94-102233 9 (0o )a33
CITY
335300 FiF rsDtEWay Sout>1 RAL MECHANICAL PERMIT PER ISSUED:MIT NO: 11/21/ 9417
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 05/20/95
ADDRESS:5147 SW 311TH PL
NO. : 321020-0430
PROJECT DESCRIPTION:HVAC - ADDING 45' GAS PIPING, FURNACE TO 100,000 BTU, & GAS HWT.
OWNER — CONTRACTOR -- LENDER
BEN JONES NORDIC HEATING, INC.
5141 SW 311TH PL 3401 C ST. NW BAY 1
IllFEDERAL WAY WA 98023 AUBURN WA 98002
i=
874-5658 931-0503
NORDIH1099BJ
FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 45 ft HOOD • 0 0-3 HP • 0 MEC PRMT ISSUANCE... $ 20.00
FURN<IOOK..: 1 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* $ 19.50
GAS HWT • 1 WOOD STOVES...: 0 15-30 HP • 0
COMV 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 $ 39.50
SDoes 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 INFORMATION FURNISED BY M IS TRUE ND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT _ X_ C z _ DATE /2741/71V
FILE COPY
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RECEIVED
• City of Federal Way N ►
CITY OF_______________----- �— 33530 First Way South 2 1 199
•
-1- ..--.I E r Z F I L_ Federal Way, WA 98003
(206)661-4000 CITY OF FEDFR;q°L 1y
WFEY-
7-
APPLICATION FOR MECHANICAL PERMIT
PARCEL #• 3'1 OZ`S ---0+36 Single Family/ Multi-Family 0 Commercial 0
SITE LOCATION:
Tenant/Owner: ) '•er i ) ',) ( AO & Phone. S'-7 V • c-) S
Address/City/State/Zip: -L I I Li --/ S. (.tib 3 I) pt
Nature of work: h.4A.kiUc.'k f C/n:%t't, rctrn 1-I,�,/Ge y -fiv G fid' 6rS .2)0:).... �`
Project Valuation: $
APPLICANT:
Name: it:G. /( i.) r C! / p i( // Ai 6-
Address/City/St/Zip:
3 i/// dA-t---.A/&:- 9-7 e'''' /-17_, Li,ii.n,, it,: 7 J "
f
3
Contact Person: - ' �` ' //'rf "�` Phone: j -c''' Fax: t S t' `' ' t
MECHANICAL CONTRACTOR:
Company Name: /t/ d l C //( Z'iJ )
Address/City/St/Zip: 3 i/ G. L'%1-'r= /31-7 V. 0//71 h r".ti,L Z-<-,--- 7 az c-i
Contact Person: l / C ,V,/,4,-//)-1 Phone: ,/ " ` ' ` Fax: '
State L & I Contractor Registration #: A' CX U 'i/ 1`' <i Gf 0' _' Exp. Date:
(Card must be presented)
MECHANICAL UNIT COUNT:
Fuel Type (gas/other) IIIA-% Gas Dryer Air Handling < = 10,000cfm Fuel Tanks:
Length of gas piping `/s - Range Air Handling > = 10,000cfm Above Ground
Furn <100K BTU's ii'' Gas Log Unit Heater Underground
Furs >100K BTU's Fans Boiler BTU/H Miscellaneous
Gas Hwt a Hood Boiler BTU/H Other
Cony Burner Duct Work A/C TONS Other
BBO's Wood Stoves A/C TONS ........v................u......n...........o....................................................................................
.
<:: aterc aa a <
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 employ ,upon the accuracy of the information supplied to the City es a part of this application.
C� 'lt� �,, /. /' '')i 7"
Owner/Agent: _ � Date: / � f