206)661-4000 v
APPLICATION FOR MECHANICAL PERMIT
PARCEL --I (P 0Single Family Multi -Family ❑ Commercial o
SITE LOCATION:
Tenant/Owner: J 1 �1 I e u Oj2 Phone:
Address/City/State/Zip: �' -2)S- - "' A, -L)
Nature of work: - r H tF' (n+A f 9E,2 Project Valuation: $ l
APPLICANT:
Name:
Address/City/St/Zip:
Contact Person:
MECHANICAL CONTRACTOR:
Company Name: _L � a
Fax:
Address/City/St/Zip: Z C6 00 tt(S pD ' %z Ai,YL�
Contact Person: 1_ �J Phone: t `�'� Fax:
State L & I Contractor Registration #: 1C)RT4VJ y ► � � Z- Exp. Date: —�
(Card must be presented)
MECHANICAL UNIT COUNT:
Fuel Type (gas/other)
Gas Dryer
Air Handlin
< - 10,000cfm
Fuel Tanks:
Length of gas piping
Range
Air Handlin
> - 10,000cfm
Above Ground
Furn <1OOK BTU's
Gas Log
Unit Heater
Under round
Furn > 1 OOK BTU's
Fans
Boiler
BTU/H
Miscellaneous
Hwt
Hood
Boiler
BTU/H
Other
EGas
Conv Burner
Duct Work
A/C
TONS
Other
Wnnd Stoval
A&
IONS
DISCLAIMER: 1 certify under penalty of periury that the information furnlle true
premises to perform the work for which permit application is made. ��:rs
o a
incurred in investigation and defense of such claim), which m&5 5by
out of thereliance of the City, including its officers and yea, upon acc
Owner/Agent:
bat of my knowledge and further that t am suthorixad by the owner of the above
if Federal Way as to any claim lintektdirtp cats. expenses; and attorneys' fees
nod, and filed against the City of Federay Way but only where such dam arises
ied to the City as • part of this application.
Date: