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CITY OF FEDERAL WAY " PERMIT NO: BL 95-07 6
3 rst1 1.:.:7.:'..fi; i4t I.. '(, ,. P .RM I. . ISSUED: 09/05/95
��5:3(J F� rpt WaySouth . '��G � �' r ,,,... ��°
Federal Way , WA 98003 Building Inspection Requests 661.-4140 BY: RM
661 -4000 EXPIRES: 03/03,496
ADDRESS : 2£3613 30 CH AVE S
NO. : 332204- 9202
PROJECT DESCRIPTION :GAS LOG
F= OWNER ----- =____----.-=q= CONTRACTOR ---->- LENDER =________ _ . ________
NW PERMIT { *** OWNER IS CONTRACTOR ***
2802 E MADISON #101
SEATTLE WA 98112
41,
f I
{{ *** NONE ***
xxxxxxsc=acct==__._ - ---..--------. C -• -. ccxccx=cc_...... •- . ........ _ =-__c=cam= n=x=
*** CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE : 8.25 ***
---- _______- -___-------x----= _ _ __=====x=--_. =
= ..-_ =^j
FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS FEES:
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 MEC APPLIANCE FEES.* $ 16.00
GAS HWT • 0 WOOD STOVES...: 1 15-30 HP • 0 I
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...: 1 > 10,000 CFM: 0 UNDERGROUND.: 0
TOTAL FEES $ 36.00
_______ .. = .___=======__=__________ x -....- ===- ------..=== 1 ..__..____=a
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) I.
Inspection Record Water Line OK Mechanical Inspection Notes: ,_- I
IGAS PIPING OK Date By I
t-'-" .. xx====*U=-__. -•.- c=_..__.-_== =x _. •-^-_�
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE NO WORK IS D , ;i 1. NIIAL ' D GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THE INFORMATION FURNISHED ,' ME IS TRU ' I ' i1 TO THE BE T IF MY KNOWLEDGE AND THE APPLIC CI FEDERAL,BX--REQUIREMENTS WILL BE NET.
rjOWNER OR AGENT /I DATE / f
vli
40
ALE COPY
City of Federal Way • ►
CITY OF �� •
33530 First Way South
Federal Way, WA 98003
__----;---___ FETO8SZFIll._' VRY (206)661-4000
APPLICATION FOR MECHANICAL PERM/T _ c.7/-C'
PARCEL
3 -)# q)_ nq-q - Single Familyyr- Multi-Family 0 Commercial 0
SITE LOCATION:
Tenant/Owner: ))() A(i)E- 5-)
/
4/7i'/I:71 Phone: • 1-3S 0)---
Address/City/State/Zip: .=. 69/.3 3'()' /4( 9
Nature of work: /7//9C-: L(>i7 /4 6-> S Project Valuation: S.--a..3.1:23.0-
D__
APPLICANT:
Name: NORTHWEST WATER HEATER, (Na
Z800 iHC.•:NJIKE VI. WEST
Address/City/St/Zip: $FATTLE, WA 96199
Contact Person: --()C;("2--- 4/1,6t-ID Phone: � 51�1 �E�,1�.��.rFax: 3, -.5-`t �T
MECHANICAL CONTRACTOR:
•
NORTHWEST WATER HEATER, IN4.
Company Name:
MO 11C. . ,k: AVE. t`.ESI
Address/City/St/Zip: SEATTLE, kWA 98199
Contact Person: (:‘,2'4:1),--/- 1/./SZL-D ��y.-�/— F
Phone2g C.- x. G(— ?.. -7-
State L & I Contractor Registration #: At G I� l�T//J f��/03A.� ( Z Q f
(Card must be presented) Exp. Date: /
MECHANICAL UNIT COUNT:
Fuel Type (gas/other) Gas Dryer Air Handling < = 10,000cfm Fuel Tanks:
Length of gas piping I Range Air Handling > = 10,000cfm
Above Ground
Furn <100K BTU's Gas Log itg l 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
BBO's Wood Stoveg A/C TONS
Fal 4Jntt Otsztn#':><2si ' <s?> zti> ,
DISCLAIMER: I certify under penalty of perjury that the infor, furnished by MIla true and correct t• • best of my knowledge and further that I am authorized by the owner of the above
premises to perform the work for which permit applicat'• is made. I further agree to,save her
incurred in Investigation and defense of such claim filch may be mad%r'' ^ the Cit of Federal Way as to any claim(including costs,expenses and attorneys'fees
out the reliance of the City, n' •ung the und- ign�•arxt filed against the City of Feideray Way but only where such claim arises
including its off -rs and employeez! . the informatio upplied to the City as a part of this application.
Owner/Agent: / Date: