94-102130 ifr
9 y46)130
CITY OF
33530 First Way South MECHANICAL PERMIT PER 61
ISSUED: 1/04/94
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: KLC
661-4000 EXPIRES: 05/03/95
ADDRESS:21O1 S 341ST PL
NO. : 212104-9033
PROJECT DESCRIPTION:MECHANICAL PERMIT. GAS PIPING ONLY.
11111 OWNER -- CONTRACTOR — LENDER
LLOYD ENTERPRISES, INC. *** OWNER IS CONTRACTOR ***
2101 5 341ST PL
FEDERAL NAY NA 98003
874-6692 927-0416
*** NONE ***
FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 80 ft HOOD • 0 0-3 HP . 0 MEC APPLIANCE FEES.* $ 3.00
FURN<IOOK..: 0 DUCT WORK • 0 3-15 HP - 0 MEC PRMT ISSUANCE... $ 20.00
GAS HNT - 0 WOOD STOVES...: 0 15-30 HP 0
CONY BURNER: 0 FURN>1OOK • 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
0 GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
TOTAL FEES $ 23.00
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
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFO ' ,i ED Bx E ' 1 AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGE A z -_ _ • 0 DATE ��-g.-57Y
FILE COPY
CITY OF �- 33530 First Way South le BED4 4- 06(, ( IV
• Federal Way, WA 98003
(206)661-4000
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APPLICA TION FOR MECHANICAL PERMIT
PARCEL it Single Family 0 Multi-Family 0 Commercial,,
SITE LOCATION: I/ F
Tenant/Owner: /L/ / •'vZ/12/?IS6S cg751- G,22
Phone:
Address/City/State/Zip: rjo,,c_ 1/1///' 'e- 7 ie/42-L- A},47
Nature of work: Avg7:/PAL -6;9-c: ( gN 49S/o,v ail 4 roject Valuation: $ �SD
APPLICANT:
Name: _am E_
Address/City/St/Zip:
Contact Person: Phone: Fax:
MECHANICAL CONTRACTOR: seL P
Company Name: /fI/ D AouNr9/N !`" cif ,4. /t4/iC/f.QL7iA�
Address/City/St/Zip:
Contact Person: Phone: Fax:
State L & I Contractor Registration #: 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 /re" ' SVRange Air Handling > = 10,000cfm Above Ground
Furn <100K BTU's Gas Log Unit Heater s Underground
Furn >100K BTU's 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 Total k3 a`Coz;<t<;zz> >:::: ;> >; s;;
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 it •e ployees,upon t accuracy of the information supplied to the City as a part of this application.
Owner/Agen : Date: --