97-100670(I I W� I y tq(i
4 1 '�; I f4 ", F M
tlfl.: 4"'/900..U' 311
OWNER
WIL110 BOFJESON
33427 41S] AVE SW
FEDERAL WAY WA 98023
815-1619
------------ I ------ I -------
ns CONTRACT V v
n, .... MM—In--� ...... '-0
PROJECT VALUATION 250
FUEL TYPES.:? ? IANS ........
GAS PIPING.: 0 ft HOOD........
FUR9<100K..: 0 DUO -
GAS owl .... : I WrN
COMV BURNER: 0 row
BBQ......... 0 "is
GAS DRYER—: 0 AIR
RANGE......: 0 <:10
GAS LOGS...: 0 > :0
it)
MECHANICA-L
bii r)�'l I fic,ri 1�equ(-"c Ls 661
PFRMII NO: ML(97-00113
C
CONTRACTOR. — ......... ..... . � LENDER
OWNER IS IN[ CONTRACTOR
ING SALES TAX FOR PROJECTS VIININ M CITY Of FtKKA1 WAY. TAX RATE 8.25
FEES:
Mechanical Permits 22.00
TOTAL FEES $ 42.00
.................. =— ............. ---- ........ --.— .... I --- . . . . . . . *= . . . . . .
Does the water supply system contain a Pressure Reduction Devices Check valve? Yes No (If "Yes" then water expansion tank is required on Not Water Tank)
Inspection Record Water Line OK Mechanical /A pectiqn No es:
GAS PIPING OK Data By
.................................... .........
lita"Ifs MINE Igo DAYS Affrk ISSUANCE If NO WORK IS STARTED. RESIKIIIAL AND UADING, PERAM 1MRt ONE YbA Atilt DATE Of ISSUANCE.
I (EATIfy TNI INFORMATION FURNISHED NY it Is TRUE AND (01111JECT TO INE BEST Of NY INMEDGE 09 1111 APPI-Milli-I (fly Of 1101RAI WAY R1.001k[KNIS 11111. OF Rif,
er" ;:Iry
0WH[F OR Aff"I '0 DATE 7
FIELD COPY
CITY OF' FEDERAL_ WAY
385:30 First Way south
Federal. Way, WA 98003
661-4000
ADDRESS:33427 41ST AVE SW
NO.: 327900-0230
PROJECT DESCRI PTION: INSTALLLING A WATER HEATER
OWNER
WILLIAM BORJESON
33427 41ST AVE SW
FEDERAL WAY WA 98023
815-1679
PERMIT NO: MEC97-0073
(C .�;;: �;�°: L ERM :�;; 7- ISSUED: 02/26/97
Building Inspection Requests 661-•4140 BY: FC
EXPIRES: 02/20/98
CONTRACTOR
OWNER IS THE CONTRACTOR
LENDER
S*; CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL NAY. TAX RATE : 8.25 sts
PROJECT VALUATION
250
FEES:
FUEL TYPES.:?
?
FANS..........:
0
BOILERS/COMPRESSORS
Mechanical Permit*
$ 22.00
GAS PIPING.:
0 ft
HOOD..........:
0
0-3 HP......: 0
MEC PRMT ISSUANCE...
$ 20.00
FURN<100K..:
0
DUCT WORK.....:
0
3-15 HP.....: 0
GAS HWT....:
1
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
$ 42.00
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
GAS PIPING OK
Mechanical Inspection Notes:
Date ...... By
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THE INFORNATIyONN FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLEE CITY OF FEDERAL MAY REQUIREMENTS WILL BE NET.
'�L - ---- DATE �l _24 L_7
OWNER OR AGENT �Z_, --- ---------------------------- I� ----
FILE COPY
MMUNIR UEELOPM NT DEPARTMENT
CO ,
CITY OF G BURRING DIVISION
FEB 2 61997 33530 First Way South
Federal Way, WA 98001v
(206)661-4000
Fax (206) 6614129
APPLICATION FOR MECHANICAL PERMIT
MEC Cy . l — 0 07
PARCEL # Single Family 0 Multi -Family ❑ Commercial ❑
SITE LOCATION
Tenant'
LL -i I�J�yI /I/,
/�J/�,/ S'cj r�i
Phone �/ S ' /(P 7 /
Length of gas piping
Range
Address/City/State/Zip
3 Z
7 S 'd �� SG'�� /'k �� w� ,�
�✓ �1 G v Z 3
Nature of Work
APPLICANT
Name ��'�� /I—
Address/City/St/Zip Address/City/St/Zip
Project Valuation: $-2—
Name
2
Contact Person Phone Fax
MECHANICAL CONTRACTOR
Company Name
Address/City/St/Zip
Contact Person Phone
State L & I Contractor Registration #
(Card must be presented)
MECHANICAL UNIT COUNT
Fax
Exp. Date
Fuel Type as/other
Gas Dryer
Air Handling <= 10 000cfin
Fuel Tanks:
Length of gas piping
Range
Air Handling > = 10 000cfin
Above Ground
Fum <100K BTU's
Gas Log
Unit Heater
Underground
Fum >100K BTUs
Fans
Boiler BTU/H
Miscellaneous
Gas Hwt
I Hood
I Boiler BTU/H
Other
Conv Burner
Duct Work
A/C TONS
Other
DISCLAIMER: i certify, under penalty of pequry, that the information famished 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 pemut application is made. I further agree to save hamdess 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 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
MwH APP
Rin m 12/11/96
Date Ai 7