00-103149City of Vederal W.Way
Conmumity Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: SMITH
Project Address: 2004 S 282ND
f 1„
Mechanical Permit #:00 -103149 - 00 - ME
Project Description: HVAC - install free standing wood stove
Inspection request line: 253.661.4140
(3:30pm cut-off for next day inspections)
Parcel Number: 422231 0170
Owner
Applicant
Contractor
Patricia Jean Smith
NONE
Patricia Jean Smith
1601 MAPLE IN #A2
KENT WA
1601 MAPLE IN #A2
98031-7443
NONE
KENT WA
Mechanical Valuation..........................................1500
Over the Counter Permit......................................Yes
Mechanical Fixtures
Description Quantity F Description Quanti Description Quantityl
Fireplace Inserts i
PERMIT EXPIRES November 29, 2000, IF NO WORK IS STARTED.
Permit issued on June 2, 2000
I hereby certify that the above information is correct and that the construction on the above described propert}
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washing
the City of Fede
Owner or agent• Date: (� 'z Vy "
MY o:' BUIIAING DrwaoN
r,+ 33530 First Way South
1 Federal Way, WA 98003
AIN (253) 661-4000
Fax (253)
01 f V OF e-,; ,�
APPLICATION FOR MECI-�i IN11C UPERMIT
Federal Way Business License number:
^A / MEC
PARCEL # /v�1° 1 r 7 Single Family Multi -Family ❑
SITE LOCATION
!?
Tenant/Owner v� v
Address/City/State/Zip
Nature of Work
A
N
A
-107,1 Ln
Commercial ❑
Project Valuation: $ /v1 --
Contact Person Phone Fax
MECHANICAL CONTRACTOR
Company Name
Address/City/St/Zip
�f (, Contact Person Phone Fax
oOState L or Registration #
�� Card must be presented)
MECHANICAL UNIT COUNT
Exp. Date
Fuel T as/other
Gas Dryer
Air Handling
< =10 000cfin
Fuel Tanks:
Length of gas pipingRange
Air Handlin
> =10 000cfin
Above Ground
Fum <100K BTU's
Gas Log
Unit Heater
Underground
Futn>100KBTUs
Fans
Boiler
BTU/H
Miscellaneous
Gas Hwt
I Hood
I Boiler
BTU/H
Other
Conv Burner
Dud Work
A/C
TONS
Other
DISCLAIMER: I certify, under penalty ofperjury, that the information famished by me is true and correct to the best of my knowledge and finther that 1 am authorized by the owner of the above premises to perfomn 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 claiml 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 ofthe city, including its officers and employees, upon the accuracy of the
information supplied to the cit
R of this application
—Owner/Ager
MECHAPP
REviseu 1(7/99
M
N
DateytltlV e e� / 6300�)