00-102571 •
•
City of Federal Way •
CITY OF ir'--- 33530 First Way South
® Federal Way, WA 98003
WICW
re.7±111KFIL__ (206)661-4000
: PLICATIONAPFOR MECHANICAL PERMIT
PARCEL #• I i4° 8° — 0210 Sin le Famil ❑
9 Y Multi-Family llCommercial
SITE LOCATION: /
Tenant/Owner: S 'N4 T4 <
Phone:
33
Address/City/State/Zip: -34t,50 6TH Avg• So .
Nature of work: IHSTA L.L_(2 ) S�[.I-r Ai , •.
Project Valuation: $ 9(oOa
APPLICANT:
Name: �IECM�Lpt`�,C�T(G ING.
Address/City/St/Zip: 600 M -e-E- T. S ,L
� '-(--T-L , WA c181
Contact Person: 121 GiIbDet-A Phone: 20 '• Co24t• 331O
Fax: &Z3•(��f(oU
MECHANICAL CONTRACTOR
Company Name:
Address/City/St/Zip: 54ME .45 A11.04 —I\
Contact Person: Phone:
Fax.
State L & I Contractor Registration #: LEL'TI''E233tJff..
(Card must be presented) Exp. Date: 2•000
MECHANICAL UNIT COUNT:
Fuel Type (gas/other) I Gas Dryer Air Handling < = 10,000cfm Fuel Tanks:
Length of gas Piping Range Air Handling > = 10,000cfm
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 V(Z-ILL MI
Cony Burner Duct Work A/C Z TONS 3 IC SL
Other
BB4's Wood Stoves _A/C
TONS Tv#at f)nat t ount
DISCLAIMER: I certify under penalty of perjury thy the information furnished by me is true and correct to the best of my knowledge and further that 1 am authorized by the owner of the above
premises to perform the work for which permit licetion is made. I further agree to save harmless the City of Federal Way as to any claim(including costa,expenses and attorneys'fees
incurred in investigation and defense of such/ml, hich ma be made by any person,including g the undersigned,edt and filed against the City of Federay Way but only where such claim arises
out of the reliance of the City,including its I--r nd e -s,upon the accuracy of the information supplied to the City as a part of tFwa application.
/
Owner/Agent: `��
Date: 7` ' 2'7 • ZIt- •