95-101931 (75 It'../,7
CITY OF FEDERAL WAY PERMIT NO: BLD95-0624
33530 First Way South el '.(..". " rctN I C L P E 1 .1 T ISSUED: 08/15/95
Federal Way , WA 98003 Building Inspection Requests 661-4140 BY: FC2
661-4000 EXPIRES: 02/11/96
ADDRESS:1411 SW DASH POINT RD
NO. : 072104-9091
PROJECT DESCRIPTION:MECHANICAL - CHANGOUT GAS FURNACE TO 100,000 BTU, ADD A/C UNIT
r= OWNER T CONTRACTORT LENDER
FEDERAL WAY YOUTH/FAMILY SVC GREENWOOD MECHANICAL CO I
1431 SW DASH PT RD 7404 GREENWOOD AVE N
4111
FEDERAL WAY WA 98023 SEATTLE WA 98103
839-6555 789-8172
GREENMC076KG
*** CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL MAY. TAX RATE = 8.25 ***
T 9
FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 1 MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 1 DUCT WORK 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 19.00
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...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
TOTAL FEES $ 39.00
=
oes 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:
I GAS PIPING OK Date By
L
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 INFORMATION FURNISHED ME IS TRUE D CORRECT TO THE :EST OF MY KNOWLEDGE AND THE APPLICABLE CITY F FED A OUIREMENTS WILL BE MET.
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OWNER OR AGENT 'I /a,4,11 DATE S
FILE COPY
3711-779 3
CITY OF FEDERAL WAY PERMIT NO: BLD95-0624
33530 First Way South MECHANICAL PERNI T ISSUED: 08/15/95
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC2
661-4000 EXPIRES: 02/11/96
,ADDRESS:1411 SW DASH POINT RD
NO. : 072104-9091
PROJECT DESCRIPTION:MECHANICAL - (HANGOUT GAS FURNACE TO 100,000 BTU, ADD A/C UNIT
Ea OWNER caaxmarmmxa:maeamxmma: mm,a¢amca,rame.mtmxmrmmaxasm:.aasa a CONTRACTOR ncn==m:anvt,rrsramas_aesc:. .vaaamo�saar-a_fm LENDER -ssasa�mxmasmammm•su, ma ac ac,:5nrnmamraaxamarmaa
FEDERAL WAY YOUTH/FAMILY SVC GREENWOOD MECHANICAL CO
1431 SW DASH PT RD 1404 GREENWOOD AVE N
FEDERAL WAY WA 98023 SEATTLE WA 98103
839-6555 789-81.12
4EEHt`aCU16K6
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r** CONTRACTORS. PLEASE USE LOCATION COIF 4717 vnti REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL. MAY. TAX RATE : 8.25 #f
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FUEL TYPES.:GAS ? FANS 0 :+}LEERS/COMPRESSORS FEES:
GAS PIPING.: 0 ft HOOD .: 0 0-3 HP......: 1 MEC AMI ISSUANCE... S 20.00
FURN<100K..: 1 DUCT WORK • 0 3-15 HP.....: 0 MEC APPLIANCE FEES.* $ 19.00
GAS HNT • 0 WOOD STOVES...: O 15-30 HP • 0
CONY BURNER: 0 FURN>100r • 0 30-50 HP • 0
880 • 0 MISC. .,..,,.: 0 5+ HP • 0
GAS DRYER..: 0 AIR HAHPtING UNITS FUEL TANKS
RANGE • 0 <:10.000 CFR. 0 A,sVE GROUND: 0
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
TOTAL FEES $ 39.00
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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 Inspections Notes:
GAS PIPING OK Ga tr3/0 8y kilifi_
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PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY TIS INFORMATION FURNISHED NE IS TRUE,�� CI 1 CT TO THE ST OF NY KNOWLEDGE AND TNF APPLICABLE CIT F F EQUIREMENIS WILL DE MET.
• , 46 / i r/ /'
OWNER OR AGENT 1____ �''1 DATE ---1— __- ---3
i'' 47
• y� A
FIELD COPY \„ \y Ix Iv
RECEIVED
• City of Federal Way • •
CITY OF 33530 First Way South
AUG 1 51995
Federal Way, WA 98003 4
- Fein ErKFIL_.ViFf 1206)661-4000
ut t yeF BUIL D NG DEPT. AY
APPLICATION FOR MECHANICAL PERMIT (lc- O(
PARCEL it. Single Family 0 Multi-Family 0 Commercialj
SITE LOCATION:
Tenant/Owner: G i `,, & (/ LY7Øf/K - 8,7? - 6 J`c
^
Address/City/State/Zip: /e/ `5k6,1-5-11 / :- ND
76v:23
Nature of work: R�,Z/I /24(/'' / Project Valuation: $ j w
/9-'°/9 ///Q c')/V.)
APPLICANT: 61-E77- /-/ -2-
Name: . / l///U lv, /____,/ EZ /14-k7C.C9s / e , - i//4
Address/City/St/Zip: 74'61- UJ 1(-1' 12L17 If 1" 4)
Contact Person: ," 't,A/ C.,��/7 ��e.._ Phone: 7g7—F/72- Fax:
MECHANICAL CONTRACTOR: /�r /� /� �J ,,�-,-
Company Name: .�.f :t/" ING���j ,r7"/ e o/ur�/7/0/u1�6 4 I"/� +'"l/A�-,
Address/City/St/Zip: 74 4 `_� v`T/�o� C}
-(i
Contact Person: k /B ' 67-<yliL. Phone: 747-117. '--- Fax:
State L & I Contractor Registration #: -',4':e A1/1 /7(G'<C7- Exp. Date: .-.--Apt/51C
51C
(Card must be presented) -
MECHANICAL UNIT COUNT:
Fuel Type ( as/other
9 �^� Gas Dryer Air Handling < = 10,000cfm'• Fuel Tanks:
Length of gas piping / 1 Range Air Handling > = 10,000cfm Above Ground
Furn <100K BTU's ) Gas Log Unit Heater Underground
Furn >100K BTU's Fans Boiler BTU/H Miscellaneous
Gas Hwt Hood Boile BTU Other
Cony Burner Duct Work NO Al A C I '7 TONS Other
BBQ's Wood Stoves
A/C-----
ONS N
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.
/ / / f / / ..�
, �.,
Owner/Agent: !C_Lw � - - Date: