95-100408 95� )0° ya8
CITY OF FEDERAL WAY MECHANICAL P I T PERMIT NO:
02/21/9537
33530 First Way South
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 08/20/95
ADDRESS:30619 28TH AVE S
NO. : 092104-9264
PROJECT DESCRIPTION:HVAC - INSTALL 1 24,000 BTU UNIT HEATER.
= OWNER — CONTRACTOR — — LENDER
JEAN HAVERFIELD AMERICAN MECHANICAL GAS APPL
30619 28TH AVE S 5803 241ST SW
FEDERAL WAY WA 98003 MOUNTLAKE TERRACE WA 98043
610-2704
AMERIMG0558L
FUEL TYPES.:GAS ? FANS • 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 1 MEC PRMT ISSUANCE... Zi 20.00
FURN<100K..: 0 DUCT WORK • 0 3-15 HP • 0 MEC APPLIANCE FEES.* 8 9.00
GAS HWT • 0 WOOD STOVES...: 0 15-30 HP • 0
CONN 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 $ 29.00
Does the rater supply system contain a Pressure Reduction Device or Check valve? () Yes () No (If 'Yes' then Mater expansion tank is required on Hot Water Tank)
Inspection Record Water Line OK Mechanical Inspection Notes: _
GAS PIPING OK _ — Date By
2
PERMITS EXPIRE 180 DAYS AFT ISSUA 4F NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THE INFORMATIO RISH Y ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT 1 DATE f"- /.-- -`3
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SETBACKS & FOOTINGS
Date By
FOUNDATION WALLS
Date By
PLUMBING GROUNDWORK
Date By
UNDERFLOOR FRAMING
Date By
SHEAR WALLS
...............
Date By
PLUMBING ROUGH-IN
Date By
GAS PIPING
Date By
MECHANICAL ROUGH-IN 2'2:.-t$ N . rife.d.474pv44, Ih
Date By ,3—.i -IS b' 1leel
G 4 osei 2,
MECHANICAL (OTHER)
Date By
FRAMING
Date By
INSULATION
Date By
GWB - 1ST LAYER
Date By
GWB - 2ND LAYER
Date By
SUSPENDED CEILING
Date By
PLANNING FINAL
Date By
ENGINEERING FINAL
Date By
FIRE FINAL
Date By
BUILDING FINAL
Date By
OTHER
Date By
OTHER
Date By
CD0193
City of Federal Way
CITY OF y-- 33530 First Way South i r'v1 . 0/
S - =IFederal Way, WA 98003 (/1/"( J
(206)661-4000
WFFY
APPLICATION FOR MECHANICAL PERMIT
PARCEL it Single Family Multi-Family o Commercial ❑
SITE LOCATION:
Tenant/Owner: "- d ��17r� Phone:
Address/City/State/Zip:
- 3a(Dl? - 2 7N/ e:- O, GtWX I,GO_ y �Je)_
Nature of work: Project Valuation: $
•
APPLICANT: �
Name: , -;e/(W/A/ //76-e1—(//cf76- &67s /9qou/i✓c� S I/rce-
Address/City/St/Zip: ✓�81�,, ' 2" — - ( --e (44- F�0- �
Contact Person: & '/C e:///9/3 Phone: �7C)Z7 -z,/ Fax: l7&
MECHANICAL CONTRACTOR:
Company Name: /1,a)
Address/City/St/Zip:
Contact Person: Phone: Fax:
State L & I Contractor Registration #: h3) 72--/i7' 705." -• Exp. Date: Lq-Zo-75-
(Card must be presented)
MECHANICAL UNIT COUNT:
Fuel Type (gas/other)i)%4fCM4Ato Gas Dryer Air Handling < = 10,000cfm Fuel Tanks:
Length of gas piping 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 Boiler BTU/H Other
Cony Burner Duct Work A/C TONS Other
BBQ's
Wood Stoves
A/C
TONS
Totai:a)nit�ozrit > >?»<<;>;<>< ;<;<
DISCLAIMER: I certify under penalty of yertury 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 wfu 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 dela of such laim),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,in ing its icers and employees,upon the accuracy of the information supplied to the City as a part of this application.
Owner/Agent: (/ n Date: