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SET BACKS AND FOOTINGS O.K TO POUR FOUNDATION WALLS PLUMBING GROUNDWORK
DATE_......_ _.._.... BY _ __ - DATE ......_ BY ._-_ DATE _..BY
PLUMBING ROUGH IN WATER LINE O.K. _ . MECHANICAL INSPECTION
DATE._. - -BY.... GAS PIPING O.K.-...... _..._-... DATE _..._. __. .-.. .._BY
O.K. TO ENCLOSE FRAMING INSULATION WALL BOARD AND FIRE WALL
DATE ... _BY..... - DATE __ BY - ....._ DATE -_ .._._....BY ... -..
FINAL O.K. TO OCCUPY
DCD PSD FD
DATE2_7.2-�3 BY Ar
Permit # &L- L)°1.2. - 1-350
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
30X 1 TENANT NAME:
OWNER - L SITE LOCATIONS r 3D''a �. . --1 . c A -
OWNER'S ADDRESS .:1, C '� e --1 ( . CITY J. A.t.,J- j- PHONE 'ALA LP M D;)-
DESCRIBE JOB t_Q-VA-`p'iV( Qi c ,jc ,
THE PROPERTY IS OWNED BY: SINGLE/L4RRIED PARTNERSHIP CORPORATION
30X 2 CONTRACTOR'S NAME Northwest wat-Pr Heater CONTRACTOR'S REG. # NORTHWH103R2
Card MUST be presented
CONTRACTOR'S ADDRESS 8201 Durango St _ cW CITY Tacoma PHONE 984-6404
EXPIRATION DATE 12-22-92
— OR —
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
30X 3 CONTACT PERSON Angel Foster
- PHONE984-6404
30X 4 SEWER DISTRICT WATER DISTRICT -
30X 5 ESTIMATED PROJECT COST t5 ?�1 J EXISTING BUILDING VALUATION
30X 6 PROPERTY TAX ACCOUNT NUMBER 181 G1e j- 0,3170
LEGAL DESCRIPTION
(If necessary, please submit a separate pace with the legal description.) - - -
K.C. Plat Recording # - _
30X 7 BUILDING SQUARE FOOTAGE:. (Existing/Proposed) 1ST- FLOOR / 2ND FLOOR • / .-- -
3RD - FLOOR I BASEMENT / • - - DECK / GARAGE - / -
•
30X 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY(NO. OF UNITS = ) ( ) EXISTING STRUCTURE __• _ __
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY • SQ FT
;OX 9 PLUMBING FIXTURES (including rough-ins) - MECHANICAL APPLIANCES— BASIC FEE$------- -
NO. - . WATERCLOSETS GAS PIPING, FEET- ,Q-5 -. '-)U
BATHTUBS NO. FURNACE, ELEC. GAS $
SHOWERS - . . - -" - GAS HOT WATER HEATER-. - - - 7— $__..-- ---
. LAVATORIES CONVERS`tON BURNER - -- __ $-
SINKS BOILER, SIZE BTU $
DISHWASHERS • - "----AIR HANDLING UNITS - $ ---
ELECTRIC HOT WATER HEATER --- - .-. -. . HEAT PUMPS, SIZE
LAUNDRY WASHER OUTLET UNIT HEATERS $
URINALS - - AIR COOLING UNITS, SIZE - - 'I- - $ • _ —
DRINKING FOUNTAINS •- -• • - - COMMERCIAL HOOD . $
SUMPS, SPRINKLER VACUUM BREAKERS __OTHER rr) , $DRAINS _ k (..t
OTHER
TOTAL FIXTURES - - $.
• TOTAL MECHANICAL FEE * $
2ERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
ND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APPLICATION IS
ADE.I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(INCLUDING COSTS,EXPENSES,AND ATTORNEYS'
EES INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM), WHICHPER
SON,MAY BE MADE BY ANY INCLUDING THE UNDERSIGNED,
ND FILED AGAINST THE CITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
-FICERS AND EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
1
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SET BACKS AND FOOTINGS O.nTo POUR FOUNDATION WALLS PLUMBING GROUNDWORK
DATE ........_ ......._ .... BY DATE _8Y ___� DATE __.
'
PLUMBING ROUGH |N VVATERUwEOX- __ _ MECHANICAL INSPECTION
DATE _-__.BY _ GAS PIPING O.n._____ .... - ..... �_ DATE _.......--_..... -_ __Bv
O.K. TO ENCLOSE FRAMING INSULATION WALL BOARD AND FIRE WALL
DATE_ ..........-_ .... DATE ...__...._ BY _____ DATE _ ........... _________8Y
FINAL o.w. TOOCCUPY
oCD pGo ro
DATE�7����- z" BY x./__....___
'
Permit # &L DI-2— — 23$(7
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
- Please Print-
30X 1 TENANT NAME:
OWNER 1.24-U1):A-- k -- SITE LOCATION; 4�3�'ID . T1 ' "A -
OWNER'S ADDRESS ,:,.-J '� ,--1r '' Z;( . CITY t.,01 ,�'�_ •L PHONE �'-1� 1$j
DESCRIBE JOB tom'\.- z�Q 11 c'�3'_l , �;;�. 0
THE PROPERTY IS OWNED BY: SINGLEJM RRIED )C� PARTNERSHIP CORPORATION
30X 2 CONTRACTOR'S NAME Northwest Water Heater CONTRACTOR'S REG. # NORTHWH103R2
Card MUST be presented
CONTRACTOR'S ADDRESS 8201 Durango qt GW ' CITY Tacoma PHONE 984-6404
EXPIRATION DATE 12-22-92
— OR —
I HAVE READ CHAPTER 18.27.010RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
3OX 3 CONTACT PERSON Angel Foster _ PHONEA
84-6404
30X 4 SEWER DISTRICT WATER DISTRICT •
30X 5 ESTIMATED PROJECT COST , ?) l J EXISTING BUILDING VALUATION
30X 6 PROPERTY TAX ACCOUNT NUMBER 1S 1 € I,- 0,32)0
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.) - - -
•
K.C. Plat Recording
30X 7 BUILDING SQUARE FOOTAGE:. (Existing/Proposed) 1ST" FLOOR / 2ND FLOOR • /--- -
3RD - FLOOR / BASEMENT / • - - DECK / GARAGE • / -
•
30X 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE __ _• __
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY • SQ FT
;OX 9 PLUMBING_ FIXTURES (including rough-ins) . - .._.-- - MECHANICAL APPLIANCES— BASIC FEE S ---- _.
NO. • WATERCLOSETS - GAS PIPING, FEET P-5'-- -X; . $....
BATHTUBS NO. _FURNACE, ELEC. GAS $
SHOWERS —- - ---- - GAS HOT WATER HEATER-- - - - - --.— S---- ---
. LAVATORIES CONVERS`tON BURNER - -- -- S.-
SINKS _ _ BOILER, SIZE BTU $
DISHWASHERS
- � AIR HANDLING UNITS -- S. ---- --
ELECTRIC HOT WATER HEATER - . HEAT PUMPS, SIZE $-- _ -
LAUNDRY WASHER OUTLET UNIT HEATERS $
URINALS - - AIR COOLING UNITS, SIZE - - y - $ —.. - --
DRINKING FOUNTAINS . -• • - - COMMERCIAL HOOD • . $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER V.(' S $
DRAINS
-- - - OTHER S - -
-- TOTAL FIXTURES _ S '
• - TOTAL MECHANICAL FEE
** $
CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
ND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APPLICATION IS
'.ADE.I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(INCLUDING COSTS,EXPENSES,AND ATTORNEYS'
EES INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM), WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
ND FILED AGAINST THE CITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
FFICERS AND EMPLOYEES, UPON THE ACCURACY 0 THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
',,NEER/AGENT: 1 !� !\----) DATE: 3
�q.