97-104256r Tl'Y OF FEDERAL WAY
Federal Way, WA rat 00tD it chart:i ca.l In peact;icm Reclt.je5�1.s 25-3--661--4140
253-661-4000
ADI)RFFSf;::3 194:1. 20 -Til Pt_ ,W
NO. - 010920-0 720
PROJEC1* DESCRIPTION;gas piping and install furnace
OWNERamfRII:9amax�a�w .
TOM MOEHLMAN
33941 28TH PL SW
FEDERAL WAY WA 980023
253-924.-0580
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IM CONTRKTO.S, PLIASf: USE
PROJECT VALUATION
1.457
FUEL TYPES.ALE GAS
FANS.....,.. �t
GAS PIPING.:
100 ft
HOOD....... ..: 0
FURN<100K..:
1
DUCT WORY... . - u
GAS NWT....:
0
ROOD S OLS.,.. 0
CONV BURNER:
0
FURN lf1f,41, . , ... 0
BOO........:
0
NIST:.. ..... ,: 0
GAS DPYLR..:
0
AIR 0119111,% 11111%
RANGE.......
0
<:10.00u (in. 0
GAS LOGS...:
0
) 10,000 Or.: 0
ONTRAC TOR ar-==c=sem
ORPA( HEATING >t A/C INC
414 "A" ST SE SUITE 1102
UUURH WA 9800':
LENDER
qty.25(o
IJL:ItMIT NO: MEC.'§7 =i'45
31.0610
iORPANA123115
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CATIO ,! K'4,,M WOFN RTMTING SIkES LAX FOR PRl17EC1S NIIRIN TK CITY Of FEDERAL MAY.
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II:iv'Macr+;11:C;9>AG ::.^:^i:z %t:'z� ..: :: 3"•9iC5C1':
TAX RATE : 8.25 tst
FEES:
polt'rklompw,':, OP,S Mechanical Persitr S 42.00
MEC PRAT TSSPANCE... 4 20.00
10- ! TOtf.... t
rUEL TAtIKS
Ap"',vE GROUND: 0
tfHDFPt;ROUND.: 0 TOTAL FEES ; 62.00
s;xa_....5......._ 11,-m----:,. v.. .. .,: ..r p::ama:aanrsa:tor-:xm"=...40",U==.«KuaY:xrxa:.smzmmaw.Mc —m.
Does the vater supply systes contain a Prassure Reduction Device ilr Check valve? () Yes () No (If "Yes" theft --;;ter expansion tank is required on Not Water Tank)
v�
Inspection Record: Mechanical Rough -i:: _._._._._ Date_., J�--
__Gas Piping DateMLCHANICAt FINh�-_ _._.....__ hate...,4 l�
A+E =.ai F....s }.:...'S'Xi4t".'....6:....'SP0... a.ow....V. :;OWNC1CWaiaS:=.23512.Ss`. Sl36:11,:1¢II4a9i@ 3L..ft.41: ..... .. ._.. Y... :'G: Y'.1 .
PfRN1IS EXPIRE IO0 DAYS AFFER ISSUANCE IF NO INK TS STARTED.
I CERTIFY Tfll 111TORKATTON IURNISNED DY LN: ;S TRUE AND CORRECT TO IK LEST OF NY KNOWLEDGE AND THE APPLICAjKE CITY Of gfE.ff t WAY KIQUIR1011115 HILL K NET.
OWNER OF, AGENT DATI
FIELD COPY
C*TTY ,j)F FEDERAL WAY PERMIT N0: C9 —0 45
33530 F i rs t Way South �'w''ti ;, �;;;;.. F11 ic!) �%41.; . �;,. '°'r N�." "'�" ;..,y' r I ME
C97-0
ISSUED: 11/21/97
Federal Way, WA 93003 Mechanical. Inspection Requests 25::,.661-4140 BY: FC2
253-661-4000 EXPIRES: 05/19/98
ADDRESS:33941 28Th PL SW
NO.: 010920•-.0720
PROJECT DESCRIPTION:gas piping and install furnace
= OWNER =__________.:.____________-____-_____________________= CONTRACTOR =_____=_____ _________________=
_____________= LENDER
TOM MOEHLMAN
NORPAC HEATING & A/C INC
'
33941 28TH PL SW
3414 "A" ST SE SUITE #102
FEDERAL WAY WA 980023
AUBURN WA 98002
a
253-924-0580
931-0610
NORPAHA123M5
CONTRACTORS, PLEASE USE
LOCATION CODE 1732 WHEN REPORTING SALES TAX
FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE
= 8.25 :a:
--- ---____ ------------------------- ----
PROJECT VALUATION
1457
FEES.-----------------
a
FUEL TYPES.:ELE GAS
FANS..........: 0
BOILERS/COMPRESSORS
Mechanical Permit*
$ 42.00
GAS PIPING.: 100 ft
HOOD..........: 0
0-3 TON.....: 0
MEC PRM, ISSUANCE...
$ 20.00
FURN<100K..: 1
DUCT WORK.....: 0
3-15 TON....: 0
1
GAS HWT.... : 0
WOOD STOVES...: 0
15-30 TON...: 0
CONV BURNER: 0
FURN>100K.....: 0
30-5C TON...: 0
F
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
$ 62.00
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: 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 FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT --------- DATE --- 1 _ Ai
FILE COPY
C" Of RECEIVED
uv RY NOV 2 11997
PARCEL #
SITE LOCATION
JI 1 BUILDING�DEPT. AY
APPLICATION FOR MECHANICAL PERMIT
Bun DING DIVISION
33530 First Way South
Federal Way, WA 98003
(253) 661.4000
Fax (253) 6614129
MEC l?- 1)3 L/5
Single Family ❑ Multi -Family ❑ Commercial ❑
Tenant/Owner !11%�'L��� Phone L V 0
Address/City/State/Zip -_ J �� ��'�✓ q �f �� �� /�� n�
Nature of Work
APPLICANT
Name r of
Project Valuation: $ / ! 15-1
�j J i
Address/City/St/Zip
Contact Person �U � T—Le-1211- V-� Phone J I _0 �0 Fax
MECHANICAL CONTRACTOR
Company Name
Address/City/St/Zip �� 1 l T / i SJ SF- -lz 1 � TQ 1 —
Contact Person 1� U/ 11`� Phone Fax
State L & I Contractor Registration # J r PU Z3 / ► Exp. Date
(Card must be presented)
MECHANICAL UNIT COUNT
Fuel Type as/other
Gas Dryer
Air Handlin < = 10 000cfm
Fuel Tanks:
Length of as piping
Range
Air Handling > = 10 000cfm
Above Ground
Fum <100K BTUs
Gas Log
Unit Heater
Underground
Fum>100KBTUs
Fans
Boiler BTU/H
Miscellaneous
Hood
Boiler BTU/H
Other
tH-
mer
Duct Work
A/C TONS
Other
Wood Stoves
A/C TQNS
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 1 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 costs, expenses, and attomeys' 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 Fedemy 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
Mrca.Arr
Revrsm 8126197
Date