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CITY OF FEDERAL WAY .
PERMIT NO: BLD95-0484
33530 First Way SouthMECHANICAL PERMIT
ISSUED: 06/22/95
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 12/19/95
ADDRESS:32105 40TH AVE SW
NO. : 873190-2340
PROJECT DESCRIPTION:HVAC - INSTALL ONE GAS FURNACE.
1 r OWNER = = ___ _= CONTRACTOR =_
0City of Federal Way • w •
--
CITY OF ,_
/^"' " 33530 First Way South &1cy:?s
®_ Federal Way, WA 980034
(206)661-4000 CE f VrD �6"I 7� t
WiF:ir
��CC
NAPPL/CAT/ON FOR MECHANICAL PLRM/T -
i Y OF FEDE-4---3 1 9 RAL INGEp„L WAY
PARCEL 02---2--- Single Family Multi-Family 0 Commercial ❑
SITE LOCATION: 1
L t t 1/ ////
Tenant/Owner: ` /
�c�_ Phone: Li!�� `" �'s -3
_
Address/City/State/Zip: tO S C—J 1 ALI i 1-- t iJ `( O
Nature of work: v ) )T PLL F0,2/UI A LG �-�!, ---
3
Project Valuation:
APPLICANT:
Name: i '7A f 6 t c- `-(�L .
Address/City/St/Zip: 3
Vi/ J t ) 5 (it-)
Contact Person: w A eA 6 1_ p Phone: 3,-.)--• --- O L
e-c
*-7-.-
Fax:
d3.-q ��7
MECHANICAL CONTRACTOR:
Company Name:
p y A\ W WP\ \\ A-Tc=-"
D.-50Address/City/St/Zip: �C 0 1�0UE_Ac b<f 1.. ST E A / 1d4, ?.V/
Contact Person: U�Q E r , Psi_ii\13(_,% Phone: -�6---.) g l 1 , Fax: 9 4-1� �-
3
State L & I Contractor Registration #: /•?O �'� ��1 1 �J (e-- Exp. Date:
(Card must be presented)
MECHANICAL UNIT COUNT:
Fuel Type (gas/other) Gas Dryer Air Handling < = 10,000cfm Fuel Tanks:
Length of gas piping Range Air Handling > = 10,000cfm Above Ground
Furn <100K BTU's I Gas Log Unit Heater
Underground
Furn >100K BTU's Fans Boiler BTU/H Miscellaneous
Gas Hwt Hood Boiler BTU/H Other
Cony Burner Duct Work A/C TONS Other
BBQ's Wood Stoves A/C TONS 7titatittht eiitit »>>`::::.,'..
DISCLAIMER: I 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 save harmless the City of Federal Way as to any claim(including }
incurred in investigation and defense of such claim),which may be costs,expenses where attorneys'c fees
.r_yt 4 b My Per ,including the undersigned,and filed against the City of Federay Way but only such claim arises
out of the reliance of the City,including its officers and e occur. of the information supplied to the City as a part of this application.
Owner/Agent: Date. /.
-.7-`-