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Building Division <br />TTY ??F <br />25 West Main Street For Staff Use Only <br />Auburn, WA 98001 <br />A?HIT (253) 931-3020 Application No.: <br />Mechanical, Backflow & Plumbing Permit Application <br />Permit Type (circle): Commercial or Residential Value of Construction $ <br />Mechanical Plumbing Backflow <br />Project InformationlDescription: Parent PermitlProject Number: <br />Site Address: <br />Parcel No. (required : Project /Tenant Name: <br />Property Owner: Phone No. <br />Project Contact: Phone No.: Email: <br />Contractor: Phone No.: <br />Address: <br />State Contractors License #: Auburn Business License #: <br />Description of Work: <br />Are you removing, replacing or adding sheet rock, framing or roofing to complete this work? <br />If yes, please explain: <br /> <br />P l u m b i n g (please indicate the number of new or relocated fixtures) <br />Bathtub Gas or Medical Gas Piping (# of outlets) Pool or Spa (circle one) <br />Clothes Washer Grease Interceptor Roof Drains <br />Dishwasher Hose Bibb Shower <br />Drinking Fountain Hot Water Tank Shower/Tub Combo <br />Floor Drain Kitchen/Bath/Laundry Sinks Toilet <br />Floor Sink Modular Building Connection Urinal <br /> Other <br />Water Service (size of pipe inc hes <br />Backflow Device: (size inches) DCVA RPBA <br />Describe: Total Number of Fixtures <br />Mechanical (please indicate the number of new or relocated appliances) <br />Air Handling Unit Fans -Stationary, incl. whole house <br />< 10,000 cfm Furnace < 100,000 Btulh Other <br />> 10,000 cfm Furnace > 100,000 Btulh Refrigeration Equipment <br />BoilerlCompressorlHeat Pump/Roof Unit Floor Furnace Unit Heater <br />> SOhp / > 1.75M Btulh Suspended, Recessed or Floor Unit Appliance Vents -Single Duct <br />> 30hp / > 1-1.75M Btulh Gas Appliances Water Heater <br />> 15hp / >500 -1M Btulh Gas Piping (# of outlets) <br />> 3hp / >100 - 500 Btu/h Comm. Kitchen Exhaust Hood Total Number of Fixtures <br /><3hp / <100,000 Btu/h (type:-) <br />I certify the information furnished by me is true and correct and that I am the owner of the subject property or I have been given <br />express permission by the owner of the subject property, to submit this application for permit. I will comply with all provisions of <br />law, code and ordinances governing this type of construction work, including state contractor registration laws. <br />Application expires 190 days after Date Submitted <br />OwnerlAgent, <br />Date <br />10/15/2008