HomeMy WebLinkAboutPermit 0626-M - PARKER RESIDENCE
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W.S.E.C. Maximum
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_
UMO EDITION (YE'; 1988
B.T.U. 100,000
FIRE PROTECTION: Sprinklers Detectors X N/A I
CONDITIONS (other than noted on or attached to permit/plena):
Provide installation instructions
for building inspector at final inspection.
98168
1
■
APPROVED FOR , BUILDING
ISSUANCE BY: A I i i i 1 ' A OFFICIAL
DATE: G -3 C) .-
imivaimmani
know the same to be true and correct. All provisions
whether specified herein or not. The granting of
the provisions of any other state or local laws
to sign for and obtain this mechanical permit.
I hereby certify that I have read and examin- d this permit and
of law and ordinances governing this work will be complied with,
this permit does not presume to give authority to violate or cancel
regulating construction or the performance of work. I am authorized
98002
DATE: //- & - /
le
. , "7
SIGNATURE*( All
...._
PRINT NAME: RiZIA-KS ..• 0 (- K.
COMPANY: M (NZ NC_ 1-/Eiriki i:-.,, "N C . ,
PROPERTY OWNER:
Beverly Parker
PHONE:
246-7664
ADDRESS:
16211 49th Avenue South, Seattle, WA
IPHONE:
IZIP:
931-0503
98168
CONTRACTOR:
Nordic Heating, Inc.
ADipaaa:_14QLcEtni,y_,.
" " Street E . Ba i Auburn
.A
IZIP:
98002
WA. ST. CONTRACTOR'S LICENSE NQ. NORDIHI099BJ
EXPIRATION DATE:
1/92
CITY OF TUKWILA
Department of Community Development - Building Division
6300 Southcenter Boulevard, Tukwila WA 98188
(206) 431-3670
MECHANICAL
PERMIT NO.
DATE ISSUED:
063210
I -
MECHANrAL PERMIT
(POST WITH PLANS IN A CONSPICUOUS LOCATION)
15. 50
0 U N
BatiC Fe.
ni
T OTAL
Plan Check No.:
91-202-M
RECEI PT.4:
AleS
6 Wan
111E
gM..XaaWMMOR
.::::::::::::::::::::i
SITE ADDRESS: 16211 49 Av S SUITE NO.
PRO ■ 'u I NAL ' Parker Beverl VALUE OF WORK: $ 1,306.00
TYPE OF WORK: • New/Addition f3 Modifications • Repair S Other:
DESCRIPTION OF WORK: Gas to gas furnace change out, electric to gas water tank.
DATE
PHONE NO. APPROVED INSPECTOR CORRECTION NOTICE ISSUED
REQUIRED INSPECTIONS
1 - Rough-in/Vents/Ducts
2 - Fire Final
3 - Planning Final
4..
5 - Mechanical Final
431-3670
575-4407
431-3680
431
DATE(S)
OTHER AGENCIES: Plumbing/Gas Piping - King County Health Department (296-4732)
Electrical - Washington State Department of Labor and Industries (277-7272)
This permit shall become null and void if the work is not commenced within 180 days from the date of
issuance, or if the work is suspended or abandoned for a period of 180 days from the last inspection.
PERMIT NO.
0[0 ` M
CONTACTED
` ;
DATE READY
O `QI"1161)�I EY
DATE NOTIFIED
(O_
II
- /�
"�
B )
PERMIT EXPIRES
2nd N O T FICATION
O I
BY:
(snit.)
AMOUNT OWING
3� 1...3
c
3RD NOTIFICATION
BY:
(snit.)
INSTRUCTIONS TO STAFF
• Contacts with applicants or requests for information should be summarized in writing by staff so that
any time the status of the project may be ascertained.
• Plan corrections shall be completed and approved prior to sending on to the next department.
• Any conditions or requirements for the permit shall be noted on the plans or summarized concisely
in the form of a formal letter or memo, which will be attached to the permit.
• Please fill out your section of the tracking chart completely. Where information requested is not
applicable, so note by using "N /A ".
DEPARTMENTAL REVIEW
"X" in box indicates which departments need to review the project.
BUILDING -
initial review
O FIRE
O PLANNING
O OTHER
%BUILDING -
final raviaw
REVIEW COMPLETED
INIT:
INIT:
INIT:
•
10 �2�j
( ROUTED )
VW6
INIT: rC_t_
r MECHANICAL('TRMIT
APPLICATION TRACKING
RE. 1IIRENI >..:
CONSULTANT: Date Sent - Date Approved -
FIRE PROTECTION: Sprinklers (l Detectors ( ) N/A
FIRE DEPT. LETTER DATED:
ZONING: BAR/LAND USE CONDITIONS? (- Yes (l No
SCREENING REQUIRED? flYes
REFERENCE FILE NOS.:
UMC EDITION (year):
n NJ
INSPECTOR:
08117/90
PROPERTY OWNER 6 . „Is ?,ti - 1�/�-hi(f,:,
PHONE � w 7G ti '
ADDRESS I l/ 1 a
ZIP /&/(�
CONTRACTOR
PHONE
ADDRESS AUBURN, WA 98002
ZIP
WA. ST. CONTRACTOR'S LICENSE # No R D I if_ i 094 ,3 L . 7 ,_
EXP. DATE //�
DESCRIPTION: ::
:::::AMOUNT::
RCPT:: #.'
:: >:DATE > ::
BASIC PERMIT FEE
15
UN IT(S) FEE
•Siti
PLAN`;CHECK 'FEE.:
:1 <
'7 '
OTHER'
:: :.TOTAL:
::
.,:L3..::.::.::. ;
. ;:.:::;. : ::
CITY OF TUKWILA
Department of Community Development - Building
6300 Southcenter Boulevard, Tukwila WA 98188
(206) 431 -3670
PLAN CHECK
NUMBER BER
oC, AA
APPLICATION MUST BE FILLED OUT COMPLETELY
CONTACT PERSON
DATE APPLI ATION A CEPTED
10 2
THAT HAV R AD AN XAMINE
HORIZED: TO <APP:I
SIGNATUR
C
cf. E,11 ^^1G�
ADDRESS 3 " /o � C 5.7 At/Z. R n 7 r
MECHANICAL PERMIT
APPLICATION
Mechanical Fee Worksheet must also be filled out
and attached to this application.
ICATI
PER
FEES (for staff use only)
SUITE #
SITE ADDRESS
16 �� U if 9 S
PROJECT NAME/TENANT
1 - ev eIRL�( R f:
TYPE OF WORK: 0 New /Addition ® Modifications 0 Repair 0 Other:
VALUE OF CONSTRUCTION - $
/ 366,00
DESCRIBE WORK TO BE DONE:
LG r ry 6 c
' Al el- er'
r t (I.
�AS t i 2 At►'� e
/ 00, vuv (3
I
C-/ 47 F•(2 A
/ MK
1
BUILDING USE (office, warehouse, etc.)
NATURE OF BUSINESS:
WILL THERE BE A CHANGE IN USE? ktNo 0 Yes IF YES, EXPLAIN:
WILL THERE BE STORAGE OR USE OF FLAMMABLE, COMBUSTIBLE OR HAZARDOUS MATERIALS IN THE
BUILDING? 0 No 0 Yes IF YES, EXPLAIN:
BUILDING OWNER
OR
AUTHORIZED
AGENT
DATE APP CATIO EXPIRES
DATE
/G 2 A! /
PHONE 9
CITY /ZIP 080)2
PHONE q3 / " 3
APPLICATION SUBMITTAL In order to ensure that your application is accepted for plan review, please make sure to fill
out the application completely and follow the plan submittal checklist on the reverse side of this form. A completed
"Mechanical Permit Fee Worksheet" must accompany this permit application. Handouts are available at the Building
counter which provide more detailed Information on application and plan submittal requirements. Application and
Plans must be complete in order to be accepted for plan review.
BUILDING OWNER / AUTHORIZED AGENT If the applicant is other than the owner, registered architect/engineer, or
contractor licensed by the State of Washington, a notarized letter from the property owner authorizing the agent
to submit this permit application and obtain the permit will be required as part of this submittal.
VALUATION OF CONSTRUCTION The valuation is for the work covered by this permit and must be filled in by the
applicant. This figure is used for budget reporting purposes only and not to calculate your fees.
EXPIRATION OF PLAN REVIEW Applications for which no permit is issued within 180 days following the date of
application shall expire by limitation. The Building Official may extend the time for action by the applicant for a
period not exceeding 180 days upon written request by the applicant as defined in Section 304(d) of the Uniform
Mechanical Code (current edition). No application shall be extended more than once.
If you have any questions about our process or plan submittal requirements,
please contact the Department of Community Development at 431 -3670.
08/18/90
DESCRIPTION
UNIT COST
UNITS
X
COST
BASIC FEE
$15.00
$4.50
SUPPLEMENT PERMIT FEE
1
Installation or relocation of each forced -air gravity -type furnace or
burner, including ducts and vents attached to such appliance, up to and
Including 100,000 Btu /h.
$9.00
2
Installation or relocation of each forced -air or gravity -type furnace or
burner, including ducts and vents attached to such appliance over
100,000 Btu /h.
$11.00
X
3
Installation or relocation of each floor furnace, including vent.
$9.00
X
4
Installation or relocation of each suspended heater, recessed wall heater
or floor- mounted unit heater.
$9.00
X
Installation, relocation or replacement of each appliance vent installed and
not included In an appliance permit.
$4.50
X
6
Repair of, alteration of, or addition to each heating appliance,
refrigeration unit, cooling unit, absorption unit, or each heating, cooling,
absorption, or evaporative cooling system, including installation of
controls regulated by this code.
$9.00
X
p,
-1
7
Installation or relocation of each boiler or compressor to and including
three horsepower, or each absorption system to and including 100,000
Btu /h.
$
X
8
Installation or relocation of each boiler or compressor over three
horsepower to and including 15 horsepower, or each absorption system
over 100,000 Btu /h and including 500,000 Btu /h.
$16.50
X
9
Installation or relocation of each boiler or compressor over 15
horsepower to and including 30 horsepower, or each absorption system
over 500,000 Btu /h to and including 1,750,000 Btu /h.
$22.50
X
10
Installation or relocation of each boiler or compressor over 30
horsepower to and including 50 horsepower, or for each absorption
system over 1,000,000 Btu /h to and including 1,750,000 Btu /h.
$33.50
X
11
Installation or relocation of each boiler or refrigeration compressor over
50 horsepower, or each absorption system over 1,750,000 Btu /h.
$56.00
12
Each air - handling unit to and including 10,000 cubic feet per minute,
including ducts attached thereto. (NOTE: This fee shall not apply to an
air- handling unit which is a portion of a factory- assembled appliance,
cooling unit, evaporative cooler or absorption unit for which a permit is
required elsewhere in this code.)
$6.50
X
13
Each air - handling unit over 10,000 cfm.
$11.00
X
14
Each evaporative cooler other than a portable type.
$6.50
X
15
Each ventilation fan connected to a single duct.
$4.50
X
16
Each ventilation system which is not a portion of any heating or
air - conditioning system authorized by a permit.
$6.50
X
17
Installation of each hood which is served by mechanical exhaust, including
the ducts for such hood.
$6.50
X
18
Installation or relocation of each commercial or industrial -type incinerator.
$1 1.00
X
19
Installation or relocation of each commercial or industrial -type incinerator.
$45.00
X
20
Each appliance or piece of equipment regulated by the code but not
classed in other appliance categories, or for which no other fee is listed in
this code.
$6.50
X
(7----
08/181/30
SUBTOTAL
c30 • C J O
PLAN CHECK FEE (ssx of
subtotal)
- 1 • (493
GRAND TOTAL
$ '8g La
CITY OF TUKWILA
Department of Community Development - Building Division
6300 Southcenter Boulevard, Tukwila WA 98188
(206) 431 -3670
THIS WORKSHEET MUST ACCOMPANY
YOUR MECHANICAL PERMIT APPLICATION.
MECHANIC; . f l.. PERMIT
FEE WORKSHEET
INSTRUCTI >- Compere the: >wo
In d i cating the number of units
Installed; •i n each; category> At t
�bmittal, staff will calculate''"
' ' MEGIBTRATION NUMBER
(MAMMA/
CC01
NORDIHI099SJ
01 /09/92
EFFECTIVE DATE
01/11/91
•
uw•w
DEPARTMENT OF LABOR AND INDUSTRIES
THIS CERTIFIES THAT THE PERSON NAMED HEREON IS REGISTERED AS PROVIDED BY LAW AS A
•
CONST CONT GENERAL
'F NORDIC HEATING INC
33014.36TH AVE S W
11,
FEDERAL WAY WA 98023
•
•
STATE OF WASHINGTON
Re2s.a521 (Reef
CEW°
C�.�( OFIt11CW1U°'
al ,1
'SOW CENSEA
CITY OF TUKWILA
6200 SOUTIICENTER BOULEVARD, TUKWILA, WASHINGTON 98188
Plan Check #91- 202 -M: Parker, Beverly
16211 49 Av S
PHONE # (206) 433.1800
THE FOLLOWING COMMENTS APPLY TO AND BECOME PART OF THE APPROVED
PLANS UNDER TUKWILA MECHANICAL PERMIT NUMBER 06 41 M .
1. No changes will be made to the plans unless approved by
the Architect and the Tukwila Building Division.
2. Plumbing permit shall be obtained through the King County
Health Department and plumbing will be inspected by that
agency, including all gas piping (296 - 4732).
3. Electrical permit shall be obtained through the
Washington State Division of Labor and Industries and all
electrical work will be inspected by that agency (872-
6363).
4. All permits, inspection records, and approved plans shall
be posted at the job site prior to the start of any
construction.
5. All construction to be done in conformance with approved
plans and requirements of the Uniform Building Code (1988
Edition), Uniform Mechanical Code (1988 Edition),
Washington State Energy Code (1991 Edition), and
Washington State Regulations for Barrier Free Facility
(1989 Edition).
6. Validity of Permit. The issuance of a permit or approval
of plans, specifications and computations shall not be
construed to be a permit for, or an approval of, any
violation of any of the provisions of this code or of any
other ordinance of the jurisdiction. No permit presuming
to give authority or violate or cancel the provisions of
this code shall be valid.
Cary L. VanDuscn, Mayor
Project: -
Type of Inspection: A� Gem
/
Address :
Date Called:
Date Wanted : -� Z
3 ---2_
' " ,,z
Special Instructions:
AStesarisMAk
/.oc. RA' 1
Requester:
Phone No.:
Vi4i*SrPFNAT. /
INSPECTION REC
R D• "
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
.Inspector:
I Aecept No.:
Retain .a copy with permit
Approved per applicable codes. n Corrections required prior to approval.
COMMENTS: • C 6,Z,
Date:
(206) 431 -3670
❑.,. :00 REINSPECTION FEE REQUIRED. Prior to reinspection, fee must be paid at
6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Date:
HEAT LOSS ITEM
D.T.
D.T.
QUANTITY
HEAT LOSS
HEAT LOSS ITEM
D.T.
D.T.
QUANTITY
HEAT LOSS
40
50
40
50
Windows and Doors
44
55
Sq. Ft
1 -1 q ,.C:
Btu Hr.
: .( (.0,- (
Roof w out Attic
No Insulation
10
12
Sq. Ft.
Btu /Hr.
Sin; le Pane
Double Pane
25
31
w /R -4
5
6
Triple Pane
17
20
w /R -7
4
5
Storm Windows
20
25
w /R -11
3
3
Doors 1 Solid
19
24
t r) �
I [, ( 7 .•
w /R -19
2
2
Door w /Storm Door
14
17
w /R -30
1
1
Other
Other
Wall Frame (Net Areas)
Sq. Ft.
Btu/Hr.
Conc. Block Walls
Sq. Ft.
Btu/Hr.
No Insulation
9
11
w /R -7
4
5
8" Block
18
20
w /R -11
3
4
f ' - "jllIllnMNII
Other
w /R -19
3
3
Wall Brick /Studs
Slab Surface Floors
Sq. Ft.
Btu /Hr.
No Insulation
7
8
No Insulation
3
3
w /R -7
4
4
Over Unheat, Basement
Sq. Ft.
Btu /Hr.
w /R -11
3
3
w /Pad & Carpet
5
5
w /R -19
2
2
w/Vin I
7
7
Other
Over Unheat. Crawl Sp. .
Sq. Ft.
Btu /Hr.
Wall Conc., Above Grade
Sq. Ft.
Btu /Hr.
No Insulation
6
8
No Insulation
32
40
With Insulation
2
3
T 2. f
3 .•:r
w /R -4
8
10
Other I
Wall Conc., Below Grade
Sq. Ft.
Btu /Hr.
No Insulation
4
6
Infiltration' (See Below)
Cu. Ft.
Btu /Hr.
w /R -3
4
5
1 /2 Air Change /Hr.
.4
.5
w /R -7
3
3
3/4 Air Change /Hr.
.6
.7
w /R -11
2
2
1 Air Change /Hr.
11/2 Air Change /Hr.
.8
1.2
.9
1.4
161 1.00
\ 7 2.-( c••)
Ceilin: Roof
Sq. Ft.
Btu Hr.
Ventilated Attic
No Insulation
25
26
w /R -7
5
6
w /R -11
4
4
Mill
w /R -19
2
2
TOTAL HEAT LOSS: Btu /Hr.
w /R -30
2
2
FURNACE
TOTAL HEAT
Plus 10% Oversize Factor
By Duct Loss Factor "OUTPUT
=AFUE 7 ( 7 %INPUT=
SIZING
LOSS =
x 1.1 =
=
: �` r„!:i r,,
'S 1
w /R -40
1
1
STYLE HOUSE �" - -. { 7v `'t
(7 ( -/ e -`,
AGE HOUSE `/) 0 V ' '
__
,'.r r ( / / / )
HEATED SQUARE FOOTAGE
-'' ( -1 t I,) °>
NAME:
ADDRESS:
A
BY:
DATE:
:`
INFILTRATION:
HE i'ING LOAD CALCULATION kith4
WNG 866.1 S (10/88)
4
BLOWER SIZING (Air Flow @ 75 —100 CFM per register):
Cubic Contents x 3.5 Air Changes _ 60 Minutes = Min. C.F.M.
Cubic Content x 5 Air Changes ± 60 Minutes = Max. C.F.M.
J! No. w/a registers x 75 —100 = To t 'f C F M Req.
RECOMMENDED FURNACE (Model #)• 1 K.) (..% ( A - $ t) ( "
1/2 Air Change per hour — Extremely tight w /extraordinary meas.
3/4 Air Change per hour — Very tight construction
1 Air Change per hour — Typical house built prior to 1975
1 -1/2 Air Change per hour — .Older construction - single pane windows - not real tight
•w Duct loss divide by .85 for uninsulated ducts in unheated area, .95 for insulated ducts unheated area, .0 for ducts w /ins, heated area.
O B No A.I
1 0q i i 0
CENTRAL �HEA HEATING S TEMS ,
DATE ,
2 -
C TOMER NAME P
I _ L . ft f ✓ /
ADDRESS
1 �
1 CITY AI IN CITY
_ „ ' COUNTY
HOME PHONE
ZyL' " k
WORK PHONE j
- Za 3 /
MARKING REP
{C LiG
1
NJ INSTALLL� V� � c 1
NSTALLER
BID BY
0 MTKGREP
SCHEDULE DATE:
❑ NEW SERVICE ❑ METER ONLY ❑ ADDED LOAD GAS REPLACEMENT
ENTRY ARR EMENTS
EXISTING SYSTEM
GAS 0 OIL 0 ELECTRIC
❑ OTHER
UP-FLOW ❑ DOWN•FLOW ❑ HORIZ 0 OCTOPUS
BASEBOARD 0 OTHER
MAKE
• , ( ,,�.� L
W/ LA I/
MODEL
4-
BTU
1 cO
NO. W/A DUCTS
` 4
NO. R/A DUCTS
Z
ATTIC INSULATION ADEQUATE YES d NO 0
AUTO T /STAT
DAMPERS EXISTING
INSULATED DUCTS
COMB Nff CI
C/A /A RETURN A ETUU ADEQUATE ADEQUATE UATE t
PROBLEM MTG. AREAS ❑
LOCATION
HEIGHT
(O
WIDTH
' (6
DEPTH
/ ��
W/A PLENUM (SIZE)
W D H
X X
R/A PLENUM (SIZE)
W 0 H
X X
EXTRAS:
ACCESS ❑ DISMANTLE EQUIPMENT
WORK TO
OLD EOU PM NT*
BE DONE I ❑ LEAVE REMOVE
0 RETURN T WNO
ILCR REQ'01
REMOVAL
❑ DIFFICULT
❑ OTHER
I HEAT LOSS:
CFM REQUIRED:
t 0
FURNACE TYPE: . VENTING: PLENUMS: WIRING 8 CONTROLS:
K PFLOW Length Diameter W /A: ❑ PROVIDE SEPARATE CIRCUIT
U
COUNTERFLOW C VENT ❑ NEW X TRANSITION RUSE EXISTING CIRCUIT
❑ HORIZONTAL B VENT C,7I IT R /A: ❑ RELOCATE THERMOSTAT
❑ CONDENSING PVC ❑ NEW Q' TRANSITION
DUCTS: • TERMINATION LOCATION: Q-€C /SET FURNACE INSTALL E.A C .
p���,,,///INSULATE RUNS GAS PIELNG ❑ PROVIDE CAC. OPTION
DON'T INSULATE RUNS VENT TO: . j 0 SERVICE LIGHT WITH SWITCH
NSULATE PLENUMS LENGTH DIAMETER AT ENTRY TO FURNACE ROOM
❑ LINED CHIMNEY ROOF JACK
❑ INSULATE EXISTING DUCTS 0 MASONRY UNLINED 0 POWER ❑ DRILL THROUGH CONCRETE ❑ CONDENSATE PUMP REQUIRED
❑ INSULATE TRUNK [] METAL PERMITS: CONDENSATE LINE TERMINATION
❑ ADD BALANCING DAMPER I ❑ FLOOR DRAIN
❑OTHER IPI NG q
# NEW W/A 0 OUTSIDE TO FRENCH DRAIN
❑ PROVIDE LINER ❑ EL TRICAL IS '
IS NEW R/A ■ OTHER
❑ PROVIDE COMBUSTION AIR URNACE IS N Lt -.C.✓
EQUIPMENT LOCATION & PIPING ROUTE (SKETCH)
TYPE OF DELIVERY: ❑ DELIVER TO INSTALLER
❑ PICK•UP BY INSTALLER ❑ CONSIGNED INVENTORY
1 I
��/(�) �� �A '`- . ''''�''''�'''''jQJ ► 1
- l`VL.O SA .L� -.Y� C �,_ 1
FR TO
0 SALE LOCATION I I 1
! f . { i
■ r 1
T R AN COD ACCOUNT NO
c Q {���� —p. j 1
n_-' :.1a I !l ., �
('�
1 =L�.2J
{�
41.'1 I0 3 IV 12- a
I I 1 +
/♦i`_.' � 1,
t rL� k • l
ITEM NO
OU AN
DESCRIPTION
�
I
j? Iv 1
r? 1
hl l� (� t 1 0 Q
i 1 6! , I
i 1
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I ' 1
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COMMENTS:
L� 2
PE ��
,l
--r (XL iZe Ed , 4f
(9(1_0 Q ` 1 A(/
ORDER RECEIVED BY DATE
ta. J
(((JJJ
MATERIALS ISSUED BY DATE
INST LLATION MOUNT
MATERIALS RECEIVED BY DATE
/7
k ‘- •JASHINGTON NATURAL GAS COMPL.
INSTALLER'S INSTRUCTIONS /MATERIAL RELEASE
0 SPECIAL HANDLING
0 RUSH
1. (WHITE) INSTALLER; 2. (CANARY) WAREHOUSE; 3. (PINK) INSTALLATIONS; 4. (GOLDENROD) POST INSPECTION
DATE�t,
�( - 21 (
AWH -CB -WALL FURNACES RM1GES- DRYERS
WNG 836.3 S (3/90)
B rlo
x10 Pi - , - 4 MJI -, I
CUST ER NAME 11 ([/'� /� r /� l`
o it L�, ft 1 ILY k L
ADDRESS ,( ' �n '� CITY f ,,n �• IN CITY
�6�. 1 I -1 1 AY 5 ; `' "�� COUNTY
HOME PHONE
'24(a =? �
' 4
WORK PHONE
45 2- - 2-,J 3 '7
MARK N REP
INSTALLER CODE
7 r 2 . I I i(clZ
SCHEDULE DATE
MTR SCHEDULED DATE
TYPE OF U DELIVER ONLY DELIVER TO INSTALLER U PICKUP BY INSTALLER
DELIVERY
DELIVER TO CUSTOMER & INSTALL CUSTOMER PICKUP ❑ EMPLOYEE SALE
Do py STALIER
E1 MTKO REP
❑ MOW Dale
0 NEW SERVICE
❑ AVER ONLY
OED LOAD
OAS REPLACEMENT
ENTRY ARRANGEI NTS
( /� '
(/1 _ � a t 5 ( --
NAME
EQUIPMENT LOCATION & PIPING ROUTE (SKETCH)
FROM MAN •. T
I I
1
EA
I
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�jj��
e
Accr No RESP
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! ITEM NO
OUAN
DESCRIPTION
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04.048
WATER HEATER•FSG•10
I
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y 04-049
WATER HEATER - FSGL -40
iI r - I _
04-087
(71
WATER HEATER-FSG-50
f1
(;1_
._._
—i—_.
�
. _. _;
F , lam-
04 -151
WATER HEATER- PRV -40
� _.. _
1_.__; -__�_ 1 ._I�. 1
04152
WATER HEATER- PRV -50
___�
~
- I
_�
_
_
04.252
WATER HEATER P•50 (HIGH RECOV)
23.971
Q i
RELIEF VALVE -P 125 LB.
3.974
Q i
RELIEF VALVE -T 8. P IXL 150 LB.
PRE•INSPECTION A CHED: ❑ BOILER ❑ CONVERSION SURF
85-684
CONCRETE BLOCK 6 x 8 x 16
WORK REQUIRED
a COLD BOILER • ROOF JACK • TYPE'S' VENT
WIRE FOR HOT BOILER NO. OF STORIES DIAMETER
85.685
CONCRETE LID 22"
03.212
CONY. BURNER - ECONOMITE DS24A
23
SWITCH - COMB- L -4084B -1451
24-784
THERMAL STACK SWITCH 11700J
cri COMBINE VE 0 INSTALL THERMOSTAT APPROX FT
23.480
PUMP RELAY SWITCH RA- 89- A- 1074 -1
SIZF • OTHER TYPE 'C VENT '],(
26-008
ECON EXTENSION RING 8"
• CHIMNEY CLEAN OUT DIAMETER /
NI CLEAN OUT IN 'T' APPROX. FT
24-320
ECON MOUNTING FLANGE
23-050
AQUASTAT -DUAL• 11 -B•30
LABOR /MATERIAL IN EXCESS (PROVIDED BY INSTALLER)
• ENCLOSE VENT THROUGH ATTIC $ ❑ L WAT� C •OFF $
23.059
AQUASTAT - SINGLE - STRAP -ON- 1127.2
23
THERMOSTAT T -87F• 1859 W /WALL PLATE
al INSTALL /REPAIR FIRE POT $ PIPINC>_�. A / FT. $ 25 (0
24.302
S.S. FLEX CONN - DRYER I /2" x 36"
• WATER PRESS. REDUCING VALVE $ ❑ ELECTRICAL OUTLET $
24-307
S.S. FLEX CONN RANGE 3�" YF{�
• THERALTIMETER $ ❑ CORRECT PIPING TO $
f� �r��
CIF
II PRESSURE RELIEF VALVE $ EXPANSION TANK
CM
1V
• ELECTRICAL CIRCUIT $ TING 1 W N ' ��-J $ � �
VEN
oC i
• COMBUSTION AIR • FROM WHERE $
IRAN CD
LEASE
2 3
ewe"
CHARGE Il EMS
ACCT NO 4 1 6 3 0 RESP
• OTHER $
GENERAL INFO� �A T / I '' ON
• STAND REQUIRED INPUT �� J) c /C r)
APPROXIMATE FEET
• COLD WATER LINE ! EXISTING WATER LINE • GALV., COPPER
• HOT WATER LINE LI R3/4" • 1 /2"
BILLING DATA
• FUEL LINE it")
• PRESSURE RELIEF DISCHARGE TO: ❑ FLOOR • DRAIN
DISCHARGE LINE P;OUTSIDE ❑ OTHER
INSTALLATION AMT 7. _5 SALE ❑ LEASE
7
EXCESS AMT 7. 1
INSTALL IN EXISTING COMBUS AIR
LOCATION? ❑YES NO ADEQUATE? (ICES ❑
ARE OTHER APPLIANCES BEING INSTALLED AT SAME ADDRESS? ES •
OLD
E • SIZE
NO
NO
• LEAVE WITH CUSTOMER
INSTALLED DATE: AMT. BILLED'
SERIAL NO'
MODEL M TOTAL S
IA TURN TO WNG ❑ OTHER
A...
��
PERMRS:`�PIPING » NL?f +G BING K
TLUM
RE ...wAx�E
• U DISMANTLE EQUIPMENT • DIFFICULT ACCESS
III OTHER
MECHANICAL x ELECTRICAL II
ORDER RECEIVED BY _l�L OAT
COMMENT 1] I , • I A
v
MATERIAL RECIEVEO BY DATE
""
!r NI:I•rR/
MATERIAL ISSUED BY GATE
WASHINGTON NATURAL GAS COMPANY[
INS�i .,LLER'S INSTRUCTIONS /MATERIAL R&...ASE
❑ SPECIAL HANDLING
❑ RUSH
PICK -UP INSTALLERS: 1. (WHITE) INST COMPLETION NOTICE; 2. (CANARY) WAREHOUSE: 3. (PINK) INSTALLATIONS; 4. (GOLDENROD) POST INSPECTION
DIRECT DELIVERY: 1. (WHITE) INSTALLER /GQMPLETION NOTICE; 2. (CANARY) INSTALLATIONS; 3. PINK INSTALLER; 4. (GOLDENROD) POST INSPECTION