01-101861 City of Federal Way Mechanical Permit #:01 - 101861 - 00 - ME
Corrmnmity Development Services
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: BROSMER
Project Address: 30255 24TH'SW Parcel Number: 893750 0010
Project Description: MEC-Replace gas furnace and hot water tank.
Owner Applicant Contractor
Ronald Lee Brosmer COMPLETE HEATING&A/C COMPLETE HEATING&A/C
1521 S CENTRAL AVE 1521 S CENTRAL AVE
KENT WA 980 32 KENT WA 980 32
(253)854-2007
Mechanical Valuation 4375 Over the Counter Permit Yes
Mechanical Fixtures
AUT;AD*so`rlp'tio►?_ , .Qi** escriptlon Qllaiitity [° iDe"scription , .Quantity,
Furnaces 1
PERMIT EXPIRES November 6,2001,IF NO WORK IS STARTED.
Permit issued on May 10,2001
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: Date: _
1
RECEIVED I - l o r kt,, l - til
gryap G r �� BUILDINGDIVLSION
� 1 ® (�E° 33530 First Way South
�" AyFederal Way,WA 98003
GI I Y Oi FLUcJiAL WAY (206)661-4000
BUILDING DEPT. Fax(206)661-4129
APPLICATION FOR MECHANICAL PERMIT
MEC -
PARCEL# Single Family Ili Multi-Family 0 Commercial 0
SITE LOCATION
Tenant/Owner
o f! '1'-"S Wt.e►^ Phone a-53-660/-u 95 Z
Address/City/State/Zip 3')a rs- S , - a.Qem0 A)A j / Gc/A 9 V.o z,3
J' �rJ
Nature of Work �(�� t 4-H Tw�`' J'A'�'4" go,-Aja Ai< Project Valuation: 3 1
APPLICANT
Name
Address/City/St/Zip
Contact Person Phone Fax
MECHANICAL CONTRATOR n
Company Name _&/$1,/e. ?fit
+A/+A/C_ X&c
Address/City/St/Zip /574 S,. ^1fr4:4- Q dt6 ) ,�,I-, lziA- 9,903 Z_
Contact Person 1 Oa-4- Phone 425.3-65W"2-00 7 Fax .2,13-eS4-M7Q
State L&I Contractor Registration# COMP 6342 3 3 Exp.Date mac/ Si-24Z e-
(Card must be presented)
MECHANICAL UNIT COUNT
Fuel Type(gas/other) Gas Dryer Air Handling<=10,000cfin Fuel Tanks:
Length of gas piping r Range Air Handling>=10,000cfin Above Ground
Fum<100K BTUs ��jj Gas Log Unit Heater Underground
Fum>100K BTU's "T Fans Boiler BTU/H Miscellaneous
Gas Hwt ( Hood Boiler BTU/H Other
Cony Burner Duct Work A/C TONS Other
RRQ's Wood Stnves A/C TONS '3'is ifl3eantY:•:::..::::f:•::;of z:r•::'s:`•>:•>:%:>:.
DISCLAIMER:I certify,under penalty of perjury,that the information fu nished by me is hue 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 it 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 part of this application.
Owner/Agentl 4` Zda-61-- Date b 5- a 9-0/
Mrca.Aee
Revise)12111/96