96-100223 CITY OF FEDERAL WAY �,.. �„ PERMIT NO: ME "96-00 _4
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33530 First Way South �� �;;;;. �,.,,. N"'1I�°1� �"'1� � � a ISSUED; 01/22/96
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC2
661 -4000 EXPIRES: 01/15/97
ADDRESS :29865 11TH AVE SW
NO. : 195460-0095
PROJECT DESCRIPTION:MECH - FURNACE 100+ BTU, GAS PIPING (501
•
LENDER ------ -
f= OWNER _____.. .. -- _ _ - _ _ __ T-- CONTRACTOR ____--•-._ •- ._.. ..._-.__...____._.._.____. .__7_ -- - T
ED/KIM STERNS ( MERCURIO NATURAL GAS SRVC INC
29865 11TH AVE SW 1 115 GOLDEN GATE AVE
FEDERAL WAY WA 98023 1 FIRCREST WA 98466
839-7496 d 566-8974
MERCUNG055ME gg
____ ._--.___.. __.._- --- --- ----- ------_. _. --.._.-____. ..-____-____ _ _.__._ ._-_---- -.- ..._
*** CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE = 8.25 ***
_______ .---___.____ ��.--__ ..•--______ _ .---•,-------------- _ -_:=�--w-_
PROJECT VALUATION 1300 FEES:
FUEL TYPES,:GAS ? FANS • 0 BOILERS/COMPRESSORS Mechanical Permit* $ 38.00
GAS PIPING.: 50 ft HOOD • 0 0-3 HP • 0 F MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 0 DUCT WORK • 0 3-15 HP • 0
GAS HWT • 0 WOOD STOVES...: 0 15-30 HP • 0
CONV BURNER: 0 FURN>100K . 1 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 $ 58.00
_.. --------------------------------- •-- -=-- ------- ._.-_ --z-. ..___.-
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
_.. ________ _.__.-----_____ ......_...___... -- - ..._.-. ___ _ -- _.....__.._.-_ _ _ - .._--- __ --- ___ _..__r-..- __ _, .
PERMITS EXPIRE 180 DAYS . ' ISSU•N IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THE INF1' 3'. 1 FURI�I • BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGEN /_ .. e- ..,.- - DATE „/ Z.I .- 6r__..
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City of Federal Way
CITY OF r---- 33530 First Way South
0 _ I ---J Federal Way, WA 98003 RECEIVED
_______________---- I `-- (206)661-4000
ViarW JAN 2 2 1996 «
APPLICA TION FOR MECHANICAL PERMIT
.;ITY OF FEDERAL WAY
��O � D q5--- BUILDING DEPT.
PARCEL it. Single Family - Multi-Family 0 Commercial 0
SITE LOCATION:
C/gAlD�2
Tenant/Owner: LA Q` �✓� C Phone: S'jY-- 7 , '
Address/City/State/Zip. n &.5 // /¢J 5 c
----- . aC>
Nature of work: —/AA4- �--'-/l 4-S /�R,4dz1,1�a' ,%/>//'e( Project Valuation: $ /-�a�
r=-ZiIt)F//e)71/04/017---, "-D/J�/ 7e7 //
7.--105/fi, /Dil,, C/40k " � Lis N X D %tz-elt
APPLICANT:
Name:
Address/City/St/Zip:
Contact Person: Phone: Fax:
MECHANICAL CONT CTOR: [ ,
/4 Cit/�/0 s !t/ 77//t l l�1'"S C tii It r -1 e-
Company Name: � G-1� /�
i
Address/City/St/Zip: WS- �dL )Z-----it..) "C- -'Tr /-z)
Contact Person: ( / 1 5 (--1---1(A/ Phone: 7Y Fax:
State L & I Contractor Registration #: dt�wti/Ce7 S/17& Exp. Date:
(Card mustbe presented)//
MECHANICAL UNIT COUNT:
Fuel Type g? /other) )1.S Gas Dryer Air Handling < = 10,000cfm Fuel Tanks:
Length of gas piping 5C>f Range Air Handling > = 10,000cfm Above Ground
Furn <100K BTU's Gas Log Unit Heater Underground
Furn >100K BTU's 1 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 >>7�[aif�rit>�az��>»>[ <z»»»»» «i;; ;
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 a c:im),w,h 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,in .."••-. its off�rs a "employees,upon the accuracy of the information supplied to the City as a part of this application.
•Owner/Agent: i Date: