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CITY OF FEDERAL WAY NO: MEC97-0385
33530 F]. r-s t Way South I ,., rI II"i� ""�i 141: ff,", _,1�';it l,... P E :;!:.M ..it -'11-
,,ti ISSUED: 02/13/98
Federal Way , WA 98003 Mechanical Inspection Requests 253-661-4140 BY : FC2
253-661-4000 EXPIRES: 08/11/98
ADDRESS: 309O0 50TH AVE SW
NO. : 112103--9040
PROJECT DESCRIPTION:HVAC - NEW FURNACE INSTALLING W/DUCTING AND GAS PIPE
r= OWNER ---------- -• - CONTRACTOR =--------•- s LENDER -•- - ---
CAMP KILLWORTH ! OWNER IS CONTRACTOR
30900 - 50TH AVE SW 1 f
FEDERAL WAY WA 98023 !
927-9241
*** CONTRACTORS, PLEASE USE LOCATION CODE 1132 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE = 8.25 ***
T
PROJECT VALUATION 15000 ( FEES:
FUEL TYPES.:GAS ? FANS 0 BOILERS/COMPRESSORS ---
MECH PLAN CHECK FEE $ 40.50
GAS PIPING.: 48 ft HOOD • 0 0-3 TON • 0 Mechanical Permit* $ 162.00
FURN<100K..: 3 DUCT WORK • 1 3-15 TON • C MEC PRMT ISSUANCE... $ 20.00
GAS HWT • 0 WOOD STOVES...: 0 15-30 TON...: 0
CONV BURNER: 0 FURN>100K • 0 30-50 TON...: 0
BBQ • 0 MISC • 0 50+ TON • 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS
RANGE • 0 <:10,000 CFM: 0 ABOVE GROUND: 0 1
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0 # TOTAL FEES $ 222.50
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: Mechanical Rough-in Date Gas Piping Date
MECHANICAL FINAL Date
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THE INFORMATIJN F ED BY ME IST ND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT / __.___64DATE <`' ~7-
FILE COPY
'Pe CITY OF G BUILDING DIVISION
33530 First Way South
\)\> Ry Federal Way,WA 98003
(253)661-4000
c°\
Fax(253)661-4129
®�G c 4 A iPPLICATION FOR MECHANICAL PERMIT
rEa��EPT��
0_,13„,,9,0 G p MEC &fl - a3��7
PARCEL# t<Z I Q 3 - CIC LId Single Family 0 Multi-Family 0 Commercial
SITE LOCATION r, Q
Tenant/Ownerf %( 4FiC_ l'i Mi,g9feS c,11 1-S-A Phone (ZS3) /Z 7 1 z
Address/City/State/Zip 309 0 0 5)m 1u S.Li-) •
Nature of Work R24-9kC& 10dval 1LA-T7e Project •Valuation $ / Ot Z)
APPLICANT D
Name �1 t2t C ° aA b
Address/City/St/Zip 2-5-217-0 33 en 'PL
,�2`5�3`
Contact Person {- lam
Phone ) 9q i-7E/D 46)'ax
(WO 6sc- 67s C.)
MECHANICAL CONTRACTOR �?
Company Name OWA�- ?1 j?AC-4 �d. R-5 CuU
ox. //��/L °"J -5 ,.4.
Address/City/St/Zip 172-2 S •• aNeb.0 Ao r �ttelti ftA WA 9:1fes"
/ ZS 3
Contact Person Pe- 1) Phone � ) 94/-7P/b ( Fax
(2." 4SS-6953 ('D)
State L&I Contractor Registration# Exp.Date
(Card must be presented)
MECHANICAL UNIT COUNT
Fuel Type(gas/other) (A'l Gas Dryer Air Handling<=10,000cfm Fuel Tanks:
Length ofp�as piping g p g /03 Range Air Handling>=10,000cfm Above Ground
Fum<100K BTU's Gas Log Unit Heater Underground
-7( Fum>100K BTU's )( 3 Fans Boiler BTU/H Miscellaneous
Gas Hwt Hood Boiler BTU/H Other
Cony Burner Duct Work I A/C TONS Other
................................................................
....................................................................
................................................................
BRQ's Wood Stoves A/C TONS 't`iaftf+tf`t iit'> ii<•>s%"•3?•::`'•:::><'i><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,end 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.
et
.,Owner/Agent /,‘ Date /2/4//97
lk
Mecn.Aer
Revrseo 8/26/97