00-103067City of Federal Way
Community Development Services
33530 1 st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Mechanical Permit #: 00 -103067 - 00 - ME
Inspection request line: 253.661.4140
(3:30pm cut-off for next day inspections)
Project Name: PALISADES RETREAT
Project Address: 4700 DASH POINT SW
Project Description: HVAC - new Das Dining for fire ulace loa
Parcel Number: 112103 9010
Owner
Applicant
Contractor
PALISADES RETREAT CENTER
NONE
AL PRO GASWORKS
POB 3739
FEDERAL WAY, WA
14111 178TH AVE E
98063
NONE
SUMNER WA 98390
Mechanical Valuation..........................................2800 Over the Counter Permit...................................... Yes
Mechanical Fixtures
Description QuantiI Description Quanti ° Description Quinti
Gas Logs 1i Gas Piping 175
PERMIT EXPIRES November 21, 2000, IF NO WORK IS STARTED.
Permit issued on May 25, 2000
I hereby certify that the above information is correct and that the construction on the above described propep
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washing
the City of Federal Way.
Owner or agent: 4- Date:
It
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PARCEL #
SITE LOCATION
Tenant/Owner
APPLICATION FOR MECHICAL. PERMIT
t; UtL0%WC- W-�J
Federal Way Business License num�0 en�
/fQ�pf
MEC
Bun iNG DfvrsfoN
33530 First Way South
Federal Way, WA 98003
(253) 661-4000
Fax (253) 661.4129
Single Family ❑ Multi -Family ❑ Commercial
Address/City/State/Zip i17,2& /->,s/ // hem
Nature of Work v"S 'fin
Phone
Project Valuation: $ r `
APPLICANT
Name
Qln
Address/City/St/Zip /10// �� �� G 0 V� -ey ° t. -J Py ID
Contact Person /���`�' Phone 242-eWl 3260 Fax
MECHANICAL CONTRACTOR
Company Name �'7/i, CJ�fWos/lS
Address/City/St/Zip �"� GS �e412-
Contact Person `F Phone �'r3- /� Fax
State L & I Contractor Registration # %LL IX !41G 3 oG Exp. Date y�
(Card must be presented)
MECHANICAL UNIT COUNT
Fuel other 64J
Gas Dryer
Air Handling
<=10 000am
Fuel Tanlo:
Length of m pipmg7S I'c-/
Rame
Air Handling>
=10 000dm
Above Ground
Fum <100K BTUs
c
Unit Heater
U
Fum>100KBTUs
Fans
Boiler
BTU/H
Miscellaneous
Gas Hwt
I Hood
Boiler
BTU/H
Other
Cony Burner
Dud Work
A/C
TONS
Other
DISCLAIMER. I certify, under penalty ofp qW, that the information fiur&Jwd by me is true and correct to the best ofmy knowledge and Either 19I am aulhorked by the owner ofthe above premises to perform the work
for which pemut application is made. I fiuther agree to save harmless the (Sty ofFedual Way as to any clahn (mdudmg costs, otpenses„ and anomeys, fees incurred in investigation and defense ofsuch claim), which may be
made by any person, mdudmg the undamped, and Mod against the Oty of Federay Way but only where such dawn arises out ofthe reliance of the city, including its offices and employees, upon the accuracy of the
infomretion supplied to the chy as a pan of ft application.
Owner/Agent
MECRAPP
Ravc4ro Ir//99
Z
Date