01-101306 City of Federal Way
Community Development Services Mechanical Permit #:01 - 101306 - 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: HILBY P1
Project Address: 33411 29TH SW Parcel Number: 010061 0050
Project Description: MEC-Replace gas hot water tank.
Owner Applicant Contractor
RUTH HILBY ACTION WATER HEATERS ONLY INC ACTION WATER HEATERS ONLY INC
33411 29TH PL S ACTION WATER HEATERS ONLY INC ACTION WATER HEATERS ONLY INC
FEDERAL WAY WA 98023 12704 NE 124TH ST SUITE 43 12704 NE 124TH ST SUITE 43
KIRKLAND WA 98034 (425)820-8848
--v—a r s s pi4 5,
Mechanical Valuation 640 Over the Counter Permit Yes
PERMIT EXPIRES October 1,2001,IF NO WORK IS STARTED
Permit issued on April 4,2001
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: — p t�G•ca►`zdL Date: 17L– Y1)-0
VY
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'CITY OF ( RECETIE.D BY BUILDING DIVISION
•
EnEZRL ,-n!,n,ni R,nr- , -77 eRT„cyI r 33530 First Way South
Federal Way,WA 98003 '
N).\> (-'{y ^,t 2001 (253)6614000
Fax(253)6614129
i. _ _Y
APPLICATION FOR �1kII, ECI j .KCAL PERMIT
MEC Ol—10136(0
PARCEL# 0 70 o /CSD Single Family a-. Multi-Family 0 Commercial 0
SITE LOCATION
Tenant/Owner .-TA lig-l.4,.- iiilk, , Phone 253 -- Y 7- 7263
Address/City/State/Zip 3 ` /1 91—'1' "'' 5• ,'T .- ` t ), ‘,..I4 I-22 _3
T
Nature of Work ✓6.2''4/37 " a 4_5 w'--t-_ //-----",--4.-z- Project Valuation:,$ 4''4/v
APPLICANT f
Name Ar€-r- -Jif-/ .2 ;r4-,i s . ,..r'4� .2 -'c-
Address/City/St/Zip '''"1 70 .y' /t)-2'''- 4 4/121- � �j //J' ' " L� �'��j�
Contact Person
2-4-e#.1/ -'-',7c--.-re . Phone Y -r257,--4-ill/1 Fax 52e) "7I-96
MECHANICAL CONTRACTOR �_
Company Name c r7L �' ,c,,`'4,J/. ',✓c.
Address/City/SdZip l, 27° e/ ,V. /'` 44-/"�T/ `--3 W //2'e -'/ 4c) 91' 3 v
�� Phone 1t2S- )- L/y Fax 1(,2r 2e- 7;19 G
Contact Person .--
�c972.GJ/Eo 5 S fl P Exp.Date - 31-0/
State L&I Contractor Registration#
(Card must be presented)
MECHANICAL UNIT COUNT
Fuel Type(gas/other) Gas Dryer Air Handling<=10,000cfin Fuel Tanks:
Length of gas piping Range Air Handling>=10,000cfm Above Ground
Furn<100K BTU's Gas Log Unit Heater Underground
Furn>100K BTU's Fans Boiler BT'U/H Miscellaneous
Gas Hwt 1 Hood Boiler BTU/H Other
Cony Burner Duct Work A/C TONS Other
RRf2's Wood Stove s A/('. TONS <'Ftital'[Irif C
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 woe
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 only 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 pan of this application.
Owner/Agent 9-12.
4'.ea-e71-- Date
Mecu.Arr 9(r/tt eg,tK
Itevtsen 8/26/97 � � n�
`220.r1 11