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CITY OF FEDERAL WAY PERMIT NO: BLD95--0833
33530 First WaySouth 11�" °;::: �:;�:: if ret �! .: ;:�:;:
� ' � w . . �, A N P E R tll .1,. r ISSUED: 1o/13/95
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY : FC
661-4000 EXPIRES: 04/10/96
ADDRESS: 1819 SW 3071H ST
NO. : 770380-0180
PROJECT DESCRIPTION:HVAC - INSTALLING ONE GAS LOG.
;.= OWNER =__== ---1- CONTRACTOR __-•_ _-7-• LENDER --=
BRIAN STAUDE *** OWNER IS CONTRACTOR ***
1819 SW 307TH ST, #B-6 -.
FEDERAL WAY WA 98023
874-0451
*** NONE ***
.. ... .. _ '---__ _______' _ _ ._ .. .... .._ -. = j
*** CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE = 8.25 ***
--- _•... ... _______ 7
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 HWT • 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...: 1 > 10,000 CFM: 0 UNDERGROUND.: 0
TOTAL FEES $ 26.50
_ ..__. _._..__._ .. ---- -- ---- .-- ------ _ -.. .___ _..__...-- -__ ._ f
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
L-__. -------- -- -. ----- -• ._ ..__==_._..__._ ._...-......_.c:==-__..____•-.• .__-.._r.::._ -• .
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 INFORMATIOM FURNISHED BY ME 1S TRUE_AND ORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS MILL BE MET.
s
OWNER OR AGEN ___ /11'x, ..--_-1__ -_ _;.e _ DATE l C�_� __ e__
/ L
FILE COPY
City of Federal Way
CITY OF p 33530 First Way South
ILTD
Federal Way, WA 98003 'bCD(q 'O� 33
114) (206)661-4000 / �/
WF1.54ITY DEVELOPMENT DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
i1 C 1 1 i Ii
PARCEL f• Single Family o Multi-Family El Commercial El
SITE LOCATION:
Tenant/Owner: 'e l "a ;`1 y, ��—'`l _� Phone: �u— S1'
Address/City/State/Zip: P7 / >/ ' 3 ns'' `/ �' pL , (,),/ .f(
1 �
Nature of work: „4S Le? `1-N 4r4-11Gr-�tb/ti Project Valuation: $ 11 `�1v6
APPLICANT:
Name:
Address/City/St/Zip:
Contact Person: Phone: Fax:
MECHANICAL CONTRACTOR:
Company Name: (5-Li Q i/
•
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 A 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
BBO's Wood Stoves AIC TONS ``k"iata f
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.
/ �/. ri
Owner/Agent ��/li1J1�\ Date: 1
7