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EDERAL WAY PERMIT NO: BLD95-07 r,
-st Way South itl I r' C ti t"l .I C L. P'E. .11 .I. ..I ISSUED: 09/13/9 ,
Way, WA 98003 Building Inspection Requests 661-4140 BY: JTH
—te1.-4000 EXPIRES: 03/11/96
ADDRESS: 29505 21ST AVE S Unit: 12
NO. : 422291--0010
PROJECT DESCRIPTION:MECHANICAL - ADD (6) FANS
r= OWNER •• --•- • =a==a-f= CONTRACTOR - .___ � LENDER _-
_
I LAURELWOOD GARDENS #12 I LARRY'S REPAIR
I 29505 21ST AVE S 1 514 N 103RD ST
I FEDERAL WAY WA 98023 I SEATTLE WA 98133
41/
487-0412
I LARRYR*081BS
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*** CONTRACTORS, PLEASE USE LOCATION CODE 1132 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL NAY. TAX RATE = 8.25 ***
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FUEL TYPES.:? ? FANS • 6 BOILERS/COMPRESSORS 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 i' 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
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oes the water supply system contain a Pressure Reduction Device or Check valve? () Yes 0No (If "Yes" then water expansion tank is required on Hot Water Tank)
I Inspection Record Water Line OK ._.. Mechanical Inspection Notes:
I
I GAS PIPING OK Date ._ By
I
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PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTERTE OF ISSUANCE.
I CERTIFY THE INFORMATION FURNISH NE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CIT t3 .Y REQUIREMENTS WILL BE MET.
OWNER OR AGENT ___ -.___ __ _ .-..04/_., --- DATE ''', ...<;:::
FILE COPY
City of Federal Way
"rITVIM !- 33530 First Way South
® [ ...--10 ..r
Federal Way, WA 98003 /3 j2
(206)661-4000 IfJLt r-- 3
v4 Fvv a).3 C. 6 S,34* P
APPLICATION FOR MECHANICAL PERMIT p� ' r
Q �U 5 - V `-
PARCEL It. i '� / 1 —��/C. Single Family o Multi-Family'--- Commercial El
SITE LOCATION: .to/. /
Tenant/Owner: 5<-Illf 1-f"CZ---- Phone:
Address/City/State/Zip: D•-•9. S -(2- _ 5-- I S�a'"•,e- 3
Nature of work: ;-c.f t:77: --.) 5 Project Valuation: $ _ ---7 2"/ >
APPLICANT:
Name: I- i '✓V `5 / "&_."0--, -----
Address/City/St/Zip:
/Address/City/St/Zip: 57q I V ) , ,9c-= -7'-/-1/-, A124 9 , ./ 3.3
Contact Person: C-��✓"V .1<-- P1��! Phone: ',Z__ ?--'2. -Fax: S� ---1-.
MECHANICAL CONTRACTOR:
Company Name: L"'f�v(5 f�pc
Address/City/St/Zip: , �4 ( ") 9 ��,..5-7 }-1-r) lel}- 9 5--1 3 3
Contact Person: Z---4; - .✓ i(---(-.� 1-4^, '� Phone: � �J L��� -��2��aX: 5.--i `�'1
rii
State L & I Contractor Registration #: Z.g✓'/'�/ C d e, S Exp. Date:
(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 TataE f:7nff.f ibunL. .> ..
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 its officers and employees,upon the accuracy of the information supplied to the City as a part of this application.
�'�� Date: ,/,�-� g3_ _
Owner/Agent: ��� -
- 4110