96-101782 / / -
TY OF FEDERAL. WAY PERMI F NO: MEC96-0119
33530 First South01 :,.<...: $w'Vit ,!�,,. ;..; I�' li ill•...• 11^;.w
Way � I jrI li �i V � •�',,,, f ,.�° I . ••. ISSUED: 06/26/96
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: 3-11-1
661--4000 EXPIRES: 06/20/97
AT)DRESS: 920 S 296TH PL.
NO. : 51.51.60-0530
PROJECT DESCRIPTION:MECH - INSTALL GAS FURNACE TO 100K BTU
OWNER _..---.. __.__...,_____..__.. _-- _._._-_.---__�___ _._.._ 4?= CONTRACTOR - _.___. ::.- _ :::: x LENDER
RICHARD DICKSON I WESTERN FURNACES INC. k )
920 S 296TH PL P.O. BOX 11145
FEDERAL WAY WA 98003 2901 SOUTH TACOMA WAY
TACOMA WA 98411
946-2221 206-474-8401
WESTEF*05302
a:s CONTRACTORS, PLEASE USE LOCATION CODE 1132 WHEN REPORTING SALES fAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE : 6.25 =t"
PROJECT VALUATION 2331 FEES:
FUEL TYPES,:GAS ? FANS • 0 BOILERS/COMPRESSORS Mechanical Permit* $ 54.00
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 1 DUCT WORK • 0 3-15 HP • 0
GAS HWT • 0 WOOD STOVES...: 0 15-30 HP.,..: 0
CONV BURNER: 0 FURN>100X.....: 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 $ 74.00
____._...._.__c_.____._____.._.._.....__.___.._.__ ••_•.-.-•_...._........._.._._._..__....._.......___.... ...__....-'-___.._...«..__,._...:.........__.__._...rrs-r..::.«....___._.............__........»^_.«.__c.._._._.._._::...._......:a:s_s_____.,.xssxrs.....
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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:
I �
GAS PIPING OK ......__._... . Date _.._._...._ By
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DAIE.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 MEI.
OWNER OR AGENT _._..__._._.._.._.. _._..__ DATE
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City of Federal Way RECEIVE •
CITY OF i' ''''— , 33530 First Way South COMMUNITYDEVELOPME "c 'At 1`4ete r
' Federal Way, WA 98003
\"` FEE-3 -1"KFII___
(206)661-4000 AY JUN W2
If 1996
APPLICATION FOR MECHANICAL PERMIT
PARCEL it...--6LcAL) n L '6Single FamilyR Multi-Family 0 Commercial 0
SITE LOCATION: veil, �j ,�
Tenan /Owner: 'i'� Phone: 44L-'-'2"2'2/
Address/City/State/Zip: 'i„?r) J. 02`i67- f L 411 /i 0-003
Nature of work: ''.-3-Y1 Aiiil IMi / 9Q// hz4/121-4-e-/ Project Valuation: $ ' ��C ��'
6
APPLICANT:
Name:
Address/City/St/Zip:
Contact Person: Phone: Fax:
MECHANICAL CONTRACTOR: �,
Company Name: J4hAt41 �1'U�'1 Lee e
Address/City/St/Zip: I O• - /i/7 Lgita ,& L22 98'1/i)
Contact Person: e/LT.,t V et- gerdi Phone: f-a"44-74)1Fax C6"4'173 -74
State L & I Contractor Registration #:
Lt-1L 5 72 / -A _ &
e� � ' ExpDate: //- Q '
p .
(Card must be presented) L, irk.
MECHANICAL UNIT COUNT: V tJ, w)
.
Fuel Type (gas/other) 91W_, Gas Dryer Air Handling < = 10,000cfm Fuel Tanks:
Length of gas piping ' Range Air Handling > = 10,000cfm Above Ground
Furn <100K BTU's f 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
E.:>::>:. : ' " < <>BBQ's Wood Stoves A/C TONS �ataf€httDaf it > ' ;; i
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 coats,expenses and attorneys'fees
r
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: k ✓//A,r'j� �i �z Date: 4 �� "�
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