90-101405CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT BUILDING
941'1 SSECTION
3 Gs /C i YO s
PERMIT NO. 90-1626M
OWNER'S NAME CHERIE KINSEY JOB ADDRESS 3641 SW 318 ST
CONTRACTOR ABC GAS
INSTALL ADDRESS 9923 64 AVE CT E PUYALLUP CONT. PHONE 845-7482
CONT. REG. NO. ABCGAI*113N3 8/91 OWNER'S PHONE 838-1977 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
TAX ACCOUNT NO. 873198-0230 LEGAL DESCRIPTION NA
ISSUED BY ELIZABETH
SNYDER DATE OF ISSUE DATE OF APPLICATION 10/9/90
BUILDING INFORMATION
NE NA
OCCUPANCY NA TYPE OF CONSTRUCTION MECHANICAL BLDG. SQ. FT. NA
ET 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 3 FT. 2, 00 BOILER
RECEIVED
BATHTUBS
LAUNDRY DRAINS
COMPRESSOR TANK(S)
SHOWERS
URINALS
FORCED AIR FURNACE AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS�iOT WATER HTR. 6-50 MISC.
RETURNED
SINKS
MISC.
CONVERSION BURNER BASIC FEE 90 _ on
DISHWASHERS
TOTAL FIXTURES NQNE
UNIT HEATER TOTAL MECHANICAL 2850
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
CHANICAL FEE $28-50
TAL BLDG. FEES
Water Line OK Mechanical Inspection Notes:
ART PIC FEE
SEPA REVIEW
GAS PIPING OK Date By
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES
MECHANICAL PERMIT
28.50
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
�- "' l4""z'"' y' DATE p l q
CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT BUILDING
941!N555ECTION
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
J/
ISSUED BY
DATE OF ISSUE DATE OF APPLICATION
BUILDING INFORMATION
PONE
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
BATHTUBS
LAUNDRY DRAINS
COMPRESSOR TANK(S)
RECEIVED
SHOWERS
URINALS
FORCED AIR FURNACE AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS rIOT WATER HTR, MISC.
SINKS
MISC.
CONVERSION BURNER BASIC FEE
RETURNED
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL
AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR.
AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
INSPECTION RECORD
_CHANICAL FEE
TOTAL BLDG. FEES
Water Line OK Mechanical Inspection
Notes:
PART P/C FEE
SEPA REVIEW
GAS PIPING OK Date L y
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 . . . ..... . .
. . .......
MECHANICAL INSPECTION
DATE - BY
O.K. TO ENCLOSE FRAMING
DATE_- BY
INSULATION
DATE BY
WALL BOARD AND FIRE WALL
DATE __..BY
FINAL O.K. TO OCCUPY
DATE _-
DCD
PSD
FD
arc e -r
<17
VJ I
ftrmit #
RECEIVED CITY OF FEDERAL WAY
OCT 91990 BUILDING PERMIT APPLICATION
CITY OF FEDERAL WAY - Please Print -
61-ju-n r. nFPT-
BOX 1 TENANT NAME:
OWNER ,x '7— SITE LOCATION G / Lu ` I N- ej—i
OWNER'S ADDRESS 34'tt' i 1 CITY v PHONE E� 38 1 F P
DESCRIBE JOB
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME-� CONTRACTOR'S REG. # 4 s6t G;,AZ r�e7t;
Card MUST be presented
CONTRACTOR'S ADDRESS 915F23 G q a -y- � � CITY � i' PHONE � � r�' & �1-
EXPIRATION DATE
-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.
BOX 3 CONTACT PERSON PHONE 69 T
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording # Q `_7 3 1 5 �:' o -Q 3 �'
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( ) SINGLE FAMILY ( )NEW -CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) (L-�-EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
f:-q1�!]
PLUMBING FIXTURES (including rough -ins)
N0. WATERCLOSETS
BATHTUBS
SHOWERS
LAVATORIES
SINKS
_—___DISHWASHERS
ELECTRIC HOT WATER HEATER
LAUNDRY WASHER OUTLET
URINALS
DRINKING FOUNTAINS
SUMPS, SPRINKLER VACUUM BREAKERS
DRAINS
-OTHER
TOTAL FIXTURES
MECHANICAL APPLIANCES — BASIC FEE $
GAS PIPING, FEET r? $
N0. FURNACE, ELEC. GAS $
/ GAS HOT WATER HEATER $
CONVERSION BURNER $
BOILER, SIZE BTU $
AIR HANDLING UNITS $
HEAT PUMPS, SIZE $
UNIT HEATERS $
AIR COOLING UNITS, SIZE $
COMMERCIAL HOOD $
OTHER $
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: �'GG� -y. DATE
ANP -008 3/90
M
40
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE SETBACKS: FRONT_
PLANNING DEPARTMENT APPROVAL
REMARKS:
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL
REMARKS:
SIDE REAR HEIGHT LIMIT _
DA
PUBLIC WORKS DEPARTMENT APPROVAL DATE
REMARKS:
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 SQ.FT. @ _
BUILDING SQ.FT. @ _
BUILDING SQ.FT. @ _
BUILDING SQ.FT. @ _
BUILDING SQ.FT. @ _
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION
BUILDING DEPARTMENT REMARKS:
RECEIVED
ASSIGNED ADDRESS:
Amount
PARTIAL PLAN CHECK FEE RECEIVED
Date
Receipt #
BUILDING DEPARTMENT APPROVAL
BY DATE
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