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CITY OF FEDERAL WAY + y, y q PERMIT NO: BLD95-0816
33530 First Way South �""��h�;.;�,.�;;, ,: �,,,.I�,�r ""�� .,, ,. d,.11:A�.,,V.. IP ,:;,.�W' ,,Ill :311 �.,. ISSUED: 10/23/95
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 04/20/96
ADDRESS: 29625 PACIFIC HWY S
NO. : 042104-9031
PROJECT DESCRIPTION:MECHANICAL ONLY - INSTALL ONE 500 GALLON ABOVE GROUND PROPANE TANK.
-= OWNER T CONTRACTOR ----- ---x- LENDER -----
ii
509 DELI ASSOCIATESPERMAHOLD INC.
29625 PACIFIC HWY SOUTH 2317 N MACHIAS RD
FEDERAL WAY WA 98032 LAKE STEVENS WA 98258
6
.1 -006)941-6600 1 206-334-8808
! I PERMAI*101CL
x;x CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE : 8.25 su
FUEL TYPES.:PRO ? FANS • 0 BOILERS/COMPRESSORS '~ -----TFEES:
i 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.* $ 50.00
I-GAS HWT • 0 WOOD STOVES...: 0 15-30 HP • 0 PLAN CHECK FEE $ 17.50
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 • 04110,
<:10,000 CFM: 0 ABOVE GROUND: 1
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0 1
TOTAL FEES $ 87.50
_.. _____. _.____._ -- __ ,
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:
GAS PIPING OK Date By -,
E___...__ ____ =--- _-:___ __ = _- = = _1
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THE INFOR 1 liar" ' If -TRULfi D CORRECT TO THE BEST OF MY KNOWLEDGE AND fHE APPLICABLE CITY OF FEDERAL NAY REQUIREMENTS WILL BE MET.
PILE COPY
GE
OWNER OR VII 1141DATE I d _ Z3 GCC
N.
• City of Federal Way •
CITY of (-- 33530 First Way South
. En,_ r-- Federal Way, WA 98003 LDqC -Qc' (" `
(2061661-4000 `'�-J
W'OMIVED
APPLICATION FOR MECHA N/CAL PERMIT
OCT 101995
PARCE Gtty QF FCDERAI WAY Single Family o Multi-Family o Commercial L-
gUIL.DING DEPT
.c. o0 `4— OO
SITE LOCATION: n
Tenant/Owner: _54)4... 0.R
P r 05,9 DELT 5 10�v,.) 0-r.v,.) 0-rv,.v,.) 0-r..4))� Phone: q LA` `(c`
Address/City/State/Zip: 9(45Z S P, 4 - .
Nature of work: 'c" ZoP41,�7:;- Project Valuation: $ t
APPLICANT: Q, �+
Name: -" `� ne EP , V
11
Address/City/St/Zip: V.,9 6 2 5 c,4 ' -• L ‘ a, . / T 3
.
Contact Person: `--e- ‘-\NZ-zNe-0 Phone: 941- 1 b 1 1 Fax: 9 -k\ - °767
MECHANICAL CONTRACTOR:
Company Name: e- 0..C61s., S L_t C ,
Address/City/St/Zip: •S (- P'4 IA T A S Q ,
Contact Person \3Q--- µiv S60-^b Ef Phone: 3. LI - 8$cFax: 3 3(I-5U/
State L & I Contractor Registration #: ec-2f•-) t,s (e'D ( C 4-- Exp. Date: 2- 7. (4,
(Card must be presented)
MECHANICAL UNIT COUNT:
Fuel Type (gas/other)POtS,0412 Gas Dryer Air Handling < = 10,000cfm Fuel Tanks:
Length of gas piping A/ Range Air Handling > = 10,000cfm ). Above Ground 1.9(.3 ScoIJAt`4on.)
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
BBQ's
Wood Stoves_ A/C TONS '>7otaE`:..>>:�: >.:«�> » z:;«::a>»»>'<>S
fJnt csun
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 offic employees pon t -accuracy of the information supplied to the City as a part of this application.
Owner/Ag•n : Date: � 5