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TAX RATE : 825 art ramsaaaaasaaasaa==a=aaaaaasaas==saaaaaasa==aa==aasaaiMsa sass==assaaasaaaeossax==asaa==saaaasaasss =arasaaaasaaa=aa=as=as=a1 �_:.; s.. PROJECT VALUATION 2590 _�� � •� �� ;�h� ��'�-�� �� •'� %w"'=fir FEES: FUEL TYPES.:OIL ? FANS .;:'.1'f BO ER ONP =YLif: :F .. :.}: �, w•,:,t:,." :-.,;. . °� , . • '. .Anita $ 54.00 . GAS PIPING.. 0 ft HOOK...... ;: 11' MME:. .>k „- 5 ., � i >° �1� DANCE... $ 20.00 ' I FURN<100K... 1 DUCTS . :.15 . " . ••"4., r. , GAS HNT • 0 f y41,� .� -3U' IP t � Y . , >_. `.. . yn CONY BURNER: 0 FU'` : I ,.4', ,1r:1!„,:,.-,•1,117. " •1 ;_- I. p -.v,-..7 :: ,,.' . . :A. BBQ • 0 MISC.: .1.'-' .'0 ":, '•,,', ,.,�x'' GAS DRYER0 AIR NA , `''z ,--,, " ; > RANGE • 0 <:10,00c5. N,;' I J, ':1/1E GROUND: 0 GAS LOGS...: 0 > 10,000 ,'_: 0- f .:-UNDERGROUND.: 0 TOTAL FEES $ 74.00 as=a=a=mama=massa=seamIMUILI sa.aaassaasaa=aasassa==ansa=aa=seam=mama=aa=mama=a=mama=aasssa=a=aaaasaadas=a=aa=aa==a=saaaatratasaa=aaaa===aaaaaa.asaa==aaaaaasall I Does the water supply system contain a Pressure Reduction Device or Check valve? () Yes () No (If "Yes' then water expansion tank is required on Not Water Tank) I I � ,_ ,__., _ Inspection Record Water line OK ___ _ Mechanical Inspection Notes: _ _ ___ ____ I GAS PIPING OK _ Date _ By __� issoaaaaamaa.Damsin=s=assaaaaa==taaasassoaassssaaawaao=.mamma==aaasaseaaasaaaaasaa=ssaasaaazamaaaa=a=masa=s=mamma===sinu=s.=susses=massaaaaasaaammansaaaaaa=a=aaaaaaaa===a==a=i PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF 18 MORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE. I CERTIFY TIE SUED I1 NE TRUE AND a, • CT TAE BEST OF NY INOIN.EICE AND TIE APPLICABLE CITY OF FEDERAL NAY REQUIREMENTS MILL BE NET. OWNER OR AGENT ___________ _____ - _ . _ _ _____........_____._.—_ DATE / r�?� FILE COPY City of Federal Way M E+cfr„_ N (�0 )1Ik CITY OF i — 33530 First Way Southr ► ` tel• �(Jo Federal Way, WA 98003 (2061661-4000 W1=:: ' RECEIVED APPLICA TION FOR MECHANICAL PERMIT DEC 0 5 1996 PARCEL U //9 (-- (-- 0 ° .--2 5 CITY OF IN "RAL WAY. Single Family Multi-Family ❑BUILDINC 'nerclal 0 SITE LOCATION: / / Tenant/Owner: 1 T ,9AiX /4`4//911/gi--/ Phone: g..59— 6.6%Z_ Address/City/State/Zip: ` .,. cs; 1'✓ 'Z 9:2 4/ (. � /1----&—b1/1/.9/ / g0�' 0,0 If/S7—,ILL ° - 3i A/' £ / ..Z.5-90 Nature of work: � ���/�1�roject Valuation: $ APPLICANT: Name: Address/City/St/Zip. Contact Person: Phone: Fax: MECHANICAL CONTRACTOR: Company Name: ©SS©t.--.6-if/z'- 'a y 5v5 • Address/City/St/Zip: �3"7 X9/9/ t1/?X Sd' 5i--?- 9g-/7g Contact Person: s /e/O /Vjt^ Phone:`2 - 7- Fax: 72`5 State L & I Contractor Registration #: 0( 05_5 d ES /442- cel Exp. Date: //79C„ (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 BBQ's Wood Stoves A/C , TONS <"•: { 'iiatf :.''. �'` '• DISCLAIMER: I certify under penalty of perjury that the information furnished by me is true and correct to the beet et 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 ae to any claim(Including cow,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 Fadara),Way but only where such claim arises out of the reliance of the City,Inclu7ding Its officer*and employees,upon the accuracy of the information supplied to tie City se a part of this application. �j� - Owner/Agent: Date: /®///fY 46.",.