95-100513 - � . 9��/aoyl3
33530OF i rst�EWay Sout h M E C H A N I C A L P E R M I T PERMSSUED- 03/09/9581
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 09/05/95
ADDRESS:27723 21ST PL S
NO. : 757562-0210
PROJ ECT DESCR I PT I ON:MECN - ADD 60' 6AS PIPE � 6AS 6AYER
� OMNEA C6NTRACTOR LENDER
IIJIRI' HILL 60ETZ C0.
21723 21ST PL S 2535 AIAPORT w�r s
fEDERAI MAy MA 98003 SEATTLE MA 98134
946-6927 625-1100
6ALENf606219
FUEL TYPES.:6AS ? FANS..........: 0 BOILERSfC011PRESSORS FEES:
GAS PIPIN6.: 60 ft HOOQ..........: 0. 0-3 HP......: 0 �• ' � � ,� ItEC PRWT ISSUANCE... f 20.00
FURN<100K..: 0 DUCT MORK.....: 0 3-15 HP.....: 0 MEC APPLIANCE FEES.� = 9.50
6AS NMT....: 0 MOOD STOMES...: 0 15-30 HP....: 0 �� � ��.���� ,, � b .���_,�, , __`'�� �
CONV BURNER: 0 fURM>1001(.....: 0 30-50 NP....: 0
88G........: 0 MISC..........: 0 5+ HP.......: 0
6AS DRYER..: t AIR NAMDLIN6 UNITS FUEL TANKS---------
RAN6E......: 0 <=10,000 CFII: 0 ABOYE 6ROUND: 0
6AS L06S...: 0 > 10,000 CFA: 0 UNDER6ROUND.: 0
TOTAL FEES = 29.50
Daes the rater supply systew contain a Pressure Reduction Device or Check valve? () Yes () No (If 'Yes' then water ezpansion tank is required on Not Nater Tank)
Inspection Record IMater line OK Nechanical Inspectian Notes:
6AS PIPIN6 OK Date By
PERqITS EXPIRE 180 DAyS AFTER ISSUANCE IF NO MORK IS STARTED. RESIDENTIAL AND 6RADIN6 PERMITS EXPIRE ONE YEAR AFTER DATE Of ISSUANCE.
I CERTIFY TNE INFORIIATION FURNISHED Bl' IIE IS TRUE AND CORRECT TO THE BEST OF MY KNOMLED6E AMD THE APPLICABLE CITY OF FEDERAL MAl' AEQUTAEMENTS MILL BE UET.
OYINER OR AGENT y�-'-���`"��---�-��---------------------------------------- DATE __3C�'r1_`_��
FII.E COPY
CITY OF FEQERAL WAY ,� E� �I A N I �A L P E R � I T ��RMSSlJ�D: 03/09/9581
3353� First Way South
Fed�ral Way, WA 98003 Building Inspection Requests 66t--414Q BY: FG
661--40QCo EXPIRES: �9/fl5/95
ADDRES5: 2772:i 21ST PL S
NO. : 757562-0210
PROJECT DFSCR I PT ION:ItECN - AD4 6U' GAS PIPE � 6AS DRYEA
^�ER CONTAACTOR lENOEA =�
� Ntll GOE1i CQ,
• '23 2tST �i. S ?535 AiRP4RT Y�AY S
EAl�L 'MA1' WA 98403 SEATTLE �A 98131
y44-b�2� � ; r _
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�$ � � TM�.��::�fi b �" � „��aPo-ii�i�r� � .�„�+��rnen�A
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�� Pi� ,a_;,�.r; A ���"�d�..�.. .
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.._�.v.c.�irs�a-�... ..._... _ .
fUEI 1YPES.:{AS 2 FANS... � 4 I�'F'S/�'^����.�� �""������� ����� s�i
6AS PIPiM6.: 80 ft HOQO....;�� 4 �' 0�»9 iiP .�ti;, � ' �� `������ � �� �� ��� �R[I�''�� ISSUANCE... { 20.00
FURN<1041(... 0 �!!�."Y 1�`tR�C� `����'�J�� � 3�*15 H� � �`� � ��� ���e t��t" P�IAkCE FEES.� � 9.50
� r�� ����� ��
6A5 N�T....: 0 �..VfOCr3 St"�'�,�� ���, �� �� ��" 1�3t1 ������", ,����� � � . _
N � � �� �'
i.4�Y 9UAMER: 0 A `� �� " '�5�
a
,,
98G........: 0 � � � �`����������.
6AS DAYEA... 1 �A� �� �I� �,� ��`""������ - �"�>`
AANSE....... Q < �}{i� � AB��A4UND: ���'�
,�
GAS LO&S...: 4 > 10; ; �Fli: � VADEA6RQUN�J.: 0
�n^k,:
,_ �,� TOTAi fEES S 2�.50
r
* :;i
Daes the rater suppiy systet c011t?�I+ d AfoeSUfE AP.�iiC�int11�@t�iC2 �f C��GI( raive? () Yes �) No IIf 'Yes' then �atar ez�ansion tank 19 flQUlfBd OR NQ� MatEt Tank)
� ;
Inspection Hacord +��ter I � �
GAS PIw 3 I6Ias� J �� (_
l
PERqTTS EXPIAf 1dQ DAYS AFTER ISSUANCE IF NQ M4RK IS STAAtED. REStOENTIAI AND GRAOIN6 PERIiITS EXPIRE ONf 1�E�? �FTc� �A?r nc r�,�t��r'r
I CERTifY THE iNfOitYATiON FURNISNE� BY YE 1S TRUE ANQ C6RAEC? TO TeE 9EST Of il� K�QI�LFDfiE ANO TNE �tPPItCABII V
� � _ _ - 1�p �'
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3�
FIELD COPY
City of Federal Way ��CE�v��
ciTv oF G 33530 First Way South ���p �99� �
_ � _ � - Federal Way, WA 98003 G'1N� 0 9
`�1���/ (206)661-4000
^ ' GIT BUILDING E T.AY �
APPL/CA T/ON FOR MECHAN/CAL PERM/T
, ��-��-` � � J I
PARCEL �• l� 7S �5 � ;j- -C ,�. 1 c� - c � Single Family � Multi-Family � Commercial ❑
SITE LOCATION:
Tenant/Owner. �'��"�"Y �'��-z'� �'�� �"�- Phone: �� `��� � �%� �
Address/City/State2ip: ��� L�,� �� � ��- ��>�--S
Nature of work: �^`�� 1� ' j'"`"�-�- r�`��` �� `r�`�-- Project Valuation: $ ����
APPLICANT:
Name:
Address/City/St/Zip:
Contact Person: Phone: Fax:
MECHANICAL CONTRACTOR:
Company Name: �'-'-``t�' 1� C��;�-°r z_ �==��
Address/City/St2ip: -�Sl- �3 � �� fZ,'"`r LL '�-`�' � .
Contact Person: �`'��L'�''� �'`��-T Z.. Phone: �j S / 7�'c�' Fax: l=�"� 1 ���}
State L & I Contractor Registration #: �'� t-�_ ^� �— CT' � ����- L-- `� Ex Date: �����'r�'�
P•
(Card must be presented)
MECHANICAL UNIT COUNT:
Fuel Type (gas/other) � Gas Dryer Air Handling < = 10,OOOcfm Fuel Tanks:
Length of gas piping � ,p ` Range S"'j�-�� ✓,� ��.- ��ti 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 Hood Boiler BTU/H Other
Conv Burner Duct Work A/C TONS Other
OISCLAIMER: I certify under penalty of perjury that the informetion furnished by me is true and torrett to the best of my knowledpe and further that I am autho�ized by the owner of the ebove
premises to perform the work for which permit applica[ion is made. I further apree to save harmleas the City of Fede�al Way as to sny claim(includirp costa,experroes and�ttorneys'fees
incurred in investipation and deferree of such claiml,which may be made by any person,includinp the undersipned,and filed aqai�st the Ci[y of Fedeny Way bu[only where such claim arises
out of the reliance of the City,includi�p its officen end employees,upon the aecuracy of the information supplied to the City ae�part of this appliution.
Owner/Agent: �'--1�-- �� �"�-�`� Date: `��� l `'s'J