00-103068B1:TIIAING DrvrsrON
33530 First Way South
Federal Way, WA 98003
�� Ay (253) 661-4000
Fax (253) 661-4129
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APPLICATION FOR MECHANICAL PERMIT
Federal Way Business License number:
MEC 60 - [0.306e
PARCEL # Single Family 0 Multi -Family 0 Commercial
SITE LOCATION
��i�c5 //C� / s Zza
Dryer
Air Handlin
Tenant/Owner
Fad Tamm:
Length of m pipingAir
Phone
Handlm
> =10 000am
Above Ground
Fum <100K BTUs
Address/City(State/Zip
Unit Heater
Undermound
Nature of Work �•
l�e/d-T
C' � GVd>z-K
Project Valuation: T
Miscellaneous
Gas Hwt
I Hood
APPLICANT'
BTU/H
Other 1)
Cony Burner
Name
A/C
TONS
Other 7 C
AddresslCity/St/Zip �D./" Uv Z O Ste-
Contact Person 21l ,e ��� '-an
MECHANICAL CONTRACTOR
Company Name
"4? , �,a - 9IF3S'S �` Z a
Phone L,0, V 7_ �6;?-O Fax jam- 297-- E �
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Address/City/St/Zip ylo � �D �ZU / el . 9Y
Contact Person 12a;& `e Phone -,1�0 9g 7'12zFax
State L & I Contractor Registration # ( --AZ_ " ' X ®' �� Exp. Date6/
(Card mud be presented)
MECHANICAL UNIT COUNT
Fuel Tym Codother)Gas
Dryer
Air Handlin
< =10 000din
Fad Tamm:
Length of m pipingAir
Handlm
> =10 000am
Above Ground
Fum <100K BTUs
Gas Log
Unit Heater
Undermound
Furn >100K BTU's
Fars
Boiler
BTU/H
Miscellaneous
Gas Hwt
I Hood
I Boiler
BTU/H
Other 1)
Cony Burner
Dud Work
A/C
TONS
Other 7 C
DISCLAIMERIcertify.unciapariallyofperjmy,W&andoanstion8nmisbedbymeishereand waedtothe bedofmylmowk*and firdwdid iamaut by die owneroft10above premises toperfomr1110work
fmwhich pemrit appflcadon is made. I dutheragree to save hamdess &a City of Pedewl Way as to soy daim (mchift cosh, expenses, and atton10W fees incurred in urvestigadon and defense ofsach daiml wbichmay be
me& by any parson, indudmg t10 undersgo4 and tiled agabnst Xy of Federey Way but only where such claim anus out oft10 refmnce offfie city, inhaling ifs offices aml employees, upon the accuracy ofdw
h0unation supplied to the city as a2art oftnis applicetilm. /
Owner/Agent
M¢csAer
ttevrsrn IJ7J"
Date 1—
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