96-104476 I • -•••• 96 /(tiz76
, ,, HI f 1 1)E1f.11 WI , ( PERM1 1 No: ME( ',,te. 1f282
.-f:35:30 I i t _.'1. ..7 tei r tic, t I toil 1.4 1 it::,' el 0. 8-1.r!Eli 1h,, . ,;11: ,t 1
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1 ' GA,t 11(p)0" i 1 (1/1 111)(t!( ;;
"-! ,.)1.1)('1-:;'I OM:fiVAC - ELL TO GAS CHANGEOU1 Of foRNACt AND 'JP 10 .0 PIPE.
-.M flLtjJ !ENDER ---- - . i
1
1 RODE ,* STIERS OWNER IS CONIRACIOR tI
1 33225 43RD AVE SW
1 FEDERAL WAY WA 98023 , I
I '1
1 927-0634 I I
. 1 I
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I sts c —...---,--.......—..„....,,—, , , , .. v I ; pi.4310,, v1.11101 uti ,11,, tfri i ,,, , . 1
A 1 NG SALES TA. 01
ouRacnTla err t,,,t, ,,,if lir PfAt
,
1 PROJEC1 VALUATION 2000 ,,: 1.---.., : , ER ..i otppt,•:,c,iir, .„: i MI, t.s pi 1OANCE...
( FUL1 TYPES•:GAS ELI rANS „Wk; . x),,, - ,,.., ,
,-0-,..,."'.-:-.--- ''''6:' 'ffAti'n'ariEs, era). .
1 GAS PIPING.: 20 ft HOOD.. „...,.,. „.4.- :. . ,135 , , '11 $ 52.00
1 FORN<LOOK..: 0
1 GAS WI • 0 WOOD - ,- .. -' ....,,,,,. : -3: P. _
( CONY BURNER: 0 f .. p •
. ,.
, .
1 B80 - 0 MIS
1 GAS DRYER..: 0 ,,
AIR IPyr
( RANGE • 0 ,:i.0,,,, ; ' F ' —ND: °
1 GAS tOGS...: 0 NmIGROUND • 0
•... 10.000 '- '' 0 r______ .. TOTAL FEES $ 1 .00
7 .,--
—
' , g..6 4127.116:14M.,42 .. •••
;; ;;710'c'tio'n—;;;;;;'o--r'- c'k- .iv-e-?.-7f'Y'e;''i..1,--'tio- -(;;"'"'"Yes" then uater expansion tank is required on Hot Water Tank)
Inspection Record Water tine OK V 1,
Mechanical Inspation Notes:
GAS PIPING or 01,14\ ) Date ./l1B/y ' '
, ,...,..„,..,_,..
, \
PORL ti, siAP11.0EL
. G1OLNIIAL AND GRAATIA; PIPtIlIS EXPIRE OWE1111AAriLA FAA1L : 1441S7RtitutSUAlkiatillsis wit, 31 NIL L.
IPit.IENRIII;;IIXP11111141INT186041111114YTISU:FILTRUINIIIsSITTADStifti fitn Kt I4,3' !RUE .4111 1.011,1tECNY,1 10 Int REST Of KNOWLEDGE AND lif APPLILA8
11 CItY NrrtR
_
/ 7.': 7-/-:,/
OWHEP OR AUNI ...,/,,., ) 1-- ,.._ _ .- ,
Did! /— - /1— - /
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FIELD COPY
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1. I /+
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CITY OF FEDERAL WAY PERMIT NO: MEC96-0282
23530 F i rs t Way South II''"'il'il!';;:::'Il.::::: Ih"'1N e,1i IPS il'.:Ir'u.;,:.'11 ilL i!a`"',irN...i11' I'liK•I'.,7i!,° Tr ISSUED: 12/12/96
Federal. Way , WA 98003 Building Inspection Requests 661-4140 BY: FC2
661-4000 EXPIRES : 12/06/97
ADDRESS: 33225 43RD AVE SW
NO. : 142103-9065
PROJECT DESCRIPTION:HVAC - ELE TO GAS CHANGEOUT OF FURNACE AND UP TO 20' GAS PIPE.
rOWNER =__ ==-- ____..._._ - _ ,.- CONTRACTOR ------------------------------ _ ,. LENDER ... ___.__.__.__.__ --
ROBERT STIERS ) OWNER IS CONTRACTOR
( 33225 43RD AVE SW !
FEDERAL WAY WA 98023 1
927-0634
1
_____ _.___.- ______________ _____ ..._.._... ?_...-.-_._- .---_-
#=i CONTRACTORS, PLEASE USE LOCATION CODE 1132 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE : 8.25 ***
PROJECT VALUATION 2000 __.. _ _____._.-._.._.._... _._____._._.._._____ __.___..._._._.__-_.___- _._ _
f____-...._.___-.- - - FEES:
FUEL TYPES.:GAS ELF FANS • 0 BOILERS/COMPRESSORS 1 MEC PRMI ISSUANCE... $ 20.00
GAS PIPING.: 20 ft HOOD • 0 0-3 HP • 0 1 Mechanical Permit* $ 52.00
FURN<100K..: 0 DUCT WORK • 0 3-15 HP • 0 1
GAS HWT • 0 WOOD STOVES...: 0 15-30 HP • 0 j
CONV BURNER: 0 FURN)100K • 1 30-50 HP • 0 1
BBO • 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 $ 72.00
1 E
( 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)
i Inspection Record Water Line OK „_ . Mechanical Inspection Notes:
GAS PIPING OK -• - DateBy .._.._-_..-
___________ _________________________________.------___________ ____ _.--____ .__..____.___. __...__.-_._.____.-_._.__.___.._-_.l
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 INFORMATION FURNISHED BY BY ME ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
Jeo--6-0,pe,OWNEROR AGENT . . .. DATE ....__../.. - /2 94
FILE COPY
City of Federal Way
CITY OF r•—•••• 33530 First Way South '
la
Federal Way, WA 98003 j� r
�� 96 (206)661-4000 MECg0 - oz z,
v� 9 19 APPLICATION FOR MECHANICAL PERMIT
,.�0,Al-T AY
to` B Jp OING DEP
PARCEL ff. Single Family 4 Multi-Family ❑ Commercial ❑
SITE LOCATION: c,�
Tenant/Owner: 0 6C12 z-:--; 5--1--7 --72,5Phone: / o� o6 3
7
Address/City/State/Zip: 3 3,77 s — 3 Av� Sc.v
FEp,A/A% k/� 9 B U23
Nature of work: /4/5--(4/4z..6 C--"i S ,<----L—cy2/---A fG"-- 2 Project Valuation: $
APPLICANT:
Name:
Address/City/St/Zip:
Contact Person: Phone: Fax:
MECHANICAL CONTRACTOR:
.
Company Name: e 0 66 6--'-t- G' I 5't7�/.-S ,
--..Address/City/St/Zip: 3 3 2 2 5 7`� /Vl/C Se—t-- . iC-- ��L Ct/ G
y wx- �8 Z
Contact Person: Phone: 7 2 Y OG 5L7 Fax:
State L & I Contractor Registration #: Exp. Date:
(Card must be presented)
MECHANICAL UNIT COUNT:
Fuel Type (gas/other) Gas Dryer Air Handling < = 10,000cfm Fuel Tanks:
Length of gas piping o2 0 Range Air Handling > = 10,000cfm Above Ground
Furn <10OK BTU's 4' Gas Log Unit Heater Underground
Furn >100K BTU's ` Fans Boiler BTU/H Miscellaneous
Gas Hwt Hood Boiler BTU/H Other
Cony Burner Duct Work , A/C TONS Other
BBQ's Wood Stoves A/C
TONS
ofxi#Jfaft Dnunt.................................
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(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.
J f t
Owner/Agent:
�'� � 2— 2
Date: