95-100678I
9 5-' /ao 678
CITY OF FEDERAL WAY MECHANICAL PERMIT
33530 First Way South
Federal Way, WA 98003 Building Inspection Requests 661-4140
661-4000
ADDRESS:1021 SW 347TH ST
NO.: 132173-0330
PROJECT DESCRIPTION: HVAC - INSTALL ONE GAS LOG.
OWNER
OTTO BAUER
1021 SW 347TH ST
FEDERAL WAY WA 9B023
661-B163
FUEL TYPES.:GAS ?
FANS..........: 0
GAS PIPING.:
21 ft
HOOD,..,......: 0
FURN<100K..:
0
DUCT WORK.....: 0
GAS HWT....:
0
WOOD STOVES...: 0
CONV BURNER:
0
FURN>1OOK.....: 0
BBQ........ .
0
MISC..........; 0
GAS DRYER..:
0
AIR HANDLING UNITS
RANGE......:
0
<=10,000 CFM: 0
GAS LOGS...:
1
> 10,000 CFM: 0
CONTRACTOR
e:s OWNER IS CONTRACTOR *S_
$$$ NONE $$*
BOILERSICOMPRESSORS
0-3 Hf......: 0
3-15 BP.....: 0
15-30 HP....: 0
30-50 HP....: 0
5+ HP........ 0
FUEL TANKS ---------
ABOVEGROUND: 0
UNDERGROUND.: 0
qL-IiE�=J 4,
LENDER
PERMIT NO: BLD95-0256
ISSUED: 04/06/95
BY: FC
EXPIRES: 10/03/95
FEES:
NEC PUT ISSUANCE... $ 20.00
NEC APPLIANCE FEES.* i 9.50
TOTAL FEES i 29.50
Does 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 THE INFORMATION FURNISHED BY 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 _�_ AVZ_:1 --------------------------- DATE __
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City of Federal Way
CITY OF 33530 First Way South
_ * _ Federal Way, WA 98003 j%/ �5 _0dC�
"mil I G�L� (206)661-4000 I✓�/
V� `V APPLICATION FOR MECHANICAL PERMIT
PARCEL Single Family) �0 Commercial El
SITE LOCATION:
Tenant/Owner:. `' 0 _ fi�,f�. Phone:r��
Address/City/State/Zip: `5/�f ��� ��'�'Ds- L i�1� ��✓J
Nature of work: 7;9Ac/Project Valuation: $�
APPLICANT:
Name: O/�d _,". ✓1,,1F
Address/City/St/Zip: %/.;k)Z & r .fir/% I fa, 126,14-<,4Z 4MY A'�f,-2e2a -
Contact Person: '4 Z ,�Ic Phone: `�P®Z 1"//'- //6' Fax:
MECHANICAL CONTRACTOR:
Company Name: ' 01 �
Address/City/St/Zip:
Contact Person:
Phone:
Fax:
State L & I Contractor Registration
#:
Exp. Date:
(Card must be presented)
MECHANICAL UNIT COUNT:
Fuel Type (gaslothor) 6#5
Gas Dryer
Air Handling < = 10,000cfm
Fuel Tanks:
Length of gas piping
Range
Air Handling > = 10,000cfm
Above Ground
Furn <10oK BTU's
Gas Log
Unit Heater
Underground
Furn > 100K BTU's
Fans
Boiler BTU/H
Miscellaneous
Gas Hwt
Hood
Boiler BTUM
Other
Conv Burner
Duct Work
A/C TONS
Other
REJQ'S
Wood fitnyes
A/C
:#
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 much 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 employees, upon the accuracy of the information supplied to the City as a part of this application.
Owner/Agent: Date: