99-101578A
CITY OF FEDERAL WAY
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33530 First Way South
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Federal Way, WA 95003
Mechariic:al
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RegUests 253-661-4140
253-661-4000
ADDRESS:504 SW 3161-11 ST
NO.: 55.5920-0215
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PROJECT DESCRIPTION. -HVAC - INSTALLING 1
FURNACE, CHANGEOUT
OWNER=___________________________________________________= CONTRACTOR
WILLIAM HARTVIG R WASHINGTON ENERGY SERVICES CO
504 SW 316TH S' ' ONE UNIO"! SQ 9TH FL
FEDERAL WAY WA 98023 ) PO BOX 91060
+1 SEATTLE WA 98111-9160
WASHIES07403
CONTRACTORS, PLEASE USE LOCATION CODE 1732 u EP- TIN - PROJ ITHIN TH
-------------
PROJECT VALUATION 1500
FUEL TYPES.:GAS ELE FANS..........: 0 BCILERS!CO RESSORS
GAS PIPING.: 0 ft HOOD..........: 0 C-3 T 0
FURN<100K..: 1 DUCT WORK.....: 0 -1 0
GAS HWT.... : 0 WOOD STOVES...
i# CONV BURNER: 0 FURN>100K....... TO,...:
i BBQ......... 0 MISC........... N......
GAS DRYER..: 0 AIR HANDLIN&NI FUEL . KS -------
RANGE ......
-----RANGE......: 0 *1.0, ABOV
GAS LOGS...: 0 > 10 UNDER 0
Does the water su ly ys n a Press eduction Device or Check 1 Yes
Inspectne M al Rou---------------- Date ---------- as Piping
PERMIT NO: MEC99-0138
ISSUED: 04/23/99
BY: FC2
EXPIRES: 1.0/19/99
RATE -- 8.25 US
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NM PERMIT FEE $ 54.00
TOTAL FEES
$ 54.00
( ) No (If "Yes" then water expansion tank is required on Hot Water Tank)
Date
I%CHAN NAL -- ----------- Date ----------
PERMITS EXPIRE 180 SSUANCE IF NO WORK IS STARTED.
I CERTIFY THE I TI N F ED N S TRUE A R TC/T/HEE BEST OF MY KNOWLEDGE AND THE APPLICABLECITYOF FEDERAL WAY
�RREEQUIREMENTS RILL BE MET.
OWNER ___________________ --
FILE
______ --_________ DATE l/___✓___\ I — 1
FILE COPY
CRY GF G BUIIAING DrvmoN
EO 33530 First Way South
\� Federal Way, WA 98003
(253)661-4000
Fax (253) 6614129
MMSoOPPLICATION FOR MECHANICAL PERMIT
Federal Way Business License number:
MECO ( -�
PARCEL # Single Famil Multi -Family ❑ Commercial ❑
SITE LOCATION
Tenant/Owner I r l To c, Phone
Address/City/State/Zip
Nature of Work�" t Project Valuation: $ ���
APPLICANT
Name
Address/City/St/Zip
Contact Person
MECHANICAL CONTRACTOR
Company Name
Address/City/St/Zip
Phone
Fax `
Contact Person ✓'`4 kA -6m Phone w� �'"'� 1�� Fax
State L &I Contractor Registration # G`v ', - J Exp. Date
(Card must be presented)
MECHANICAL UNIT COUNT
Fuel Type as/other
Gas Dryer
Air Handling < = 10 000cfm
Fuel Tanks:
Length of gas piping
Range
Air Handling > = 10 000cfm
Above Ground
Fum <100K BTUs
Gas Log
Unit Heater
Underground
Fum>100KBTUs
Fans
Boiler BTU/H
Miscellaneous
Gas Hwt
I Hood
Boiler BTU/H
Other
Conv Burner
Duct Work
A/C TONS
Other
Wood 'stoves
A/C TONS
DISCLAIMER: 1 certify, under penalty of perjury, that the information furnished by me is true and correct to the best of my knowledge and further that I 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 claim (including 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 o y where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of this application.
Owner/Agent Date
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