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Federal Way, WA 98003 -1�=i�Si''wra— Ail LJJQ (206)661-4000 WFIF"5fian &393 - aei APPLICATION FOR MECHANICAL PERMIT '� y''� ( id77 PARCEL ff. t �I 1 LP h - I? .0 P4 l Single Family Multi-FamilR C I ❑ LV pt * 6Lo3 - 13(si / i/���. �-- SITE LOCATION: 14 211994 PQT Q OF FEDERAL WAY Tenant/Owner: APhonre:Egil ;�j/. Address/City/State/Zip: L 53 S W `"i `34- dQTL� c ci C -Vo3 Nature of work: I Y1S- A --()(ift C1Y) (6) 90-1) On i1tProject Valuation: $ 4-0 �r n�.�q 3—) tic- - lldtpa±jU / APPLICANT: Name: ma) LLicitiil kock,U( Address/City/St/Zip: SDC) c j ( ii fir) C) S+ SW Contact Person: j (A-1 C k_a n Ci ( ( ' rC ,/ C� �Q 1�Y Phone: "I U `l T `1L '�/ Fax: � �^ �� l 1� MECHANICAL CONTRACTOR: -�— Company Name: , w' 1 `'(�---- 12-A. 4 D a-4 LA Address/City/St/Zip: ac\A l Wri'' SA-• 5 `'u • . Contact Person: C S 1 tC ,.rt A J vu x Qphone: qoF3X, ' R-C1393 State L & I Contractor Registration #: )30(' #h win \0 3R0 Exp. Date: lal. ....19V (Card must be presented) MECHANICAL UNIT COUNT: Fuel Type (gas/other) _rz,`D Gas Dryer Air Handling < = 10,000cfm Fuel Tanks: Length of gas piping Range Air Handling > = 10,000cfm Above Ground Furn <100K BTU's 1 Gas Log Unit Heater Underground — Furn >100K BTU's Fans Boiler BTU/H Miscellaneous Gas Hwt f Hood Boiler BTU/H Other Cony Burner Duct Work A/C TONS Other ..............................:*,: .... .............iei i...... ................................................................. ........................................ .......................... BBQ's Wood Stoves A/C TONS ::'T tarttiii:Ci i t::i*:>: »>i i*:i> »> 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 such 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 l)offic�' ` officers and employees,upon the accuracy of the information supplied to the City as a part of this application. Owner/Agent: JJC� --. '- -J1�- v I Date: 1 ��