97-1006411. 1 1 tit t- t 1.,1 ) lit
il(: I I FA C", ft g-1 "t, T
,�f735'40 Fii-sl, W�Aw
Vede-r�il W;-iy, WA 1,11wj
e,61 - 4000
ADL)R['.t; =;:2907 ",� 2841`11
NO.: 7'4020-0450
PROD EC I DESCR I P I ION: OVA( - GAS TO GAS FURRA(l REPLACEMENT.
F)tRfvfli NO: MFC9,f jui-i
BY: K L, C
1. ',(.IRE'S:
OWNER...... ......... .. ;- ................. . ..... CONTRACTOR ....... LEND[P . ........
MURIE1 VERCOUTERE NORINW[SI WATER HEATER
2901 S 284TH ST 8201 DURANGO ST sw
FEDERAL WAY WA 98003 TACOMA WA 98499
941-w3 984 x404
"A err:....... . . . . . .
tst (011RAC14k, PtIASft SAI C SALES TAX FOR PNOJUCIS WITHIN Iff, CITY Of F[KRAt NAY. TAX RATE = 8.25 23
PROJECT VALUATION 1885
FUEL TYPES.:GAS ? FANS........' bo V it-Alml-PL, --,w
GAS PIPING.: 0 It HOOD.
FURN(IOOK..: I DKOWWW%"Aftook" 5
GAS NWT..... 0 N 3 P.
CONY BURNER: 0 0 P.
BBQ......... 0 his(..
GAS DRYER—: 0 AIR RAN 61W 1 K ------
RAKE ...... 0
—10 00 VE D: 0
GAS t0fS ... 0 > 10:0001 C 0 ADERGROUND.: 0
Does the water supply system contain a Pressure Reduction Device or Check valve?
Inspection Record Water Line Ok Mechanical Inspection Note,
GAS PIPING Of Date b
PLRNIIS EXPIRE 180 SAYS AFTER [SSME If NO WORK IS ,
I (fRIIfY IR INFORMATION FURNISHED BY ME IS TPOf AND
ow"(P OR AGENT
o(f ... 1 20.00
reit* $ 50.00
$ 10.00
.. ---1--n=- —g—,: a.. ;-- .........:a . . . . .:— :....e.:_...
() Yes 0 No (if 'Yes' then water expansion tank is required on Not Water Tank)
�I ON, '44�- (0-- -.1
AW®lx PfRNIFS EXPIRE Ow YEAR AFIFN PAT[ OF IS'Awl.
Of MY DISE Ab Illf APPIICAK[ CITY Of FLNIAL WAY REQUIREMENTS 1111.1 BE 111-1.
FIELD COPY
CITY OF FEDERAL WAY
33530 First Way South
Federal Way, WA 98003
661-4000
HE( Z7 t...I M ICH L �° Ali I T
Building Inspection Requests 661-41.40
ADDRESS:2907 S 284TH ST
NO.: 730320-0450
PROJECT DESCRIPTION: HVAC - GAS TO GAS FURNACE REPLACEMENT.
p= OWNER
MURIEL VERCOUTERE
2907 S 284TH ST
FEDERAL WAY WA 98003
1
941-5573
CONTRACTOR
NORTHWEST WATER HEATER
8201 DURANGO ST SW
TACOMA WA 98499
984-6404
NORTHWH103R2
LENDER
PERMIT N0: MEC97-0071
ISSUED: 02/25/97
BY: KLC
EXPIRES: 02/19/98
*** CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL NAY. TAX RATE = 8.25 ***
,I 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 WORK IS
I CERTIFY THE INFORMATION FURNISHED BY ME IS TRUE AND
OWNER OR AGENT
I GRODING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
MY ONIEDGE AND THE APPLICABLE CITY OF FEDERAL MAY REQUIREMENTS WILL BE NET.
--------------- DATE
FILE COPY
{ PROJECT VALUATION
1885
FEES:
FUEL TYPES.:GAS ?
FANS..........:
0
BOILERSJCOMPRESSORS
MEC PRMT ISSUANCE...
$ 20.00
GAS PIPING.: 0 ft
HOOD..........:
0
0-3 HP......: 0
Mechanical Permit*
$ 50.00
FURN<IOOK..: 1
DUCT WORK.....:
0
3-15 HP.....: 0
j
GAS NWT....: 0
WOOD STOVES...:
0
15-30 HP....: 0
CONV BURNER: 0
FURN)100K.....:
0
30-50 HP....: 0
f BBQ......... 0
MISC...........
0
5+ HP........ 0
GAS DRYER..: 0
AIR HANDLING UNITS
FUEL TANKS ---------
--------RANGE......:
RANGE ...... 0
<:10,000 CFM:
0
ABOVE GROUND: 0
.I
GAS LOGS...: 0
> 10,000 CFM:
0
UNDERGROUND.: 0
TOTAL FEES
$ 70.00
,I 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 WORK IS
I CERTIFY THE INFORMATION FURNISHED BY ME IS TRUE AND
OWNER OR AGENT
I GRODING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
MY ONIEDGE AND THE APPLICABLE CITY OF FEDERAL MAY REQUIREMENTS WILL BE NET.
--------------- DATE
FILE COPY
City of Federal Way
CITY OF 33530 First Way South
- Federal Way, 98003 C 0D
(206)661-4-4 000 ___ ttt l
V�V
APPLICATION FOR MECHANICAL PERMIT
PARCEL O �� O 'C �O -
Single Family Multi -Family ❑ Commercial ❑
jI
r " V `J
¢U' la DEPT.
SITE LOCATION:
L_
Tenant/Owner:.,AA._��, I�' %� n i J_ Phone:
Address/City/State/Zip:
Nature of work: ( ����V � �- I'-�'(J � �+�fProject Valuation: $
APPLICANT:
Name: i
Address/City/St/Zip:
Contact Person:' --- Phone:
MECHANICAL CONTRACTOR:
Company Name: - b-1 a 9:Rt1 1
Fax:
Address/City/St/Zip: Z C'E_,-D O o (Irtk!Y D"e �� / V I� � �> >�(s� iG t� i -F G7
Contact Person: �L 1�(Ii�-:L L ` I Phone:11 I
State L & I Contractor Registration #: �10RTk-l1lti I Exp. Date: 12
(Card must be presented)
MECHANICAL UNIT COUNT:
Fuel Type (gas/other)
Gas Dryer
Air Handling <
= 10,000cfm
Fuel Tanks:
Length of gas piping
Range
Air Handling >
= 10,000cfm
Above Ground
Furn <100K 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 Work
A/C
TONS
Other
Wood Stoves
A/C
TONS
DISCLAIMER: I certify under penalty of perjury that the information fur ni y e is true
premises to perform the work for which permit application is made. rther agree to sa
incurred in investigation and defense of such claiml, which ma made by any pens in
out of the reliance of the City, including its officers and em yeas, upon acc
mrect best of my knowledge and further that I am authorized by the owner of the above
City f Federal Way as to any claim (including coats, expenses and attorneys' fees
the undani sed, and filed against the City of Federay Way but only where such claim arises
nation sup lied to the City as a part of thus application.
Owner/Agent: k 4 1 Date:
r�