95-101160 � � _ �i�'/ol/(o �
CITY OF FEDERAL WAY PERMIT N0: BLD95-0419
33530 Fi rst Way South ��'�H�1��'�il�l'i�. ���.�� � ISSUED: 06 f 02/95
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 11/29/95
ADDRESS:28414 22ND AVE S
NO. : 422220-0290
PROJECT DESCRIPTION:hvac - replace furnace to 100,000 btu
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MAX MONZIN60 NORDIC HEATIN6, INC.
28414 22ND AVE S 3401 C ST. i�i BAY 1
FEDERAL iiAY MA 98003 AUBURM MA 98002
441-4695 931-0503
MORDIHI099BJ
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� COIITRACTORS, PLEASE IISE LOCATION CODE 1732 YHEM REPORTINC SAIES TAX FOIt PROJECTS YITNIN Tlff CITY OF FEDERAL WIY. TAX RATE = 8.25 tt=
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FUEL TYPES.:? ? FANS..........: 0 �ILERS�COMPRESSORS FEES:
6AS PIPIN6.: 0 ft NOOD..........: 0 0-3 HP......: Q , a MEC PAMT ISSUANCE... S 20.00
�- FUAH<100K..: 1 DUCT MORK.....: 0 3-15 HP.....: 0 � ��,�' � � _�>>� ���°` lIEC APPLIANCE FEES.� S 10.00
6AS HNT....: 0 WOOD STOVES...: 0 15-30 HP....: 0 ` ��� .����.��,���,:
CONV BURNER: 0 fURN>100K.....: 0 30—SO NP....: 0
BBQ........: 0 MISC....,.....: 0 5+ HP.......: 0
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6AS DRYER..: 0 AIR NANDlIN6 UNITS FUEL TAHKS---------
RAN6E......: 0 <=10,000 CFM: 0 ABOVE 6ROUND: 0
6AS L06S...: 0 > 10,000 CFM: 0 UNDER6ROUND.: 0
TOTAL FEES S 3Q.00
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Does the �ater supply syste� contain a Pressure Reduction Device or Check valve? () Yes () No (If "Yes' then Water expansion tank is required on Not Water Tank)
Inspection Record Nater Line OK Mechanical Inspection Motes: �
6AS PIPIH6 OK ��__�_ Date �_� By �_�_ �____ _ _�_________ __�
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�ERMITS EXPIRE 180 DAYS AFTER ISSIIANCE IF NO YOR[ IS STARTEB. RESIDENTIAL ANl 6RADIM6 PERMITS EXPIRE ONE YEAR AfTEa DATE � ISSUAIKE.
I CERTIFr T� INFORMATION flIRNISNED BY ME I TRUE AND CORRECT TO TNE BEST Of MY CNaiLED6E Alm TNE APPLICAHLE CITY �' FEIERAL MAY REWIRfMEMTS NILL HE MET.
OWNER OR A6EHT �i'\ � � __ , +� --------_—________--_--_--_____--_ _� �TE !����
FILE COPY
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�'ederal Way, WA 9�00� Building Tnspecti.on Req�ae��s 661-4140 BY: �`C
6�1-400U EX(�IRES: 11/2Q/95
ADDRESS.284�.4 22ND AVE S
NO. : 42222C3-0290
PROJFCT DESCRIRTIOhJ:hvac - replace furnace to 100,000 btu
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'?Nn AVf S 3401 C ST. MN BAY 1
� � � � � AUBURN MA 9A002
931-0503
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� CBNTItACi�s, �IEASE ilSE LIICIt�F�ON COAE 17�2 YH�I� aEPOdTtl16 SALES TAX FOR �RBJECTS YITNIM TAE CITY Ui FEDEItt�. WIY. TAX lATE = 8.25 �
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FUEL 1YPES.:? ? FAMS..........: 0 B�iSIERSjf0�l�tfS'S�'3 ° � ��� fEES.
6AS PIAIH6.: 0 ft HOQD ........: E Q-3 NP. ; Q �� � � ,� � � �° ����� � �3 � �� !�� PRM�t I3Si!ANCf... S 20.00
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` Fl�tNt100K... 1 D!lCi�� �K.....� ��� 3-15 HP .. @ � � r �
�� ��� � � ��3 �t APPLI�N.E fEES 3 10.00
6AS HNT..... 0 inDOD STOVES... �� �5-30 HP.... �Q �� ���"� z
CONV BURNER: 0 F�ttk>140K..... ��� �:30-�Q NP.. � ��-� ������������,����������.:�°,n, �� � � �_�,
' � 5+ MP.... , � � � ,
BBQ........: 0 MISC. ..; �`
6AS DRYER..: 0 AIR WAlIDlIN6 tlNITS iUEI TAt}��*-�»�----• � ��`
RANfiE......: 0 <.�O,tIRQ CFM ~�< ABOVE �R�UND: a N,��``��
6AS IOGS...: 0 > 10,0� +Cf!!� 0' UNDER6AOUND.: 0
TOTAI FEES : 3Q.04
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Does the water s+�ply syste� contain a Dressure Reduction Device or Check valve? () Yes (} No (If "Yes" then uater expansion tank is required on Hot kater Tank)
InsRection Record Nater line 4K Me�h�?ti�=' Ir,�pe�►ior. Notes•
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PfRNITS EXPIRE 180 OAIR I�TER ISS�ANCf IF NO YORC IS STARTE/. RESIBENTIAt pMB �AADIN6 FEl�IITS EXIIaf BiIE YEAR 1�'iElt 1ATE OF ISSUANCE.
I �ERTIFY T� IIlFORIIATI011 FURNISME6 EY ME IS TRl� f�ll9 CORRECT TO TNE BEST Of Nr Ki1011LED6E IHI6 Ti� AMLICA9LE CITr �f ��D�R�� ��Y �+O.+PIP#MEkiS if:�4 :� MF�-
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FIELD COPY /
" ��� � �-- C�� �
City of Federal Way ��(� i V E D
CITY OF � 33530 First Way South ;
_ � _ � Federal Way, WA 98003 4 ��
� ��'J (206►661-4000 ���!N 0 219��
vv F�Y `
APPL/CA T/ON FOR MECHAN/CAL PERM/T''���,��DING DEPT.r���
PARCEL �• �C��'�^��v ^ �t�� Single Family-� Multi-Family ❑ Commercial �
�l
SITE LOCATION: r
Tenant/Owner: ��' � ' ' � � ��" � �� �", Phone: �~ ,�
Address/City/State2ip: �� ;! �� ��"�� ��� �'Pn ��a�1 `�V � / �d U'�
�j'.4,j �/-��/1Ci c � C�/���A i�;f- ��-G�C'� ��-
Nature of work: _ Project Valuation: S
APPUCANT:
Name: ���f�•� �� � ��'�� ,
Address/City/St/Zip:
Contact Person: Phone: Fax:
MECHANICAL CONTRACTOR: ,
Company Name: ---- -
/v'C/.� �� � /T 2lt�I��� �
Address/City/St2ip: � ��� � � /�✓t-` �./.i'Ii � �'7l/�i' y���!�i ����`/ 7 �O�'�'
Contact Person: N��� ��/���� ��� Phone: �'y�� �`� ��� Fax: - �-r�� �'� ��
State L & I Contractor Registration #: ���� � -L ��-� �� � T �� J Exp. Date: �i � D(
(Card must be presented)
MECHANICAL UNIT COUNT:
Fuel T pe ( as/other) Gas Dryer Air Handlin < = 10,OOOcfm Fuel Tanks:
Length of gas piping Range Air Handlin > = 10,OOOcfm Above Ground
Fum <100K BTU's i Gas Log Unit Heater Underground
Furn >100K BTU's Fans Boiler BTU/H Miscella�eous
Gas Hwt Hood Boiler BTU/H Other
Conv Burner Duct Work A/C TONS Other
DISCLAIMER: I certify under penalty of perjury that ttx information furnished by ma ia true and correct to the best of my knowledpe and further that I am authorized by the ow�er of the above .
premisea to perform the work for which permit�pplieation is mede. I fwthe�apree to aave humlesa the City of Federal W�y a to�ny el�im(ineludinp ewt�,axperoe��nd�ttwneys'fees
i�curred in i�vestiQation and defenw of such claiml,whieh may be made by any penon,includirq the undenipnad,ud filed pairot the City of Feder�y Way but orJy whers sueh el�im arises
out of Ihe relia�ce of the City,includinp it�officers and employeea,upon the aecuracy of ttx informstion supplied to the City p a part of thi�applicatio�.
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Owner/Agent: ��� Date: 'f �