90-101945MECHANICAL PERMIT
q1 13-101gL15
CITY OF
FEDERAL WAY
C� Oy 5 001 �t
BUILDING PERMIT BUILDING
941'1 55ECTION
PERMIT NO. 90-1823M
OWNER'S NAME RON GIPPE JOB ADDRESS 1323 SW 323 ST
CONTRACTOR PACIFIC
GAS HTNG/AIR ADDRESS 2702A 112 AVE E TACOMA CONT. PHONE 536-7997
CONT REG. NO. PACIFGH110ME 7/91 OWNER'S PHONE 874-9170 OWNER'S ADDRESS SAME
TYPE JOB: NEW RESIDENCE
ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI -FAMILY (UNITS
) MULTI. ADD. SIGN GRADING OTHER MECHANICAL ONLY
TAX ACCOUNT NO. 010450-0180
LEGAL DESCRIPTION NA
i
t
ISSUED BY $T$
SNYDER DATE OF ISSUE '
r DATE OF APPLICATION 11/21/90
BUILDING INFORMATION
ZONE NA
OCCUPANCY NA TYPE OF CONSTRUCTION 1 ENCANTCAL BLDG. SO. FT. NA
SET BACKS: FRONT _ NA
SIDE NA _-____ — REAR NA STORIES NA HEIGHT LIMIT NA
PLUMBING NO.
NO.
MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS
ELEC. HOT WATER HEATER
GAS PIPING 30 FT. 2_00 BOILER
RECEIVED
BATHTUBS _
LAUNDRY DRAINS
COMPRESSOR TANK(S)
SHOWERS
URINALS _
FORCED AIR FURNACE inn _ 00 AIR HANDLING UNIT
NUMBER
LAVATORIES _
DRINKING FOUNTAINS _
GAS JIOT WATER HTR. 6 50 MISC, LOGS 6-50 _
RETURNED
_gNKS
misc.
CONVERSION BURNER BASIC FEE 90 - 00
DISHWASHERS
TOTAL FIXTURES 19QNP
UNIT HEATER TOTAL MECHANICAL
AMOUNT NONE
VALUATION NONE
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
INSPECTION RECORD
MECHANICAL FEE $45.
00
TOTAL BLDG. FEES
Water Line OK Mechanical Inspection Notes:
PART PIC FEE
SEPA REVIEW
GAS PIPING OK Date By
WATER SERVICE
WATER MAIN CHG _..
S.B.C.C. FEE
OTHER FEES
MECHANICAL PERMIT
AMOUNT DUE *45. 00
Account No. 010-000-322-10-004 Total Fee $ 45.00 Receipt No.
ALL PERMITS EXPIRE 180 DAYS
AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET:
OWNER OR AGENT
DATE
9 0-1!C f -c?:L,5
CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDINGPERMIT BUILDI941!1 SSECTION
PERMIT NO.
OWNER'S NAME JOB ADDRESS
CONTRACTOR
ADDRESS
CONT PHONE-
CONT. REG. NO,
OWNER'S PHONE OWNER'S ADDRESS
TYPE JOB: NEW RESIDENCE
ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD,
NEW MULTI -FAMILY (UNITS
) MULTI. ADD. SIGN GRADING OTHER
TAX ACCOUNT NO.
LEGAL DESCRIPTION
ISSUED BY
DATE OF ISSUE. DATE OF APPLICATION
BUILDING INFORMATION
ZONE
OCCUPANCY TYPE OF CONSTRUCTION
BLDG. SO, FT.
SET BACKS: FRONT
SIDE REAR STORIES
HEIGHT LIMIT
PLUMBING NO.
NO.
MECHANICAL APPLIANCES AMT.
AMT.
BOND
WATER CLOSETS
ELEC. HOT WATER HEATER
GAS PIPING FT. BOILER
RECEIVED
BATHTUBS
LAUNDRY DRAINS
COMPRESSOR TANK(S)
SHOWERS
URINALS
FORCED AIR FURNACE AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS�IOT WATER HTR. MISC.
RETURNED
SINKS
MISC.
CONVERSION BURNER BASIC FEE
DISHWASHERS _
TOTAL FIXTURES,
UNIT HEATER TOTAL MECHANICAL
AMOUNT
V
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR.
AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
INSPECTION RECORD
MECHANICAL FEE
TOTAL BLDG. FEES
Water Line OK Mechanical Inspection
Notes:
PART P/C FEE
SEPA REVIEW
GAS PIPING OK Date By
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES
MECHANICAL PERMIT
AMOUNT DUE
Account No. 010-000-322-10-004 Total Fee $
Receipt No.
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET:
OWNER OR AGENT
DATE
SET BACKS AND FOOTINGS
DATE. BY
OX TO POUR FOUNDATION WALLS
DATE -BY
PLUMBING GROUNDWORK
DATE BY
PLUMBING ROUGH IN
DATE -BY-
WATER LINE O.K. _
GAS PIPING O K. _
_
MECHANICAL INSPECTION
DATE
O.K. TC ENCLOSE FRAMING
DATE BY - - -
INSULATION
DATE _ BY
WALL BOARD AND FIRE WALL
DATE -BY
FINAL O.K. TO OCCUPY
DATE
DCD
PSD
FD
I J
uA!
M(ArN�i-T-
<j-C) t
,�2
` kD
(ZIP
"-`1re
149CEIVED
Permit # qQ � I 11�
NOV 21 1990
BUILDING DEpT�AY
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
OWNER :SaM!L- SITE LOCATION &
OWNER'S ADDRESS 17',�eQ SVJ 3Q3 ST CITY PHONE 7 IT7
DESCRIBE JOB G-� "F�]RS -, W459A MFPE � �-6" !
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME
CONTRACTOR'S REG. #.
CONTRACTOR'S ADDRESS SD ` i )AQ7' E�f CITY PHONE 6 3(P `7Rq��—
EXPIRATION DATE
—OR—
I HAVE READ CHAPTER 18.27.010 RELATI O DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION,
BOX 3 CONTACT PERSON PHONE, ---
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER _ DID 95a "
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR I 2ND FLOOR :_ J
3RD FLOOR_,_ _I BASEMENT_ _ �J DECK i GARAGEI
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = __ } ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY _—SO FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES — BASIC FEE $ �'' iv<-"
N0. WATERCLOSETS
GAS PIPING, FEET _ 30 —_
$
BATHTUBS
N0._1_ —FURNACE, EL£G, GAS_—
$ r
SHOWERS
_-i--GAS HOT WATER HEATER
$-
LAVATORIES
CONVERSION 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
$
DRINKING FOUNTAINS
COMMERCIAL HOOD
$
SUMPS, SPRINKLER VACUUM BREAKERS
_1— _OTHER CAS i 0q,,S _—
$
DRAINS
$
THER — --
$
TOTAL FIXTURES
$
TOTAL MECHANICAL FEE
$ --_
I CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE 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 IN INVESTIGATION AND DEFENSE OF SUCH CLAIM), WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
AND FILED AGAINST THE CITY OF FEDERAL 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/AGENT. — — — ---- — — — — . DATE: tU�
ANP-000 3/90
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE SETBACKS: FRONT_ , SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL
REMARKS:_
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DATE
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVA
REMARKS:
DATE
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ADD/ALT NEW MULTIFAMILY (UNITS )
MULTIFAMILY ADD/ALT TENANT IMP. OTHER
OCCUPANCY . ___ ___ TYPE OF CONSTRUCTION STORES
BUILDING SO. FT. _ __ @—
__ BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ —
___ BUILDING SO. FT. _ _ @
BUILDING SO. FT. @ —
BUILDING SO. FT. @ —
TOTAL SQ. FT.
BUILDING DEPARTMENT REMARKS:
RECEIVED
ASSIGNED ADDRESS:
PARTIAL PLAN CHECK FEE RECEIVED
Amount Date Receipt #
BUILDING DEPARTMENT APPROVAL
BY DATE
TOTAL VALUATION
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
ACCEPTED FOR FILING