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City of Federal Way CITY OF � 33530 First Way South '] �(,/ /� ��/ _ � _ � Federal Way, WA 98003 l✓�,�f���� li � " [ � � (206)661-4000 �1�� APPL/CA T/ON FOR MECHAN/CAL PERM/T PARCEL #• '?`-�►' ~ �� ����J c'/�/���� �� Single Family�-- Multi-Family � Commercial o SITE LOCATION: Tenant/Owner: 1������ � ����f�`� Phone: � � Address/City/State2ip: � � � �� ' . � I� � � � �- ���G�C- G'}�C()(7 � Nature of work: -�'� � ��� ������ C ���'n��� Project Valuation: S � � APPLICANT: Name: � ' � Address/City/St/Zip: r-� � � ' �` r 1C�����n '� �dt�l-�_ ��I� c�' Contact Person: 1- y-�-��I�� r(/I Phone:��� �n�G� � Fax: �-���`�� / J MECHANICAL CONTRACTOR: Company Name: �'�� ������'� ���'�✓ Address/City/St/Zip: ���%�� � ���1 D�F"1�!�fil��_ �� ��� ��Q�C� "fC���� Contact Person: � � �� Phone: Fax: State L & I Contractor Registration #: �I���i���l ' �n��� Exp. Date�� -���'�� (Card must be presented) MECHANICAL UNIT COUNT: Fuel Type (gas/other) Gas Dr er Air Handling < = 10,OOOcfm Fuel Tanks: Length of gas piping � Range Air Handling > = 10,OOOcfm Above Ground Furn <100K BTU's Gas Log Unit Heater Underground Furn >100K BTU's Fans Boiler BTU/H Miscellaneous Gas Hwt Hood Boiler BTU/H Other Conv Burner Duct Work A/C TONS Other DISCLAIMER: I eertify under pe�elty of perjury that the informetion furnished by me ia true and eonect to the beat of my knowledpe and further that��m authorized by the owner of the above premises to perform the work for which permit�pplieation is made. I further pree to save harmlesa the City of Fedaral Way aa to�ny claim lincludinp ewta,expenses and attorneys'teos i�curred in investipetion a�d deferme of�uch clsim),which may be made by��y person,includirq the urdenipned,and(iled apairut the City of Feder�y Way but only where such claim arises out of the relia�ce of the City ineludi it�officen and employees,upon the�ceuraey of the infamatio�supplied to the City p a p�rt of this�pplication. � � Owner/Agent: Date: G � �