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CITY OF FEDERAL WAYPERMIT NO: MEC96-0062
33590 First. Way South "� :;;,,, �, i�„ A .,,�,; '�::,.,.1' "Y :;,:.� � 1�"h .. ,.. �... ISSUED: 03/27/96
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 03/21/97
ADDRESS: 30625 5TH PL S
NO. : 241330-0640
PROJECT DESCRIPTION:HVAC - FURNACE/HWT REPLACEMENT
F. OWNER .-...-...... _-= _.. ____:K... CONTRACTOR - T
JOHN HIGHBERG UNIVERSAL REFRIGERATION INC.
30625 5TH PL S 4102 B PLACE NW
FEDERAL WAY WA 98003 j AUBURN WA 98001
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839-8418 939-5501
UNIVERI159RF t
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*** CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE = 8.25 ***
PROJECT VALUATION 3000 FEES:
FUEL TYPES.:GAS GAS FANS • 0 BOILERS/COMPRESSORS Mechanical Permit* $ 54.00
GAS PIPING.: 0 ft HOOD..........: 0 0-3 HP 0 ! MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 1 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
880......... 0 MISC . 0 5t HP0
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 $ 74.00
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Does the water supply system contain a Pressure Reduction Device or Check valve? () Yes O No (If "Yes then water expansion tank is required on Hot Water Tank)
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Inspection Record Water Line OK ,,__-_______•_. Mechanical Inspection Notes:
GAS PIPING OK Date .__.__._. By _..
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PERMITS EXPIRE 180 DAYS T ' IS NC F N► 'ORK IS TED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THE INFORMA " H H N S TRUE CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT !' ___,_......_._._...._.____..----•_--- DATE 7= 7.' `_`-. 6._...
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di- City of Federal Way A PC- (VC
CITY OF ,- 33530 First Way South
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- Federal Way, WA 98003 R EC E \IE
(206)661-4000
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'AR 2 7 1996
APPLICATION FOR MECHANICAL PERMIT
>r FLL)::AAL WA r
BUILDING DEPT.
PARCEL it- -'`4! > 5 c '4Single Family 11 Multi-Family 0 Commercial 0
SITE LOCATION:
Tenant/Owner: Acts-r , C Lid") I (-4rc L h-e'43 Phone: 133 - Pits
Address/City/State/Zip: ,e' ZS S Pr,- So -I.,,,,, ( t:. _.} L.Ja,, C'9 col'
Nature of work: 4-012-1--''"•4-Z- 1/2-Z e[A-c-t 6--i-' 'r Project Valuation: $ ' ( °e O
APPLICANT:
Name: (,,,A i--1.v.
-I, .0✓5,,,_.C. fn
Le -e_v-r, p r o".. i c.
Address/City/St/Zip: `1 t 0 z 3 tr PL ,i)• G✓. cc ,14, //
Contact Person: /C e /-44,,,A, is l i--SS d. % -US- -5 Z
Phone: Fax:
MECHANICAL CONTRACTOR:
Company Name: 1-.( Ini 04 -Sr-E `
o ,-`S a ---)L'-')---- e-
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Address/City/St/Zip: J f (...'--L fLY 6 t v' 1.c..iso 41/
Contact Person: l c ( k"' `'IL,,---,3
C3 S-.f J ° / -/ t r >v s
Phone: Fax:
State L & I Contractor Registration #: C/N/✓ -i /..(-9 / 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 Range Air Handling > = 10,000cfm Above Ground
Furn <100K BTU's 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
BBG's Wood Stoves vas
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(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 officer7d employees,upoerihe accura of the information supplied to the City as a part of this application.
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Owner/Agent: ,/!' / �- " Date: —2--7 '�