94-102290 . ! �y� IDa-�-9�
CI i Y OF FEDERAL WAY MEC ICAL PEl�:MI T PE�ISSUED: 1�1/30/9436
33530 First Way South
Fsderal Way, WA 98003 Building Inspsction Requests 661-414Q 8Y: FC
561-4000 EXPIRES: 05/29/95
ADDftESS:3b13 SW 311TH LN
NO_ : 058755-0140
PROJECT DESCRIPTION:HVAC - Add gas piping, range, gas log, hrt, furnace to 100 btu
OMNER CONTRACTOR LENDER
NELMER PACIFIC HELMER AACIFIC, INC
22035 SE MAX RD SUITE 14 PO BQX 1010
MAPLE YALLEY IOA MAPLE VALLEY MA 98038
432-5055 631-6091
NELMEPI1580S
FUEL TYPES.:6AS ? FANS......,...; 0 BOILERSjCOMPRES50RS FEES:
6A5 PIPIN6.: 99 ft HODD..........: 0 4-3 HP......: 0 � �� � ��,� '� � � MEC PRMT`ISSUAMCE,.. ; 2Q.00
; ��.
fURN<100K..: 1 DUCT pORK..,..: 0 3-15 HP�....: 0 � � ; , e.A.� ���' , m =��� MEC APPLIANCE FEES.* ; 32.50
6AS HNT....: 1 MOOD STDYES...: 0 15-30 MP..... 0 `"� ; � �� - � �� �
CONV BURNER: 4 fURM>1001(.....: 0 30-50 NP....: 0
BBO......... 0 MISC.......,... 8 5+ NP....,... 0
6AS DRYER..: 0 AIR HANDlIN6 UNITS FUEL IAMKS---------
RAN6E......; 1 <=10,000 CFM: 4 ABOVE 6ROU�D: 0
6AS L06S,..: 1 > 10,000 CFM: 0 UNDERGROUND.: 0
TDTAL FEES = 52.50
Does the Mater supply syste� contain a Pressure Reduction Device or Check valve? () Yes () Mo (If 'Yes' then oeater expansion tank is reauired on Not Nater Tank}
Inspection Record IOater Line OK Mechanical Inspection Notes:
6AS PIPIN6 OK Date By
PERMITS EXPIRE 180 DAYS AFTER IS UARCE IF ND MORK IS ST TED. RESIDENTIAL AND 6RADIN6 PERMITS EXPIRE ONE YEAR AfTER DATE Of ISSUANCE.
I CERTIFIf THAT THE INFORMATI019 NISED BY ME UE D CORR T TO THE BEST OF MY KNO�OLED6E AND TNE APPLICABLE CITY OF FERERAL MAY REQUIREMENTS MILL B� MET.
._ ..
OWNER OR AGENT --------------7----- - --- - - ----- DATE _������'�
-- ----------------------------------
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FILE OOPY
�
City of Federal Way
CITY OF � 33530 First Way South �]
_ � _ �E Federal Way, WA 98003 ���E'L ,�D
``\` � (2061661-4000 ' ��
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APPL/CAT/ON FOR MECHAN/CAL PERM/T ��OV 3 0199�
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PARCEL �• Single Family� Multi-Family ❑ Commercial �
SITE LOCATION:
Tenant/Owner: ` /���'�- ��"�G����"` Phone: ��� " ��
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Address/City/State2ip: �b�� �w =5� �
Nature of work: /'��GC������ � Project Valuation: 5
APPLICANT:
Name: -' �7l' iQet �'
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Address/City/St/Zip: �� ��x ( o�� �'��� � % `% GV,� �c�' � �
Contact Person: �'�`- '`��1 L'� Phone: �7� '� ���'�� � Fax: ��� '�l�7�
MECHANICAL CONTRACTOR:
Company Name: - - - �:.-�,�,��
Address/City/St2ip:
Contact Person: Phone: Fax:
��d O S �
State L & I Contractor Registration #: r �--�✓��(� Exp. Date: �' � � � "�
(Card must be presented)
MECHANICAL UNIT COUNT: `
Fuel Type (gas/other) 45 Gas Dryer — Air Handling < = 10,OOOcfm - Fuel Tanks: "
Length of gas pipi�g `2 � Range Air Handling > = 10,OOOcfm ._ Above Ground -
Furn <100K BTU's � Gas Log Unit Heater Underground -
Furn >100K BTU's � Fans — Boiler BTU/H Miscellaneous --
Gas Hwt j Hood — Boiler BTU/H - Other �
Conv Burner —' Duct Work � A!C TONS Other .�
— - i
DISCLAIMER: I certify under penalty of perjury that the info�metion furnished by ma ia true ind cor�eet to the beet of my knowledpe�nd further tlut 1 am�uthorized by the owner of the above
premises to perfo�m the work tor which permit�pplie�tion is made. 1 further pree to aeve harmlesa the City of Federal Way as to any cl�im(includirq eoets,expermes ard�ttorneys'fees
. incurred in investiQation�rd deferue of such cleiml,which may be made by�ny person,includirq tFx u�deroipned,�M filed apainat the City of Feder�y Way but o�ly where such ctaim arises
out of the relianee ot the City,includirq ib offieen�nd employaea,upo he�eewaey f the infwmation�upplied to the City u a part of this appli�atio�. -
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Owner/Agent: Date: - ,
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