00-100672•
City of Federal Way
Conmmnity Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: KLIEN (HVAC)
Project Address: 32522 42ND SW
0
Mechanical Permit #:00 -100672 - 00 - ME
Project Description: HVAC - GAG TO GAS FURNACE CHANGE OUT
Inspection request line: 253.661.4140
(3:30pm cut-off for next day inspections)
Parcel Number: 873201 0590
Owner
Applicant
Contractor
Donald C Klein
NONE
VALLEY FURNACE INC
32522 42ND PL SW
FEDERAL WAY WA
PO BOX 507
98023-2649
NONE
PUYALLUP WA 98371
Mechanical Valuation..........................................4000 Over the Counter Permit...................................... Yes
Mechanical Fixtures
Description Quanti Description Quant—it Description IlQuanti
Furnaces 1
7OF G • 11 V
VW F �v�� 2 Q
GJ r V ®F FE®EML WAY
APPLICATION FOR MECIZAMWIT°PERMIT
Federal Way Business License number:
PARCEL # Single Family 0
SITE LOCATION
Tenant/Owner
MEC
BUILDING DrvimoN
33530 First Way South
Federal Way, WA 98003
(253)661-4000
Fax (253) 661-4129
Multi -Family 0 Commercial 0
Phone 9.70
Address/City/State&ip -� -2—ZZ/ 2— h
Nature of Work ���� �� �� i ` i ;'a S Project Valuation: $
APPLICANT 12—le
Name 1-2V IXIX ',00M�' 4---
Address/City/St/Zip
t4
Contact Person Phone y'�^ % Fax
MECHANICAL CONTRACTOR
Company Name
Address/City/St/Zip
Contact Person Phone Fax
.G Exp.
State L &I Contractor Registration #
Date
(Card must be presented)
MECHANICAL UNIT COUNT
Fuel T other
Gas Dryer
Air Handling
< =10 000cfin
Fuel Tanks:
1,ength of gas pipingRange
Air Handlin
> =10 000ofin
Above Ground
Fum <100K BTU's
Gas Lolt
Unit Heater
Underground
Furn >100K BTUs
Fans
Boiler
BTU/H
Miscellaneous
Gas Hwt
Hood
I Boiler
BTU/H
Other
Cony Burner
Duct Work
A/C
TONS
Other
DISCLAIMER 1 certify, under penalty ofpedury, that the information famished by me is true and correct to the best of my knowledge and finther that I am authorized by the owner ofthe 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 (mcluding 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 ollicers and employees, upon the accuracy of the
information supplied to the city as a part of this application
Owner/Agent
Mecu.Arr
Rtwsem 01"
Date 2 — 2—