00-103135Cityoi`hederal Way
Community Development services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: DSHS
Project Address: 616 S 348TH
Project Description: HVAC - gas piping only 132 feet
Mechanical Permit #:00 -103135 - 00 - ME
Inspection request line: 253.661.4140
(3:30pm cut-off for next day inspections)
Parcel Number: 926480 0020
Owner
Applicant
Contractor
STATE FARM MUTUAL AUTOMOB
NONE
JOHANSEN MECHANICAL
1 STATE FARM PLZ
BLOOMINGTON IL
PO BOX 1768
61710-0001
NONE
WOODINVILLE WA 98072
Mechanical Valuation..........................................6500
Over the Counter Permit ...................................... Yes
Mechanical Fixtures
Description QUantl Description Quanti Descri tion Quanti
Gas Piping 132
PERMIT EXPIRES November 28, 2000, IF NO WORK IS STARTED.
Permit issued on June 1, 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 Washingb
the City of Federal W_V.
Owner or agent: I �� Date: ` ��
City of Federal Way
33530 First Way South
Federal Way, WA 98003-6210
(253)661-4000
APPLICA TION FOR MNICAL PERMIT
PARCEL #•- L ®� ®� ' SinQn�' Family/ ❑ Multi -Family ❑
�v�B i ,e- F'",. -.a. rr'%r
8UILDINf3 DEPT"
SITE LOCATION:
Tenant/Owner:
LeL.6,
Phone: a
Commercial
Address/City/State/Zip: -410 1 C®
Nature of work: Project Valuation:
APPLICANT:
Name:
Address/City/St/Zip:
1 / / t� %1
I u�-
Contact Person: &,`2 46 s
:CHANICAL CONTRACTOR:
Company Name:
Address/City/St/Zip:
Contact Person:
Phone:
Fax:
State L & I Contractor Registration #: Exp. Date:
(Card must be presented)
MECHANICAL UNIT COUNT:
Fuel Twe a Handlin 3 Fuel Tanks -,
3Z. a 1 0.000cfm Above Ground
Furn <100K Loui ea a Underaround
Furn > 1 00 Fans Boiler BTVIH Miscellaneous
Gas HW Hood Rnilar BTUIH Other
o v Bu ner Ducto C TONS O e
ARQ'r W—el +. Ic --TZUS—
•''r:EiF.e:�y.
:':'�' iii:•: �':•`.:
DISCLAIMER: 1 certify under penalty of perjury that the information furnished by me Is true and correct to the bed of my knowledge and further that 1 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 dalm On eluding costs, wgmv as and attorneys' fees Incmed
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 arkas out of the
reliance of the City. trtdudbq "cam and employees, upon the accuracy of the information supplied to the City as a part of this application.
Owner/Agent: / //l�'�L� , ��t� �� ��� Date- `y `/