03-103430City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: CARROLL
Project Address: 30134 3RD S PI S
Project Description: Replace gas furnace in residence.
Mechanical Permit #:03 -103430 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 795450 0080
Owner
Applicant
Contractor
NORMAN CARROLL
RITE WAY GAS SERVICE
RITE WAY GAS SERVICE
30134 3RD PL S
PO BOX 7003
PO BOX 7003
FEDERAL WAY WA 98003
KENT WA 98042
KENT WA 98042
(253) 631-4700
Mechanical Valuation..........................................900 Over the Counter Permit ...................................... Yes
PERMIT EXPIRES February 18, 2004.
Permit issued on August 22, 2003
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 Federal /Way.
Owner or agent: L� Date: �''�
REC;EN LU
Cnf of G
AuG 2 2 2003 Bu DING DIVISION
33530 First Way South
Vii ��
'1.1y UILDWG DEPS AY Federal Way, WA 98003
(253) 6614000
Fax (253) 6614129
APPLICATION FOR MECHANICAL PERMIT
Federal Way Business License number: 1 - j `Q •CSO $E..
MECO (�3?70-C*
f7 a
PARCEL # ` `Yq5/oe)o *d Single FamilyW Multi -Family ❑ Commercial ❑
SITE LOCATION
Tenant/Owner OLL Phone
v
Nature of •rk i i / • • ,Jr r
APPLICANT
Name K/7F'' 10ay "6 �} 14
I
Address/City/St/Zip ?, 0, boy, r7o d 3 '% l �Q `7 7� F
Contact Person —D&M- ! /M i 1 Phone � ' A41260 Fax
MECHANICAL CONTRACTORZ&IC . O ia ?j �S • l�
Company Name . - La%y �E►eU��`J '
Address/City/St/Zip
Contact Person �� J m i -W Phone 1Z- 3 -101 -y f)Q6 Fax
State L &I Contractor Registration # R I 6rs,234Q16% Exp. Date Z
(Card must be presented)
MECHANICAL UNIT COUNT
Fuel other
Gas Dryer
Air Handling
< = 10 000cfrn
Fuel Tanks:
Len of gas piping
Range
Air Handling
> =10 000cfin
Above Ground
Fu <100K BTU's
Gas Log
Unit Heater
Underground
Fum >100K BTUs
Fans
Boiler
BTU/H
Miscellaneous
Gas Hwt
Hood
Boiler
BTU/H
Other
Cony Burner
Duct Work
A/C
TONS
Other
RRO's
Wood Stoves
A/C
TONS
DISCLAIMER I certify, under penalty of perjury, that the information famished by me is true and correct to the best of my knowledge and fiuther that I am authorized by the owner of the above premises to perform the work
for which pemrit 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 claiml, 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 officers and employees, upon the accuracy of the
information suo hed to the city as a Dart of this armlication.
Owner/Agent
MecBAre
Revom 1/7/99
Date 9'1-03