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CITY OF FEDERAL WAY PERMIT NO: ME 96 00 4
33 530 First Way South ;';.�,,.,,. ,,,,�if�';;,l� .,„ �,.,,,. ';...� L.... .,..w �, M ,.
� N �. � �.,,,.� �, ,�.1 �,,,. ISSUED: 03%07/964
Federal Way, WA 98003 Building Inspection Requests 661-.4140 BY: FC2
661-- ' 1fl0 EXPIRES : 03/01/97
ADDRESS: 91319 13TH AVE S
NO . : 787520-0300
PROJECT DESCRIPTION:HVAC - INSTALL GAS piping and range
OWNER =: _.. _..____ ----__..._.__===x= CONTRACTOR - :____= LENDER -- --
WILLARD LAURIE J
31319 - 13TH AVE S
FEDERAL WAY WA 98003
f839-7152
NONE
*** CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE : 8.25 ***
PROJECT VALUATION 500 FEES:
FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS ' Mechanical Permit* $ 22.00
{ GAS PIPING.: 40 ft HOOD 0 0-3 HP 0 MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 0 DUCT WORK 0 3-15 HP 0
GAS HWT • 1 WOOD STOVES...: 0 15-30 HP 0
CONY 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 1 <:10,000 CFM: 0 ABOVE GROUND: 0
IGAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0 TOTAL FEES $ 42.00
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 Water Line OK Mechanical Inspection Notes:
GAS PIPING OK .._ Date By
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 TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE NET.
OWNER OR AGENT ' DATE 3--6
FILE COPY
City of Federal Way
CITY OF f---, 33530 First Way South '
. Federal FETIDEIZFIL__ Federal Way, WA 98003 • .
'WRY
(206)661-4000 f,
APPLICATION FOR MECHANICAL PERMIT
PARCEL it. Single Family II Multi-Family 0 Commercial 0
SITE LOCATION:
Tenant/Owner: _ 1 ' f S �-� l 4 Lt. r i e. Phone: -3 9 _ 7
Address/City/State/Zip: 3 I I of 13 4 V)z S1< _ r Lk 'v)< _ (CSU
Nature of work: CSS 6,1 n
Project Valuation: $ / ��
APPLICANT:
Name: Cr Geld eS <()Yi -St(c.k.c-f-io-)rl,
Address/City/St/Zip: P O x e 7E 8 I cc c k D) wry,c,/Id c.A.,cZ [ $"o l 0
Contact Person: FD Ge,-{c es Phone: 35 �(, 70 Fax:C 0) b ‘ -075 c
MECHANICAL CONTRACTOR:
Company Name: ( p/ (C -L4t.4
4----
Address/City/St/Zip:
Contact Person: Phone: Fax:
State L & I Contractor Registration #: . e de C m G� Exp. Date: 7_2‘ - /6
(Card must be presented)
MECHANICAL UNIT COUNT:
Fuel Type (gas/other) C-/71-j 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 I Hood Boiler BTU/H Other
Cony Burner Duct Work A/C TONS Other
BBQ's Wood Staves
A/C
TONS
tat fintf Cauttf ''..............
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.
- 1114
Owner/Agent ---/J-1-4171----
Date.
( 3 6