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02-100993v N . -, City of Federal Way Comnmuity Developnxnt Services Mechanical Permit #: 02 -100993 - 00 - ME 33530 1st Way S Federal Way, WA 98003-6210 Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050 Project Name: BRANLUND Wt/ Project Address: 32811 12TH SW Parcel Number: 926494 1050 Project Description: MECH - Gas hot water heater changeout in existing residence. Owner Applicant Contractor Clinton S & Sandra B Branlund NORTHWEST PERMIT WASHINGTON ENERGY SERVICES CO (Get 32811 12TH AVE SW 2320 1 STAVE SUITE 250 2800 THORNDYKE AVE W FEDERAL WAY WA 98023-5203 SEATTLE WA 98121 SEATTLE WA 98199 (206)282-4700 Mechanical Valuation..........................................500 Over the Counter Permit ...................................... Yes PERMIT EXPIRES September 4, 2002, IF NO WORK IS STARTED. Permit issued on March 8, 2002 I hereby certify that the above information is correct and that the construction on the above described property and the oc'�upancy and the use will be in accordance with the laws, rules and regulations of the State of Washington and the Cit -of Federal Way. Owner or agent: Vt 1�5 '/ U� Date: MAR -06-02 15:41 FROM-NORTHWEST-CASSINIAR 206-374-0834 T-479 P-01/02 F-157 CQN51 KUL-1 LlJiv rl-nr•r+. r r,, 1 — - J fE— PLICATION NUMBBR: HY ppLICATION NUMBER: - - pLICATION NUMBER: - - **The following is required information - Please print (in ink) or type" Please nota: Electrical, fire Prevention Systems and Engineering permits may require a separate application. SITE ADDRESS: ASSESSOR'S TAX/PARCEL 7r: �' - 5 _0 LEGAL DESCRIPTION OF SUE{JECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING IfMECHANICAL ❑ DEMOLITION 0 ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM (�4S L,a4c4- �" PROJECT DESCRIPTION (Provide detailed description): - PROJECT NAME: vND PROPERTYOWNER: Hat4Gs !!2aj I WU-1 FODDP4SS (SfREEr ADORESSt CMS 5-109, ZIP)' CONTRACTOR: CONTACT PERSON Fop ,r i1S PROJECT: ❑ PROPERTY OWNER EXISTING BUILDING ASSESSED/APPRAISED VALUATION PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ SPRINKLERED BUILDING? 11 YES El NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED. ❑ YES WATER SERVICE PROVIDER: SEWER SERVICE PROVIDER; ❑ IAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) C7 LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC) MAR -06-02 15;41 FROM-NORTHWEST-CASSIMAR OF 0601122MS: EMMATED SCLUNG PRICC: S 206-374-0834 T-479 P.02/02 F-157 r Indicate number of each type of fixture MECHANICAL AIR HANDLXf 0 UNITS) EVAPORATIVE COOLER(S) GAS LOG(S) RERUG, SYSTEMS I�BQ(S) FAN(S) HOOD(S) w000srovE(s) _ BOILER(S) FIREPLACE INSERT(S) RANGES) MISC. :Ss01t(s) �— P PE(OUTLET(S) DUCT(S) GAS HEAT SOURCE: Q ELECTRIC ❑ GAS DUCTS PLUMBING BATHTUBS) , LAVATORY(S) URINAL(S) WAVER HEATERS DISHWASHER(S) RAIN WATER SYS, VACUUM BREAKER(S) © ELECT= AGAS DRINKING F:)UNTAIN(S) SHOWERS) WASH MACHINE OUTLET GAS PIPE OAITLET(S) SINK(S) WATER CLOSET(S) MISC. jKTERCEFTQ FSC$) SUMP(S) IIII: DISCLAIM ER/SIGNATU RE 13LOCK I certify eindei, penalty of perjury that the Information famished by me is true and correct to the best of my knowledge, al further, that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I furtheragree to hold harmless the City of f=ederal Way as to any claim (including .costs,, expenses, and attorneys' fees incurred In ti Investigation and defetie of sudr (m), which be made by any person, induding the undersigned, and filed against the City Pederal Way, but only 1MNere suds d acs o of the reliance of the city, including Its officers and employees, upon the acture of the Information -i p�alied to the d a .pals application. NAME/TPU'. ❑ PROPERTY OWN APPLICANT DATE: �3 16 101,/ -- ODMMUNr Y CENM 3FHWr SERVICES • 33530 FIRST WAY SOM • P.O. ROX 9713 • FMO AL WAY, WA 9800-9718 . 2ST"l-4000 -FAX. 253561-4129