98-100062 CITY OF FEDERAL WAY y PERMIT NO: C9$-0004
I ME
33530 First Way South il'�''ii F.�„,.. N...H��.,,;`11 N �,..„ �,, L, ."- E6:::.N�°'�,,N'�p''�, ..,N,.: „.N,... ISSUED: 01/06/98
Federal Way , WA 98003 Mechanical inspection Requests 253--661--4140 BY : FC2
253--661--4000 EXPIRES: 07/04/98
ADDRESS:28715 11TH AVE S
N0. : 515296-0420
PROJECT DESCRIPTION:G/G FURNACE REPLACEMENT
-- OWNER - ....__. ..____ T CONTRACTOR
LENDER •-
PAM BURPEE CITY SHEET METAL
28715 11TH AVE S ( 4202 AUBURN WAY N #8
FEDERAL WAY WA 98003 1 AUBURN WA 98002
852-2174
CITYSM*173JA
a: CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE = 8.25 #ir
_.. MIS----. ..... --------- ------ =:=::-=- ------ -- .. ..._r:
PROJECT VALUATION 1800 FEES:
FUEL TYPES.:GAS GAS FANS • 0 BOILERS/COMPRESSORS Mechanical Permit* $ 48.00
GAS PIPING.: 0 ft HOOD • 0 0-3 TON • 0 MEC PRMT ISSUANCE... $ 20.00
FURN<100K..: 1 DUCT WORK • 0 3-15 TON • 0 If
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+ ION • 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 $ 68.00
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)
's s
Inspection Record: Mechanical Rough-in Date Gas Piping Date
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MECHANICAL FINAL -- Date _.
_.__ _ _. -- 3
PERMITS EXPI' 180 DAYS • R ISSUANCE IF NO WORK IS STARTED.
I CERTIFY T INFORMATION F,'NISHED BY ME IS TRUE AND CORRECT TO THE BEST OF NY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGEN 1pi_ _tiel __.. DATE / -14? i
FILE COPY
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c7st, IOD 0(ID
C Of 11.1,11RilL WIY PURMIT NO: MEC913-0004
33511 1 i 1 .:',1-. Way ‘,..',,,,w11, ,.., ten n 4 n,...
MIE:(e 11(1N I IL IrAL 1 , t. P.M 1 . " 1 , (.,1 if 0: 01/06/9H
Fek-1c,,r A I Way, WA 9100 3 11,.,( hilict tn .ri---ktiott r; , ,!, '..,! , '..-J "„ f ,i. 1 ,0 13Y: Fc2
25.3 6 .1. -400o I - i'I PI S: O7,'O4/ '
ADIVI•Sr.: ',28 71 5 t tIli Wit (.3
(..)-1296• 1.34'.?.0
1)T (.1,-1 V T DI •.;I'R IP I Toil.:G/C, FURNACE REPLACEHERT
nA1 BUPPEL CITY SHEET HMI .,
i28715 11TH AVE S 4202 AUBURN WAY LI 118
FEDERAL WAY WA 98003 ALTHORN WA 18002
852-2174
jiinifitliai
Us COITRACIORS,-7011115$ la titiii* CiNie1/32'1001 REPOTETTIK SALES TAX FO PROJECTS WIININ TX CITY OF FEDERAL 1811. Tax RATE = 8.25 tst
,
PRO EC I VALUATION 1800
4.‘ Si,.'„L
HILL TYPES.:GAS GAS TANS l'-0; BOIL t011PRititO - Mecharlifai Pettit' $ 48.00
,
s PIPIKC.: 0 ft HOOD. rt,!:' '0, -'. 0- TO-...„: 13„ -: :; ‘ :.., .' .'r,t... $ 20.00
f URN',100K..: 1 MKT DOM::. 't-0"s‘''' 345 TOIL. e 0
GAS MT • 0 WOOD,,STO4S...; 0 „„:1S' 30 t011...:
COLO BURNER: 0 FURNATIpt,4' i':- 0
tt. '' ''''', ,,.$,, --',,,,,,, ,
BM ' 0 MISC..-V40.4*:...11 ''-4 A4,9
GS DRYLk..: 0 AIR HAN ', , WTS,'-
RAKE • 0 <7-10,000i tt: ,,-1 -.-: *VE GROUND: 0
GAS LOGS...: 0 > 10,000 CFIEF 0 ''';'\EINDERGRALILD.: 0 TOTAL FEES $ 68.00
I Does the water supply systes contain a Pressure Reduction Device or Check valve? ( ) Yes ( ) No (If "Yes" then water expansion tank is required on Hot Water lank)
1
IInspection Record: Mechanical Rough.in _ _ Date Gas Piping Date I
1_ ___ ._ . . _ _
I
MECHANICAL FINAL b I- Date
I ,
PERMITS EXPIRE 180 DAYS Arta ISSUAOCE IF NO NORK IS STARTED. ''N)
I CERTIFY IRE INEORNAIION FURNISIEO OT Nt IS TRUE AO CORRECT 10 TNE NEST 0111 (MEM AND III APRICARIL CITY Of FEDERAL WAY REOUIRENENTS NIEL NE NfT. 4,
/ .
OWNER 0 AGENT DATE _
.._ _ .., . . _.
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FIELD COPY
_ ___.....____ , l - , - , ., • __— .._..--.......__-—2 -.,2' — L. .,.. ,, ., ann
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CITY OF s RECEIVED BUILDING DIVISION
• MEI _ 33530 First Way South
```` SZFILFederal Way,WA 98003 •
v v �y JAN 0 6199 (253)661-4000
Fax(253)661-4129
CITY OF FEDERAL AY
sCT.
APPLICATION FOR MECHANICAL
PERMIT
MEC -r 7-- p;z0 4-
PARCEL # Single Family El--' Multi-Family❑ Commercial 0
SITE LOCATION
Tenant/Owner l/Vl ore�� Phone
Address/City/State/Zip CIS l S I l t- ii-cA. S U
Nature of Work n9..atrA Fl F - -IA Project Valuation: $ (A D O '
1
APPLICANT 1r Q
Name - yI
Address/City/St/Zip 4O 2 At&\dim AAA uo Gi tum)
_ I
Contact Person l C 1A k �'✓` Phone $ Fax
a h 7`r Fax QI-S(3 S -) a-a S
4,1
MECHANICAL CONTRACTOR
Company Name li i:1_t--l)-C_
Address/City/St/Zip
Contact Person Phone Fax
State L&I Contractor Registration# l ..S -4- /i 3 TA Exp.Date l — 1 —9c:5
(Card must be presented)
MECHANICAL UNIT COUNT
Fuel Type(gas/other) Gas Dryer Air Handling<=10,000cfm Fuel Tanks:
Length of gas piping ) Range Air Handling>=10,000cfm Above Ground
Fum<100K BTU's / Gas Log Unit Heater Underground
Fum>100K BTU's Fans Boiler BTU/H Miscellaneous
Gas Hwt Hood Boiler BTU/H Other
Cony Burner Duct Work A/C TONS Other
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RRQ's Wood Stoves A/C TONS ?it#at>GliFt>4`iiiriit:»>::%»>:iii>::::<:>:;;:>:»z>:»:
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 1 am authorized by the owner of the above premises to perform the work
for which permit applica' :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 per:o eluding the undamped,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 supe ed to the city as a part of . application.
Owner/Age . '.1/ - . J. _A rte',, Date l— C4, _e7 g
1
Mrcu.Are
Reviser,8/26/97