95-102251 '5 /Das (
C.IT'Y OF FEDERAL WAY NO: BLD95-0720
33530 First Way South i�` i;:. 't�,,., ,,.�ll'"t ill ..,ii ("1 A . PIff.:k it 1:1 ,,,11 ISSUED: 09/06/95
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC2
661-4000 EXPIRES: 03/04/96
ADDRESS: 718 SW 9441ELDiS - Thier i b
NO. : 506880-0010
PROJECT DESCRIPTION:MECHANICAL - GAS PIPING (1), FURNACE TO 100,000 BTU (1), GAS HWT (1), GAS LOG (1), DUCT WORK (1)
OWNER =_____ - =----=--= - CONTRACTOR . r LENDER = -- __= 4
• DONALD SUMPTER *** OWNER IS CONTRACTOR ***
718 SW DASH POINT RD
FEDERAL WAY WA 98023
680-3636
*** NONE ***
- - _ _ -- ___ _ 1. _ ..__=
sxx CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE : 8.25 ***
FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS I FEES:
GAS PIPING.: 99 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... $ -20.00
FURN<100K..: 1 DUCT WORK • 1 3-15 HP • 0 MEC APPLIANCE FEES.* $ 32.50
GAS HWT • 1 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 $ 52.50
___ = 1= _w_.._w__==
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
__ .. = ===== ===_= I
= ____ === .-.- _
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 BY NE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT __ " __� / =%M, f `
DATE --e - ci S'' 37 '17? 923
FILE COPY
—..,_,_,__,,,,_,,_,_,...,___
CIT OF FEDERAL WAY PERMIT 1 NO:
MECHANICAL
33530 First Way South ....,
I.
AL PERMIT ...;SUED: 0,6/95
i Fecieral Way. WA 98003 Ptii 1 ,4 ' n,i Inspection 14eques.ts 661.-4140 BY: FC2
661-4000 EXPIRES: 03/04/96
ADDRESS: 718 SW :4R1-77-7- 1%v -Cii: -PO/VT' kb
NO. : 506880-0010
PROJECT DESCRIP LION-.MECHANICAL - GAS PIPING (1), FURNACE 10 100.000 BTU (1), GAS 1W11 (1), GAS LOG (1), DUCT WORK (1)
r OWNER 'n ucam (ONIRAC TOP LENDER
DONALD SUMPTER ttl OWNER IS CONTRACTOR 131(
FlE18DERSAWIDAWASYN WPAOI9N8TOR93D
t•
680-3636
t* W0 *
Su Ultfikirg i0kS, ti EASI Val tOLATION CO ( M2 WIEN PEPINtliNG SALES TAX FOR PROJECTS 111111111 TIE CITY 01 ILDERAI WAY. TAX RAII -. 8.25 ***
FUEL TYPES. ? FANS ,"1(0.11 E., °=- -;,,,`• - FEES
1 * *„,,,,7,221
GAS PIPING.: 99 ft HOOD44, 3 ,.... ,1,4•, =2,, ,,,,.:,,,i ,,,,,,,o,,,,,,, ,,,p„4., ,,.-,.. ,„.„,.. ..:,„:,. . ., , ,,,, , „ L' UANCE... $ 20.00
FUNI<1.001...: 1 DUf.I 4044......i.44-„Avooff,,,, - 1 ,'-- P. -.*f.'''' ,.. --fi,,!:7::
- 41141 I. E FEES.' $ 32.50
GAS HWI • 1 IMO
DDOSTOVES..i' ,..
t7-#01 :4- HP -•.%(1:'
CONY OURNtP: 0
401., ,'''' .4
1411Or•"N-*7 " g 1011, ' I- HP....
' 0 N ' . . ''\ '# , - - '`;''° :,.., 441'-`-jk,
GAS DRYER..: 0
Ili
RANGE 0• AIR L ' 4 , \ ,,, I v
,'
A
:‘,P
(.40, t , 4-, , 1 , wt': nk
GAS LOGS...: 1
> 10,0' ' 0 . DERGPAOND.: 0
TOTAL FEES
I $ S2.50
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 Water Line OK Mechanical Inspection Notes: -
GAS PIPING or Date By
PERMITS EXPIKE 180 DAYS ALIEN ISSUANCE If NO MORI IS SIMILE RISIDLAIIAL AND GRADING PINNIES EXPIRE OWL. YEAR MIER DAlt Of ISSUANCE.
1 fEXIIFY TNE INFORM11011 1041RISULP BY NE IS TRUE AND (MEC( 10 INE NEST Of NY KNOWLEDGE AND INE APPLICABLE CITY Of FEDERAL WAY RtOUIRENENIS WILT III NET.
OWNER OR AGENT -;-e'‘ IFF"--------
. DAIL -4 - 9 ce---
......_______
FIELD COPY
RECEIVED
City of Federal Way
CITY OF 8'"°-- 33530 First Way South
_ 17-710E.1"KFR____
Federal Way, WA 98003 SEP 0 6 i999 �'\,`\ (206)661-4000
v V CITBUILDING DEPT.
OF FEDERAL AY
APPLICA TION FOR MECHANICAL PERMIT I�
b2 E of s-e56-te i LDf5 -'07 _O
PARCEL #• 3 Lei cis-- 0 3�7S
Single Family Multi-Family 0 Commercial 0
SITE LOCATION:
Tenant/Owner:
Phone:
Address/City/State/Zip: �1 `�C� - bk - ,2.1 y� � .'
Nature of work: 0720-0-C-7—e--
Project Valuation: $
APPLICANT:
Name: p..)---- ���ti411'p-�-z,
Address/City/St/Zip: 541
Contact Person: 5 14 _ Phone: Cr -3 Cr
S ax: Z 476. 3 34„
MECHANICAL CONTRACTOR:
/2155:›0�
Company Name: { :
Address/City/St/Zip: ►' `s ` z5q scy & ''lr 8
XM 1 Contact Person: (,17 e_5 � r Phone: '5z 5 ")S-5-_- Z 3- 3 it'
Fax:
State L & I Contractor Registration #:
(Card must be presented) Exp. Date:
MECHANICAL UNIT COUNT:
Fuel Type (gas/other) (=- 4, '' Gas Dryer Air Handling < = 10,000cfm Fuel Tanks:
Length of gas piping I Range Air Handling = ,
> 10000cfm
Above Ground
Furn <100K BTU's I Gas Log , Unit Heater
Underground
Furn >100K BTU's Fans Boiler BTU/H
Gas Hwt Miscellaneous
Hood Boiler BTU/H Other
Cony Burner Duct Work A/C
TONS Other
Wood :..
ood Stoves A/C TONS Ttatf)nttfovrt*i:E'.:::
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 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.
Owner/Agent: ....40.11111/ow- L.�� • Date: :...),.<.:7)77
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