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II„ II ISSUED: 08/15/95 Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC 661-4000 EXPIRES: 02/11/96 ADDRESS:4700 DASH POINT RD SW NO. : 112103-9010 PROJECT DESCRIPTION:mechanical - replace gas hwt r= OWNER CONTRACTOR -- - LENDER 1 PALISADES RETREAT ASSOC BURNER & CONTROL SERVICES 1 I4700 SW DASH POINT RD 5416 S "K" ST FEDERAL WAY WA 98023 TACOMA WA 98408 411P0 838-9583 472-2833 BURNECS097M2 *** CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE = 8.25 *** F = FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS I FEES: GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... $ 20.00 FURN<100K..: 0 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 6.50 GAS HWT • 1 WOOD STOVES...: 0 15-30 HP • 0 CONV BURNER: 0 FURN>100K • 0 30-50 HP • 0 BBQ • 0 MISC • 0 5+ HP • 0 1 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 III TOTAL FEES $ 26.50 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 MET. OWNER OR AGEN —� AGG��T' DATE ,44 . 4C09<5- FILE COPY • City of Federal Way • RECEIVED CITY OF �— 33530 First Way South 1 --a- _ I-- Federal Way, WA 98003 AUG 1 5 1995 (206)661-4000 WAY APPLICATION FOR MECHANICAL PERMIT GITBUILDING DEPT AY ±)-7� 5-062 PARCEL #• I ( 2-1 O 3 ` `— (v —° E3 Single Family ❑ Multi-Family 0 Commercial SITE LOCATION: /� @ Tenant/Owner: �-1A •-'...- 6-1---130ZPitt 1 +r. ...t + � iLt:Z t r'I'% Phone: 838- '958 3 Address/City/State/Zip: 47t) " . 14). i �41r&1 1-1-,..--- `e• p, 4i3O23 Nature of work: i\tu =- Oma` �- `T 1.4:-.-- -►I cr ( ►t' 5�, G7L7C Project Valuation: $ APPLICANT: Name: Address/City/St/Zip: ''t. Contact Person: Phone: Fax: MECHANICAL CONTRACTOR: Company Name: �(.c21 ! � -(714-7-1.?C.:-)L.... -----'(..i'.-IR.-)1 C Er �, Address/City/St/Zip: _5-416:7 'Jv. A C.-opt A- )4; `Degi".© Contact Person: -;,-----' t,:' 6.5. ` r .,,,:(2Ls Phone: 4'72."2333 Fax: 7 - 57 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 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 i Gas Hwt 5 7 v%k t-- it' Hood Boiler BTU/H Other Cony Burner Duct Work A/C TONS Other ................................................................. .................................................................... BBQ's Wood Stoves A/C TONS <T' #at#)r it Cau t:=':<:'::>:`> »>»»»> 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,inc .its officers and employees,upon the accuracy of the information supplied to the City as a part of this application.AP /,��f Owner/Age v —s /46 -277--- Date: �fus''' l3 /99S