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CITY OF FEDERAL WAY ` ' ` ' ` NLKIIII NU: bLLrf4-00.44
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'- --_;=-_ �` '.,--, --.r_.�. �— __.. ....-- "kC9d�R U x ADD CAS IDCS — LENDER EXPIR 5� 22 95
JEANNE BLUNCK NORTHWEST MATER HEATER
:72:'_,-,- •-332 8 SM 329TH ST. 8201 DURANGO ST SW
FEDERAL MAY MA 98023 TACOMA MA 98499
984-6404
INORTHMH103R2
FUEL TYPES.:GAS GAS FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 15 ft HOOD - 0 0-3 HP - 0 MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 1 DUCT MORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 19.50
GAS HMT • 0 MOOD STOVES...: 0 15-30 HP • 0
CONY BURNER: 0 FURN>100K - 0 30-50 HP • 0
88Q • 0 MISC • 0 5+ HP • 0
GO 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 $ 39.50
Does the nater supply system contain a Pressure Reduction Device or Check valve? () Yes () No (If 'Yes' then mater 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 MORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE I I!.ATIQN FURNISED ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERE 1 NAY REQUIREMENTS WILL BE MET.
�WNER AGEN ,/.�,,./1 DATE _44/�- -
PILE COPY
• City of Federal Way RECEIVED
CITY OF �— 33530 First Way Southlk
III
CITY
_ Federal Way, WA 98003 OCT 2 41994
(206)661-4000
�� .ITY OF FEDERAL WAY 1.
APPLICATION FOR MECHANICAL PERMIT BUILDING DEPT.
/5 CD Ciq—o 8'zy
PARCEL # 1099750590-06
Single Family)b Multi-Family D Commercial 0
SITE LOCATION:
Tenant/Owner: Jeaule Blunck Phone:
Address/City/State/Zip: 3320 SI329th St Fe feral Way 98023
Nature of work: qasrepIaoarent, install furnace ad gas legs Project Valuation: $ 3344.82
APPLICANT:
Name: Baffy Gix
Address/City/St/Zip: 2802 E M3iiscn Saattle 98112
Contact Person: c4-Plicalt Phone: 322 8191 Fax:
MECHANICAL CONTRACTOR:
Company Name: 1\W Water Inter
Address/City/St/Zip: 2800 `eke Seattle 98119
Contact Person: lic-alt Plan-4700 Fax:
State L & I Contractor Registration #: 10382 Exp. Date: 12/22/94
(Card must be presented)
MECHANICAL UNIT COUNT: `
Fuel Type (gas/other) G Gas Dryer Air Handling < = 10,000cfm • Fuel Tanks:
Length of gas piping 15' Range Air Handling > = 10,000cfm Above Ground
Furn <100K BTU's 1 Gas Log 1 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 sY�taf`t}riit<�ii���»i:»»> :>�<?»:>><z
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 defynse 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,incl •ing its of cars and emplo --,upon the accuracy of the information supplied to the City as a part of this application.Mel
krOwn:r/Agent: ('� Date: