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CITY OF FEDERAL WAYPERMIT NO: MEC96-0284
33530 First Way South t14 !". ...;`#„„01109 ,
!! ”'$ ,, . 'b,:,''11011 .. /1"1, „„,,,,.P,d, 111- ISSUED: 12/17/96
Federal Way, WA 98003 Building Inspection Requests 66.1 -4140 BY: FC2
661-4000 EXPIRES: 12/11/97
ADDRESS: 34243 18TH PL. S
NO. : 412960-0055
PROJECT DESCRIPTION:HVAC - GAS TO GAS FURNACE CHANGEOUT.
OWNER CONTRACTOR ._..._...__.: ----r..._.__...-
MARY BELLMAN NATURAL GAS SERVICES
34243 18TH PL S 38020 236TH AVE SE
FEDEAL WAY WA 98003 ENUMCLAW WA 98022
874-4336 931-5479
NATURGSO44PS
U=i CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE : 8.25 :ts
PROJECT VALUATION 1500 FEES:
FUEL TYPES.:GAS GAS FANS • 0 BOILERS/COMPRESSORS MEC PRMT ISSUANCE... $ 20.00
GAS PIPING.: 0 ft HOOD 0 0-3 HP • 0 ? Mechanical Permit* $ 42.00
FURN<100K..: 1 DUCT WORK • 0 3-15 HP • 0
GAS HWT • 0 WOOD STOVES...: 0 15-30 0
CONV BURNER: 0 FURN>100K 0 30-50 HP • 0
BBQ • 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 $ 62.00
Does the water supply system contain a Pressure Reduction Device or Check valve? O 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 _. . DateBy _._....._._
1 I
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 ME IS TRU ND CTT THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MEI.
OWNER OR AGENTC -, `_
- DATE 1?
FILE COPY
1
CITY OF G BUILDING DIVISION
• F� 33530 First Way South A
Ay' '�i�`" '` Federal Way,WA 98003
�.,„ (206)661-4000
996 Fax(206)661-4129
0�� 1 , goAPPLICATION FOR MECHANICAL PERMIT
P
I `�` p•-Nc'O�pT.
G‘, BVL /o - ) /
/� MEC TZ8(
PARCEL # 4 I���0- 10'1) Single Family❑ Multi Family 0 Commercial 0
SITE LOCATION `/
Tenant/Owner /14 tt R?/ `( Phone y 3 3
Address/City/State/Zip C( 3- LI 3 ( gS
Nature of Work C' S /`'v(`A--'3<} L i- +q<V) Q vi Project Valuation: $ (3 U U /
APPLICANT
Name I..'1/} (.) (tib / G-A- S S T44.,-/ c t
Address/City/St/Zip ->a-0 0 2 3 A-1../ S E ___Av ` c./s-I-L1 ,- `) $-0 2 D.
Contact Person T) '-`v I U I i6 7/E %' E Phone ,3 7 s ci 7 ! Fax
MECHANICAL CONTRACTOR
Company Name -- /1-' t_
Address/City/St/Zip
Contact Person [ ' I Phone Fax
State L&I Contractor Registration# k I IlT L . ( `'1" P5 Exp.Date I D(1 o 1 g 1-
(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>=10,000cftn Above Ground
Fum<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
........:...............:...........................................
...............................................................
................. .................................................
...............................................................
BRQs Wood Stoves A/C TONS fis£ti{tle ::;::><::<:::::>;::<::::>::::<:'?>`d?'>`><>:<:
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.
Mi
i /
Owner/Agent = c �' f Date / `l
/ 7 /
MECu.APP lr
Revisrn 12/11/96