94-101776 9il /Of 7/(c,
CITY OF FEDERAL WAY MECHAN 1 CA L PERM ' T PERIASSUED: 09/14/9419
33530 First Way South
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661 -4000 EXPIRES: 03/13/95
ADDRESS: 32034 23RD AVE S
NO. : 162104-9028
PROJECT DESCRIPTION:COMMERCIAL MECHANICAL - GAS PIPING ONLY.
OWNER o?3 _ v_ s - CONTRACTOR
EGG ROLL KING RESTAURANT JIM'S GAS APPLIANCE SERVICE
•82028-- 23RD AVE S P 0 00X 032
FEDERAL WAY WA 98003 TrItew itt°`98055
& JiMSUASIW
p,m
FUEL TYPES.:GAS ? fAt4 .., 6 BOILEPSICO PFFSSOR" rEC!-
GAS PIPING.: 120 ft 0100D....._ ... n _* 3-3 HP .. .... 0 MLC PRM f. $ 20.00
FURN<100K..: 0T K .��.. -15 F� 0 NEC APPLIANCE FEES.. $ 4.50
GAS RWT • 0 � S *3kW. 0
CONY BURNER: 0 FUR '' � 0 >
BBQ 0 MISC - 5+ H0G
GAS DRYER..: 0 AIR HAND ,, UNITS A - FUEL TANKS
RANGE • 0 <_10,000 CFM: 0 ABOVE GROUND: 0
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
TOTAL FEES $ 24.50
Does the water supply systeo contain a Pressure Reduction Device or Check valve? (1 Yes (l No {if 'Yes' then water expansion tank Is/fettife4'on Hot Water Tank)
Inspection Record Water Line OK __. Mechanical Inspection Notes:
GAS PIPING OK Date By
Y-/s-g C- 5 F2r`SSwec-- %
CITY
F FEDERAL WAY
NO:
33530OFirstt Way South MECHAN I CAL P T PERISSUED: 09/14/ 9419
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 03/13/95
ADDRESS:32034 23RD AVE S
NO. : 162104-9028
PROJECT DESCRIPTION:COMMERCIAL MECHANICAL - GAS PIPING ONLY.
OWNER CONTRACTOR LENDER
EGG ROLL KING RESTAURANT JIM'S GAS APPLIANCE SERVICE
32028 - 23RD AVE S P 0 BOX 2632
FEDERAL WAY MA 98003 RENTON MA 98056
235-8656
JIMSGAS164PJ
FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 120 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.* $ 4.50
GAS HMT • 0 WOOD STOVES...: 0 15-30 HP • 0
CONY 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
IIIPPGAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
TOTAL FEES $ 24.50
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 Mater Tank)
Inspection Record Mater Line OK Mechanical Inspection Notes:
GAS PIPING OK Date By
A. PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORM$TION FURNISED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CIITYY OF FERERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT �� � ,�2 -t-. -fttE - DATE q'—" / /E
.11.
City of Federal Way •
CITY OF 33530 First Way South t./"' + _
• _ Federal Way, WA 98003 "I VV
WAY
Fe.TDIrKFII-- (206)661-4000
APPLICATION FOR MECHANICAL PERMIT
PARCEL Single Family 0 Multi-Family 0 Commercial0.
SITE LOCATION: ,
Tenant/Owner: / / ?// Oa-- / � Phone:
Address/City/State/Zip:
.
Nature of work• —
4", Project Valuation: /
APPLICANT:
Name:
Address/City/St/Zip:
Contact Person: Phone: Fax:
MECHANICAL CONTRACTOR:
Company Name: J -
/ /-S
Address/City/St/Zip: ^ 66 -�3 �' g, „, /--- -..t. (,?_)/‘_-- ' �`� �G�
�- J�4-r ,4fir-'
Contact Person: G �� -� �' S� Phone: Fax:
State L & I Contractor Registration #: S G-7- /6 J Exp. Date: /�'', y
(Card must be presented)
MECHANICAL UNIT COUNT:
Fuel Type (gas/other) Gas Dryer Air Handling < = 10,000cfm Fuel Tanks:
Length of gas piping r----7 0 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
zsC f`ai#i riit> o tit? < >`:»s>3i<:#3i[:?::#:::::>::
BBQ's Wood Stoves A/C TONS
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,including-iti officers and employees,upon the accuracy of the information supplied to the City as a part of this application.
J / — G �V.
Owner/Agent: - � —�' Date: J / � �