95-103310 c5 le.3 /v
CITY OF FEDERAL WAYi�'"�� PERMI T NO: BLD95-0980
33530 First Way South M L' ;ff� - fr�„�,9i .''It. .....i�'""r 1.,,,., 11',:;,4 �:., ':'"'k, ' 3,:. .. ISSUED: 12/05/95
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC2
661--4000 EXPIRES: 06/02/96
ADDRESS : 30204 10TH AVE S
NO. : 515390-0220
PROJECT DESCRIPTION:MECHANICAL - GAS PIPING (28"), FURNACE TO 100K BTU, GAS HWT
f= OWNER _.._.__. _-____. __._____.____ _;= CONTRACTOR - ---._ _ r- LENDER =______ =j
1 DENNIS OLSON I NORTHWEST WATER HEATER ELEC. - _ !
1 -
30204 10TH AVE S j 2800 THORNDYKE AVE WEST 1
FEDERAL WAY WA 98003 j SEATTLE WA 98199 1
839-5025 1 I
NORTHWHO99J1 j
___ ____._;__ __-__.. i
;t: CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE : 8.25 #__
FUEL TYPES.:? ? FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 28 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 1 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 19.50 I
GAS HWT • 1 WOOD STOVES...: 0 15-30 HP • 0
, CONV BURNER: 0 FURN>100K • 0 30-50 HP • 0
BBO • 0 MISC • 0 5+ HP • 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS I I
RANGE • 0 <:10,000 CFM: 0 ABOVE GROUND: 0
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0 1
TOTAL FEES $ 39.50
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I 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)
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I Inspection Record Water Line OK _________ Mechanical Inspection Notes:
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GAS PIPING OK Date By
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PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STILT •1 AL • D GRAD . PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THE INFORMATION FURNISHED BY ME IS TRUE AND CI '' '�BEST OF K i LEDGE AND THE APPLICABLE CITY OJ.EDERAL i�LRWOUIREMENTS WILL BE MET.
OWNER OR AGENT
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(----- DATE i ____
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FILE COPY
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CITY OF FEDERAL WAY PERM!. r NO: IR D95-0980
39530 ri rst Way South 11C(._ 1 iral I,ILi Iii.., P12, 11,11 ,11' ISSUED: 12/05/95
Federal Way, WA 98003 Hui ldinq inspection Requests 661 -4140 BY: FC2
6616000 . EXPIRES: 06/02/96
ADDRESS:30204 10TH AVE ..',
NO. : 515390-0220
PROJECT DESCRIP TION:HECHANICAL - GAS PIPING (28"), FURNACE 10 100t BTU, GAS HWT
1 DENNIS OLSON NORTHWEST WATER HEATER ELEC.
0204 1011I AVE S
1111111
DERAL WAY WA 98003 2800 TOORNDYKE AVE WEST
SEATTLE WA 98199 1
1
839-5025
,te, ITORTt
tit (ONIRWORS, MIRA MA 10(AtiON (010t 113PINWATWEPORTIS SALES TAX FOR PROJECTS MINH ENE CITY Of FEDERAL $AY. TAX RATE : 8.25 smt
FEES
FUEL TYPES ? ? FAN . -' '''.1 P°ItIF /(umPPL'-°K- ' ?,4114 . 1 °'
GAS PIPING-: 28 ft 0008— . -* I/ 0-' qP. °.: 1 "11.1 - Y, „ -,6, . 1r PR4 °AKE-.
FORH(100X..: 1
GAS NWT • 1
CON? BURNER: 0
880 • 0 DUCTIORK... ... u 3-1'.., 01 ,.: A $ 20.00
1:: 'A,DY *t 1 .7.-;-4,,, . Wr Olt E FEES.* $ 1930
,
0004! t4(40. ° 0 It '0 1 : ,7.0- _ - _ .°1--:- '.-1 °*.' :-.)3"4!,
_,,
PIRO, iHn. .: W ,--
iii _ ", : 4) , 1))). 19,1< A.
1 GAS DRYER..: 0 AIR HANOW4WW1,1 , flt I I
RANGE
f 10,0**fti: -4 HP" ' POtitib. 0 i
GAS 0
ASLOGS...; 0 AL 000 I*, 0 untR.,:t.tlifiD.: 0
TOTAL FEES $ 19.50
Does the eater supply systes contain a Pressure Reduction Device or Check valve? 0 Yes 0 No (If "Yes" then tater expansion tank is required on Not Water Tank)
Inspection Record Water Line OE Mechaniclt Inspection Notes:
GAS PIPING Ut;7)0-96' Da' 2-d0.96
A/A.)
KNITS EXPIRE 180 DAYS AFTER IcSUAIRL 11 km Rol IS_-S ITg 1<i) ---,, ‘ RITA AND gtAlf PERfilr EXPIRE ONE TEAK Affix DAIL to ISSUANCE.
14ERIITY IRE INTORHATION 11111141.AILD BY tit TS OrATIO .' C WIRE REV Of MY K T.114 Alit THE APPI.H.A E C111 Ofl-EDIRAI ili-itrOliIRENENIS WILL DE KT.
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OWNER OR AGENT 7/ __-- 7 DATE /
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FIELD COPY
City of Federal Way 5 I flG 5 b Cf $'0
CITY OF r--- 33530 First Way South l� l
Federal Way, WA 98003
----,--_ r&CIEPCF11- (206)661-4000 N
WFIY RECEIVED ' '
APPLICATION FOR MECHANICAL PERMIT
DEC 0 51995
PARCEL ft.SISNOC ri-� Single Family/ Multi-Family D CITY OFWBEWE' )A
BUILDING DEPT.
SITE LOCATION:] n` 1
Tenant/Owner: 1)-AN (5 Q� , rn Phone: SCS-
Address/City/State/Zip: -3 4 /(jitt� <I )
e" ,)-- 3iv ciV)03
Nature of work: (�� t A IL f t) �C�` 1 i C i 1""/ tu"`-f uI Project aluation: $ 2%
pLom6 4-610-
APPLICANT: p
Name: A) Lk! PGg. F
Address/City/St/Zip: ' - l D— F-- iI74I)'S�nl ) /6/ co ?3/(
Contact Person: ( c < i' r A1OL Phone: • .5--- i(0615-4 ) Fax: _3D-61-1): 7
MECHANICAL CO/NTRACTOR• ,
Company Name: 1 UL- ( 17 kT- 4-_
Address/City/St/Zip: ACO )th -11 171 t- S to 9c19 1
Contact Person:(4,.--1--- oft. ✓-1'`'4V01--D Phone::XS 10� 0( 715 Fax: -3;19 -LI)- 9
State L & I Contractor Registration #: i V n rte- I f I L( \ H i 63 f_D - 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 ,,-,z a Range Air Handling > = 10,000cfm Above Ground
Furn <100K BTU's I Gas Log Unit Heater Underground
Furn >100K BTU's Fans Boiler BTU/H Miscellaneous
Gas Hwt `ilayn , ) / Hood Boiler BTU/H Other
Cony Burner Duct Work A/C TONS Other
i'Ct ti : < <? a >BBQ's Wood Stoves A/C TONS i: btat,#t t't z t* : > >j>
DISCLAIMER: I certify under penalty of perjury that the infor• .n furnished •y me is true a.. orrect.•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 applica is made. I f . •r agree • - • harmless the City of Federal Way as to any claim(including costs,expenses and attorneys'fees
incurred in investigation and defense of such clai. ,which may be • .e by any,..-• including the •ersigned,and filed against the City of F-ederay Way but only where such claim arises
out of the reliance of the City,including its of'era and employ.- informat'•n supplied to the City as a part of this application.
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Owner/Agent: — Date: I ( ��