00-100467City of Federal Way,
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
t
Mechanical Permit #:00 -100467 - 00 - ME
Inspection request line: 253.661.4140
Ph: 253.661.4000 Fax: 253.661.4129 (3:30pm cut-off for next day inspections)
Project Name: JACKSON (HVAC)
Project Address: 404 SW 305TH Parcel Number: 178890 0070
Project Description: INSTALL GAS FURNACE & HOT WATER HEATER
Owner
Applicant
Contractor
CARY JACKSON
NONE
ROSSOE ENERGY SYSTEMS INC
404 SW 305TH ST
FEDERAL WAY WA
9367 RAINIER AVE S
98023
ONE
SEATTLE WA 98118
Mechanical Valuation..........................................4000
Over the Counter Permit ...................................... Yes
Mechanical Fixtures
Description Quanti ' I Description Quanti Description JQuantN
Furnaces I Water Heaters I 1
$ z/� 0/,0 �*4
)r1a,eJ Zhy jev 5.5
Conditions:
PERMIT EXPIRES August 7, 2000, IF NO
Permit issued on February 09,
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington and
the City of FederalWay
City of Federal Way CITY OF 33530 First, Way SouthFederalWay, WA98003
Oil.
APPLICATION FOR MEC AL PERMIT
PARCEL ff- f ® ® 7e Il � I� �AV
Multi-Family 0 Commercial 11
SITE LOCATION:
Tenant/Owner: 0 ' r ®� Phone: z? .5-3 5 a
Address/City/State/Zip: _ •
Nature of work: r 6 144 /f A) )9 �'� Project Valuation: $
APPLICANT:
Name:
Address/City/St/Zip:
Contact Person: Phone: Fax:
MECHANICAL CONTRACTOR:
Company Name: '5 ��'� ��' �o Sys '
Address/City/St/Zip.
Contact Person: Phone:. 7 Fax: 7�, 3.3,/
State L & I Contractor Registration #:.U� �� / Exp. Date:
(Card must be presented)
MECHANICAL UNIT COUNT:
Fuel Type (as/other) CA
Gas Dryer
Air Handling
< 10,000ofm
Fuel Tanks:
Length of gas piping
Range
Air Handling
> 10,000cfm
Above Ground
Furn <100K BTU's /
Gas Log
Unit Heater
Underground
Furn > 10oK BTU's '
Fans
Boiler
BTU/H
Miscellaneous
Gas Hwt
Hood
Boiler
BTU/H
Other
Conv Burner .
Duct Work
A/C
TONS
Other
DISCLAIMER: I certify under penalty of perlury that the information furnished by me Is true and correct to the best of my knowledge and further that 1 am authorized by the owner of the above
premises to perform the work for which permit application to made. I further agree to save harmless the City of Federal Way as to any claim Oneludin g costs, expenses and attorneys' fees
Incurred In Investigation and defense of sunfrdalml. which may be made by any person. Including the undersigned. and filed against the City of Foderay Way but only where such claim arises
.,.n M tM re0anee of the Ckv. breludinta Its officers and employees. upon the accuracy of the Information supplied to the City as s pct of this application.
0
Owner/Agent:
Date: