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CITY OF FEDERAL WAY y,� A PERMIT NO: BLD95-0811
WayM[7.:( H�,,,,;�� 11 1 „11., �,,.... li P E,.Pi,., 'I 11".
...
33530 Fi rst. Wa South �..,.,,. . � � � ..�,, � ISSUED: 10/09/95
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC2
661-4000 EXPIRES: 04/06/96
ADDRESS:475 SW 345TH PL
NO. : 132170-0180
PROJECT DESCRIPTION: INSTALL GAS LOG TO EXISTING GAS PIPING
F= OWNER --- •-----__----= -. - T- CONTRACTOR =_- .- ------ -•- LENDER --
DOUGLAS LANDEIS 1 *** OWNER IS CONTRACTOR ***
475 SW 345TH PL
FEDERAL WAY WA 98023
1
927-5154
I *** NONE $#_
X** CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE = 8.25 us
= _ _ ______._.__ __=__. .. -- ..............._____.______=---- ----_ _._-._ . -,-. -__
FUEL TYPES.:GAS ? FANS • 0 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 MEC APPLIANCE FEES.* $ 6.50
GAS NWT • 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
GAS LOGS...: 1 > 10,000 CFM: 0 UNDERGROUND.: 0
I TOTAL FEES $ 26.50
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 Water Tank)
Inspection Record Water Line OK __________ Mechanical Inspection Notes:
� B
GAS PIPING OK Date By
PERMITS EXPIRE 180 DAYS AFTE ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THE INFORMATION F MIS ED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
�WNER OR AGENT :: Z<�,,, _ r ` -
DATE ,
FILE COPY
- City of Federal Way
CITY OF f- 33530 First Way South
_ _ Federal Way, WA 98003
(206)661-4000
WFW
APPLICATION FOR MECHANICAL PERMIT
PARCEL #• Single Family ❑ Multi-Family ❑ Commercial ❑
SITE LOCATION:
Tenant/Owner: ► ('ll,(&�(,--/1' Kt:E,-f:- I I`1 =i= Phone: l I z .,2;154
Address/City/State/Zip: �1 ZL c �' Ti" �- -rJA'ZAI_ 'tn1A1f WA. gbU1 J
Nature of work: '— �'ee lol.A07 (.�— Project Valuation: $
APPLICANT:
Name: A,6,L.�(; A . 1_An)r' d3
Address/City/St/Zip: 4.7 -• E.•11J. 345-(' P,. rei7e2AL ',A1AN( / ift‘/A. 23
Contact Person: Phone: ' ''/ Fax:
MECHANICAL CONTRACTOR:
Company Name: k...4t %,,....
Address/City/St/Zip:
Contact Person: Phone: Fax:
State L & I Contractor Registration #: 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 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 Tetzit flnit0ovnt
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 defert1e 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.
/-
6-7�J
Owner/Agent: V% • -��� Date: (` 'ill.