21-102320Mechanical
City of Federal Way Permit #:21-102320-00-ME
Community Development Dept,
33325 8th Ave S tr1
Federal Way, WA 98003 j� ��.- �1 , Inspection Request Line: (253) 835-3050
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: HALL
Project Address: 28019 20TH AVE S Parcel Number: 422231 0520
Project Description: install air conditioner and replacing gas furnace
Owner A�licant Contractor
DANIEL HALL SUSAN DUNHAMBLACK HILLS INC BLACK HILLS INC (GENERAL
28019 20TH AVE S 1003 85TH AVE SE UNIT A BLACKHI066JL (7/19/21)
FEDERAL WAY WA 98003-3200 OLYMPIA WA 98501 1003 85TH AVE SE UNIT A
OLYMPIA WA 98501-5706
Additional Permit Information
Mechanical Work Valuation?........... ....................... 500 Is this an Online or O.T.C. application?.................. Yes
Mechanical Fixtures
Air Conditioners - Stand Alonf 1 Furnaces
PERMIT EXPIRES Monday, 13 December, 2021
Permit Issued on Wednesday, June 16, 2021
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
aM
an a itf Federal Way.
Owner or agent;
CC Date:
THIS CARD IS TO REMAIN ON -SITE
CITY Or Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 21 102320 00 Address: 28019 20TH AVE S
Project: LORI ANNE HALL FEDERAL WAY WA 98003-3200
Scheduled inspections may be failed if this card is not on -site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as possible
(read left to right, top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your inspector if
you are unsure about any of the inspections or the inspection sequence. On -going inspections are logged on the back of this card.
0 Mechanical Rough -in (4165) 2❑ Gas Piping (4125) 3❑ Final - Mechanical (4065)
Approved
By Date
Approved to release test
By Date
Approved n
By f Date
Rough Electrical
El
Final Electrical
❑
Right of Way
Approved
Approved
Approved
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Date
By
Date
By
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