99-101738CITY OF FEDERAL_ WAY
33530 First Way South
Federal Way, WA 98003
253-661-4000
ADDRESS:30506 1211 PL.. SW
iP rr E #,..1 ,y.11 if-) i N
hIechardcal Irisp>ection Requests 253-661-4140
i
NO.: 178850--0070
PROJECT DESCRIPTION:MEC - INSTALL GAS LINE EXTENSION WITH ATTACHED GAS LOG SET AND KITCHEN
OWNER=_____=__________________________________ ___________ CONTRACTOR
RICHARD BUSHEY OWNER IS CONTRACTOR
30506 12TH PL SW
FEDERAL WAY WA 98023 .
253/945-6340
E
'A
*i CONTRACTORS, PLEASE USE LOCATION CODE 1732 NNE R4sj�
PROJECT VALUATION 3500
FUEL TYPES.:GAS ? FANS..........: 0
GAS PIPING.: 35 ft HOOD..........: 0
FURN<100K..: 0 DUCT WORK.....: 0
GAS HWT....: 0 WOOD STOVES...: 0
CONV BURNER: 0 FURN>100K.....: 0
BBQ......... 0 MISC......... 0
GAS DRYER—: 0 AIR HANDLING U
RANGE......: 1 *<a0y CFM
GAS LOGS...: 1
Does tlrw'Aer su&v1vs1%kc%b1k a R
InspecWRecjj%&M4QU&l WP -in
FINAL
BC
3- .l
15-
30-50
50+ TC ..
ENDER
ERMIT IVO- EC99-0161
I: D: 05/06/99
BY: FC2
EXPIRES: 11/01/99
FOR PROJECT III THE CITY OF FEDERAL.WAY. TAX RATE : 8.25**
FEES:
I MECH PERMIT FEE $ 97.25
`s
NLM
i
AB' ROUND: 0
RGROUND.: C TOTAL FEES $ 97.25
ure Reduction Device or Check valve? () Yes () No (If "Yes" then water expansion tank is required on Hot Water Tank)
Date ---------- Gas Piping ---------------- Date
Date
PERMITS EXPIRE 180 S
MATAFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THE I ION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL NAY REQUIREMENTS WILL BE MET.
OWNER ORA ?TrK ----------------------------------------------------- DATE
FILE COPY
MY of G
uv AY ,:IE C IVED
MAY 0 61999
PARCEL #
SITE LOCATION
APPLICATIQN fQR,1 r4HANICAL PERMIT
BUILDING DEPT.
BUIIAING DmsroN
33530 First Way South
Federal Way, WA 98003
(253) 6614000
Fax (253) 6614129
MEC,!"9 — �(p
Single Family X Multi -Family ❑ Commercial ❑
Tenant/Owner /;�l/GLi.��,�,-/ Phone ..2y -S - V 0
Address/City/State/Zip 3 QSO Z- -
Al / cr
Nature of Work -I ], ri4 G � ;2,4 t (ty e. E'd rem-WAI w .Y Project Valuation: $ 4Sp 0
-417Ae e d gA15- 40-) S e -r .4,vd K t r c L e,v ✓Z,a, v � c--- -
APPLICANT
Name
Address/City/St/Zip
Contact Person
MECHANICAL CONTRACTOR
Company Name
Address/City/St/Zip
Contact Person
Phone Fax I
Phone
Fax
State L & I Contractor Registration # Exp. Date
(Card must be presented)
MECHANICAL UNIT COUNT
Fuel Type as/other
Gas Dryer
Air Handlin
< = 10,00061n
Fuel Tanks:
Len of as i in S f Ran
a
Air Handling>
= 10 000cfm
Above Ground
Furu <100K BTUs
Gas Log
Unit Heater
Underground
Fum>100KBTUs
Fans
Boiler
BTU/H
Miscellaneous
wtHood
Boiler
BTU/H
Other
LConBurner
Duct Work
A/C
TONS
Other
Wood Stoves
A/C
TONS
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. I further agree to save harmless the City of Federal Way as to any claim (mcluding 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
MEco-AEE
REv ED 8/26/97
Date Z25 06,
('t rY OF FEDERAL Wf)Y
33530 F°a r -7t Wray ! south
Feder -al W,'Ay, , WA t)t3003
253-661-4000
ADDR SS::.341506 121'I4 PL.
NO.: 178850 0070
PROJECIT DE!5CP1P f0M:NEC
OWNER
RICHARD BUSHEY
30506 12TH PL SW
FEDERAL WAY WA 98023
253/945-6340
9 g -/01738'
! -1 �P �,.�. I I 1� ' APERMIT PE'RMI �C NO : MCC'�'�—Olf,�.
1'SSUED: 05/06/99
Mucha+i►:icci:i. :I.m pectdori Pse gt_res3ts '253--661-4140 BY- FC2
LXPI RES: 1-1./01./99
SW
INSTALL GAS LINE EXTENSION #118 ATTACHED GAS LOA SET AND KITCHEN RANGE
_ CONTRACTORS, 14.0% ME LOCAT#
AKCAY'.f..�.....Y........�l.tl%�TIR::�-']itXt:N.�O Y: G^.5.•'�.".'�....,...... _ ':�¢,:ffi.�.9'3IId[p
PROJECT VALUATION 3500
CONTRACTOR...... ENDER �<a xn>s::�arza�: �z�ffi:F��:,a=:. =..�r.l:..�� ����•�«.�
OWNER IS CONTRACTOR
�A
LL.Y ..� .t..i. ,.:... . '. �.... .. ... .. .. ,.; .. .:. .....:.:... .;:.. .. ......_::..:.:.:..'....-..Y'ST[1C'tn•:RTAIY:9t...iSYS.a.i;G,^,7➢55dWAS fitC:•.".»..l[lA::tlG1L$'At:TALYip:lritt:�
E rot PO4 f. YITM CITY Of CEDEkAI. VAY. TAX RATE = 0.25 ___
I'cM � :'_SCT.^. LY'3:" 3R HY 10 S1.4i C.YL .4M5ffiFKL1tla4 A"W..'tRaYY3[:N.:.1Y'"Y.TwC.'.^..9'J:4 LWST. f>3R9i.XC..'•.i£XA::."..C�MG9 :S"!
FUEL TYPES.:GAS ? FAN::. AM
EE # 91.25
GAS PIPING,- 35 ft HOOP. � � �`
.,,-
FURN<100K. , ; 0 DUCT Wm
GAC NWT..... 0 WOOD SIO`iES.. F r 1
COHV BURNER: 0 FURN;100K.....�� 'r''0 � ,t
RBO........ . 0 "ISC......... gni
GAS DRYER..: 0 AIR HANDLING 11RI S L NARKS- -----
RANiGE......: I <-10,000 CFR: 0 ABO71 GROUND: 0
GAS LOGS...: I 10,000 (FM: UNDERGROUND.: 0 TOTAL FEES # 47.25
.SLEY^.'iii':Y'S3::..n.,1.1'.'Y. t.tt:,YT.�iS :�Y;.Lm.`:.CG�L F.�2:lt51'.9.v'Sh'. r1 tt`1::::�."y1mY .laYC: i:...f:LIQ'isY'1'YF.ii{h'�G,GYl[S8'.AIS:Ln�1^.^:�!iG6i::3tllY'2GXw�^99L'1'd'.]T[�,:.J:9ix6l:�t^.'.i4Z3k.:YR:9TJM1ti A1ffi.S�Im.:RiF4:[Jli!Y, YER!>2AFY. ": SSS:.".t�i:4i i2a14:'.EL^:::W.iSc:A_.i3.'.'nG�'.:F�.CRT:LRW'^i:AY`{::S[•!W:`:.:
Does the water supply sYstea ' ain a Pressure Reduction Device or Check valve? �) Yes f } No Of "Yes" then water expansion tank is required on Not Water Tank)
Inspection Record: N ani
Rough-in .__,. Date _.._.__..,...__ Gas Piping G �Date4.17:._.QJ 5
MECHANICAL FINAL Data
.1.9C'.".... Y.. Ftti;YtS:TG CIRI'.Y;:bS `•S.rE6'kSs'iC.'Nik ArQ'SIY.R:SC:S 5ia9fi T.itS3CiS`a....Y@«"::.EGffi'::SJ9t:li:6'L14[C liCtli�3'Q4l9ICl3i JY:#I I:i�Sit :P'8:y%KTSzn= .4.A.1'•.z... ......
PERMITS EXPIRE 188 MYS AFTER ISSUANCE If NO WORT IS STARTED.
I CERTIFY THE INFORMATION MISSED NY ME IS Im AND CORPICT TO THE UST Of NY KNOIN.EOGE AND THE AMICAMI CITY Of #LIKkAI. WAN' R1.00110MS PILL Of MI:T.
OWNER OR AGENT.` ... DACE _r's
FIELD COPY