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CITY OF FEDERAL WAY PERMIT NO: BLD95-0726
33530 First Way South Pi E.' het f tkM.,. . 4::.itot I 1F°''"E M.ti .r "r ISSUED: 09/13/95
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: KLC
661-4000 EXPIRES: 03/11/96
ADDRESS: 29510 21ST PL S
NO.. : 422291-0010
PROJECT DESCRIPTION:HVAC - INSTALL 6 BATHROOM FANS IN BUILDING 8.
r= OWNER = -_-- T CONTRACTOR =___=__---•--= LENDER = ____
1 LAURELWOOD GARDENS 1 LARRY'S REPAIR
! 29510 21ST PL S, BLDG. 8 1 514 N 103RD ST
I FEDERAL WAY WA 98003 1 SEATTLE WA 98133
111° 487-0412
LARRYR*081BS
_ 111 _ _ _ _- _ 1
us CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL MAY. TAX RATE : 8.25 2;i
-^
FUEL TYPES.:? ? FANS • 6 BOILERS/COMPRESSORS 1T 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.* $ 27.00
GAS NWT • 0 WOOD STOVES...: 0 15-30 HP • 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 $ 47.00
........=--_----...-....____... _ 1 =_ _ ....= .. ___
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)
11-
Inspection Record Water Line OK __________ Mechanical Inspection Notes: ..
GAS PIPING OK Date By
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO MORK 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 AGENT i` a DATE _ �
FILE COPY
" City of Federal Way 41-. 7 104°
-,..iry of �-- • 33530 First Way South
® Federal Way, WA 98003 9�/ , ) Sfi®/ $
(206)661-4000
WiPifY
APPLICATION FOR MECHANICAL PERMIT N,Dc1S-07- -6
PARCEL it. r (7/ 1-00/0
Single Family ❑ Multi-Family}a`-- Commercial ❑
SITE LOCATION: Ple_y
Tenant/Owner: 5(--1-11P J c;9€=?--- Phone:
Address/City/State/Zip: a 9S-03--- (-2-.) S I- A-✓,_ _S
Nature of work: •`-f/�--7�-c � -' -'--� /
U � Project Valuation: $ _� / 1/6 -"
APPLICANT:L)_ r',,,/',71r',,,/',r',,,/',71/. n
Name: Z._ C lI'` -_pc_ ../-
le
Address/City/St/Zip: ?7 G/ 1 )C r �� �,"=>/ !. !'„..2/1- 9 5.7 , 3
Contact Person: , .,^✓ . t_ I Phone: 95- ?--(2)y/ 7-Fax: 5--- --, CJ
•
MECHANICAL CONTRACTOR:
Company Name: Le--''-'•,,- (f ��z�,. .�✓
Address/City/St/Zip: �1 4/ 1 *--)9 --(4) j<-7, /-P (-r2,4 9 / ) j
Contact Person: Le'r ---"--,,\I ik-C-' j,.- , {1 Phone: -? -0q/•,) Fax: 5'1 t---,-
State L & I Contractor Registration #: L cl.p✓!'\/ c ; Lam' f,--) ) Exp. Date: /---V%). 3/)s
(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 6 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 Total UnitCount
DISCLAIMER: 1 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.
Owner/Agent: ; -_/fd/�, -.....c... 10.1"- - Date: ,�� `��
c