17-103605 Building Single Family
City of Federal Way Permit #:17-103605-00-SF
Community Development Dept.
FILE33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax(253)835-2609
Project Name: CONACHAN .
Project Address: 522 S 288TH LN Parcel Number:515293 0220
Project Description: ADD-Whole house remodel to include construction of a 64 square foot addition and adding
new walls.Mechanical and Plumbing by separate permit.***REVISED 10/13/17 TO INCLUDE
MECHANICAL FIXTURES AND GAS PIPING***
Owner Applicant Contractor Lender
JACK CONACHAN MICHAEL RADUTSKIYARMADA ARMADA DESIGN&BUILD INC OWNER IS LENDER
522 S 288TH LN DESIGN&BUILD INC 12727 NORTHUP WAY SUITE 6
FEDERAL WAY WA 12727 NORTHUP WAY SUITE 6 BELLEVUE WA 98005
98003-3186 BELLEVUE WA 98005
Census Category: 434-Residential alt/add-no change in number of units
Includes: ( #1 #2 #3 #4
Occupancy Class: R-3
Construction Type: Type V-B
Occupancy Load:
Floor Area(sq.ft.) 0.00
Additional Permit Information
New/Additional Sq.Feet-1st Floor 64 New/Additional Sq.Feet-2nd Floor 0
New/Additional Sq.Feet-3rd Floor 00 Occupancy#1-Area(Sq.Feet) 0
New/Additional Sq.Feet-Basement. 0 Occupancy#1-Construction Type Type V-B
New/Additional Sq.Feet-Deck. 0 New/Additional Sq.Feet-Garage 0
Mechanical to be Included Yes Plumbing Work Valuation 0
Mechanical Work Valuation 800.00 Number of Stories 1
New/Additional Sq.Feet-Other 0 Is this an Online or O.T.C.application No
Plumbing to be Included? No New/Additional Sq.Feet-Total 64
Will Certificate of Occupancy be Issued'? Yes Occupancy#1-Use Residence(1 or 2
family)
Comprehensive Plan Designation SF-High-Density Zoning Designation RS 15.0
Residential
Total Valuation:48,600.00
� ;�✓°`s�`�n� ,sr`3 EEt�'i '�'�'1''. "�`z'"'_� � "��eg€ riY� €�a ;q�5' < � .�a' "/ 4 � �,� l'p- &mjr:E[. S`r�s`��j �'��� �� ''a �p
Ducting 1 Fans 1 Gas Piping 1
Hoods 1
CONDITIONS:
Subject to field inspection with plans.
-VGoKk'kclw PlakKiwo� b'^ is Rt EXPIRES T06-uesday, l0 April,2018 Fat,'
AKd *( 1rt�iolt '�+�iG
c'�s�124" � rk 4( l0 «I
Permit Issued on Thursday,July 27,2017
11
I hereby certify that the above information is correct and that the construction on the above described property
V and the occupancy and the use will be in accordance with the laws, rules and regulations of the State of
Washington and the City of Federal Way.
• ner or agent: Ma(f Date
V
. .
City of Federal Way
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 111 of the International Building Code or Section
R110 of the International Residential Code is certifying that at the time of issuance,this structure was in
compliance with the various ordinances of the City regulating building construction or use.This certificate is valid
ONLY when endorsed by City staff.
Tenant Name: CONACHAN Permit# 17-103605-00-SF
Address: 522 S 288TH LN
Includes: #1 #2 #3 #4
Occupancy Class: R-3
Construction Type: Type V-B
Occupancy Load: 0.00
Floor Area(sq.ft.) 0.00
Owner Name: JACK CONACHAN
Owner Address: 522 S 288TH LN
FEDERAL WAY WA
98003-3186
Building Official Date
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which
experience has shown most severely affect the health and safety of the general public. Although the City has made as complete
a review and inspection as is reasonably possible(within budgetary time and personnel limitations),the City neither guarantees
nor warrants to the owner/occupant or to any other person that this Certificate evidences strict compliance with each and every
ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon
which it is situated. Such compliance is the responsibility of the owner and/or occupant of the premises.
Building - Single' Family
City of Federal Way Permit #;17-103605-00-SF
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: CONACHAN
Project Address: 522 S 288TH LN Parcel Number:515293 0220
Project Description: ADD-Whole house remodel to include construction of a 64 square foot addition and adding
new walls.Mechanical and Plumbing by separate permit.
Owner Applicant Contractor Lender . .
JACK CONACHAN MICHAEL RADUTSKIYARMADA ARMADA DESIGN&BUILD INC OWNER IS LENDER
522 S 288TH LN DESIGN&BUILD INC 12727 NORTHUP WAY SUITE 6
FEDERAL WAY WA 12727 NORTHUP WAY SUITE 6 BELLEVUE WA 98005
98003-3186 BELLEVUE WA 98005
•
Census Category:434-Residential alt/add-no change in number of units
Includes: #1 #2 #3 #4
Occupancy Class: R-3
Construction Type: Type V-B
Occupancy Load:
Floor Area(sq.ft.) 0.00
Additional Permit Information
New!Additional Sq.Feet-1st Floor 64 New/Additional Sq.Feet-2nd Floor 0
New!Additional Sq.Feet-3rd Floor 00 Occupancy#1-Area(Sq.Feet) 0
New!Additional Sq.Feet-Basement 0 Occupancy#1-Construction Type Type V-B
New/Additional Sq.Feet-Deck 0 New/Additional Sq.Feet-Garage 0
Mechanical to be Included? No Plumbing Work Valuation? 0
Mechanical Work Valuation? 0 Number of Stories 1
New/Additional Sq.Feet-Other 0 Is this an Online or O.T.C.application? No
Plumbing to be Included? No New!Additional Sq.Feet-Total 64
Will Certificate of Occupancy be Issued? Yes Occupancy#1-Use Residence(1 or 2
family)
Comprehensive Plan Designation SF-High-Density Zoning Designation RS 15.0
Residential
Total Valuation:48,600.00
s £� F
m
CONDITIONS:
Subject to field inspection with plans.
PERMIT EXPIRES Tuesday,23 January,2018
Permit Issued on Thursday,July 27,2017
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 +- in accordance with the laws, rules and regulations of the State_of
-- ington and the City of Federal Way.
Owner or agent: ,
j�� Date: d7 271/7
f O.
4 , r
City of Federal Way
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 111 of the International Building s ie or Section
R110 of the International Residential Code is certifying that at the time of issuance,this stru. •re was in
compliance with the various ordinances of the City regulating building construction or u •. his certificate is valid
ONLY when endorsed by City staff.
Tenant Name: CONACHAN Permit# 17-103605-00-SF
Address: 522 S 288TH LN
•
Includes: #1 #2 #3 #4
Occupancy Class: R-3
Construction Type: Type V-B
Occupancy Load: 0.00
Floor Area(sq.ft.) 0.00
Owner Nam-• JACK CONACHAN
Owner Addr- s: 522 S 288TH LN •
FEDERAL WAY WA
98003-3186
B tiding Official Date
The priority fo. sin the review and inspection made by the City prior to issuance of this Certificate was on those matters which
experience as shown most severely affect the health and safety of the general public. Although the City has made as complete
a review, d inspection as is reasonably possible(within budgetary time and personnel limitations), the City neither guarantees
nor w. ants to the owner/occupant or to any other person that this Certificate evidences strict compliance with each and every
ordi'.nce or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon
w ich it is situated. Such compliance is the responsibility of the owner and/or occupant of the premises. 1
THIS CARD IS TO REMAIN ON-SITE
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 103605 00 Address: 522 S 288TH LN
Project: GLADYS CONACHAN FEDERAL WAY WA 98003-3186
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.
® SWM Precon Site Mtg(4400) ® Initial Erosion Control(4365) ® Footings/Setback(4110)
Approved To be done PRIOR to breaking ground Approved to place concrete
By Date By Date By 0_14...^i Date CI „19--I1
�
® Foundation Wall(4115) ® Drainage/Downspout(4040) ® Slab/Concrete Floor(4255)
Approved to place concrete Approved to backfill Approved to place concrete
By Date O - 1Tr-11 ..By Date r�By Date
® Underfloor Framing(4285) ® Floor Sheathing(4105) ® Shear Walls(4245)
Approved to sheath floor Approved to install flooring Approved to install siding
By Date By Date By Date
El Roof Sheathing(4220) 1 ID Fire/Draft Stops(4095) 12 Interim Erosion Control(4370)
Approved to install roofmg ( Approved Approved
By Date By ;y,) Date to j ! By Date
Prior to scheduling a Framing inspection; 13 Framing(4120) El Insulation(4150)
Electrical,Plumbing&Mechanical Rough-in
Approved to insulate Approved
and Fire/Dr:tt Stop inspection must be signed- pPr ..1Ins to install wallboard
off and approved. IBC 109.3.4
By Date (0 (1 h By ,� Date /e lg I
El Gypsum Wallboard Nailing(4130) [19 Final Erosion Control(4375) 1:1 Final-Building(4050)
Approved to install mud&tape Approved Approved
By j Date 10(1' I.1 1�By Date By Date
0 Rough Electrical 0 Final Electrical Q Right of Way
Approved Approved Approved
By Date By Date By Date
•
41004' THIS CARD IS TO REMAIN ON-SITE
Federal V1ia Construction Inspection Record
INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 103605 00 Address: 522 S 288TH LN
Project: GLADYS CONACHAN FEDERAL WAY WA 98003-3186
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.
El SWM Precon Site Mtg(4400) El Initial Erosion Control(4365) Footings/Setback(4110)
Approved To be done PRIOR to breaking ground Approved to place concrete
By Date , By Date By Date
•
® Foundation Wall(4115) Drainage/Downspout(4040) ® Slab/Concrete Floor(4255)
Approved to place concrete Approved to backfill ; Approved to place concrete
By Date By Date 1 By Date
El Underfloor Framing(4285) ® Floor Sheathing(4105) ® Shear Walls(4245)
Approved to sheath floor Approved to install flooring Approved to install siding
By Date By Date By Date
10 Roof Sheathing(4220) Mechanical Rough-in(4165) Gas Piping(4125)
Approved to install roofmg Approved Approved to release test
By Date By 1f4P4 Date 10 110 l Ii By VW, Date 10 I Iv 1't
0 Fire/Draft Stops(4095) ® Interim Erosion Control(4370) Prior to scheduling a Framing inspection;
Approved Approved Electrical,Plumbing&Mechanical Rough-in
and FireIDratt Stop inspections must be signed-
By Date By Date off and approval. IBC 1093.4
El Framing(4120) El Insulation(4150) ® Gypsum Wallboard Nailing(4130)
Approved to insulate Approved to install wallboard Approved to install mud&tape
By Date By td Date /4'i t$ By Date to 24- h
El Final Erosion Control(4375) Final-Mechanical(4065) El Final-Building(4050)
Approved Approved Approved
By Date By N Date Z Z By 4. Date E
FILE
0 Rough Electrical ❑ Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
•
PERMIT APP ON
CITY OF
Fe d e ra I Way PERMIT CENTER+ 33325 8th Avenue Southp + e er t1' 98003-6325
253-835-2607 + FAX 253-835-2609 + ermitcente I offederalwa com
J OCT 132017
PERMIT NUMBER I C) 3/,7 CITY OF FEDERAL WAY
_ TARGET DATE COMMUNITY DEVELOPMENT
SITE ADDRESS
2Z C, e 8 tet-]i LA) SUITE/UNIT#
$ P' ECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
TYPE 0' •ERMIT ❑ BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PRE NTION
NAME OF PRO CT
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only <(k'S
NAME PRIMARY PHONE
PROPERTY OWNER MAILING ADDRES E-MAIL
CITY STATE ZIP
. -
NAME . _. - - PHONE
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY ' ATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE I EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
. _ NAME .... .. PRIMARY PHONE
APPLICANT- MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT
(The individual to receive and MAILING CRESS E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
AME _ ..
PROJECT FINANCING 0 OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095)
I certify under pen• ty of perjury that I am the property owner or authorized agent of the property owner.I c fy that to the best
of my knowledge, t information submitted in support of this permit application is true and correct.I certify tha will comply with
all applicable Ci of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I un• • and that the
issuance of thi permit does not remove the owner's responsibility for compliance with local, state, or federal • s regulating
construction o environmental laws.
I further ••ree to hold harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees i rred in
the investi••tion and defense of such claim), which may be made by any person,including the undersigned, and filed against the city,
but only here such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
informa on supplied to the city as a part of this application.
S 'ATURE: DATE
PRINT NAME:
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application
.w1�GI RECEIVEDPERMIT APPLICATION
Federal JUL 2 7 2017 PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
253-835-2607+FAX 253-835-2609+permitcente a,citvoffederalway.com
CITY OF FEDERAL WAY
COMMUNITY OPME F-
r,
NUMBER I 1 _ ' V `3 Co V - 5 S T
_ TARGET DATE F
SITE ADDRESS SUITE/UNIT#
5.2. S a_a-K,.., Lh r e awl tel- 6,4 g86o`>
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
y ` c 6 1 3 2 cl 3 b z-- Z- C7
TYPE OF PERMIT E tSUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT h
I�l,o l k�,c zi t? 1-6-(x-GJ eeei l%l vc-G%C CC 6 GLS U
PROJECT DESCRIPTION
Detailed description of work to 2"1r Gvu d/42.0 C-1.0 c ,1- ,17J2}7.1-z
be included on this permit only !�a-, e-r-
NAME PRIMARY PHONE
al-k 4t '4.a_. 206-332—q6-11
PROPERTY OWNER MAILING ADDRESS E-MAIL
—5"41146 4S ? -oj., ,
CITY STATE ZIP
NAME A PHONE
n(f4404 DC (6?XI 4' /3c,(14_,E) /Air y 2.2S- SC is' t GC,
MAILINGG ADDRESS E-MAIL ,,/
CONTRACTOR /2-?2 ? 4'ctb' i t ,/,-, GJ 6 �(G6(4)4t---avw�4a/t.t-Lal
CI / STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE 8
/ / P 13/4/4
NAME //, (� PRIMARY PHONE
S'.4 J4'Jifealit
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT M/Cf/ASL n ,6,e-- I.o N low/ /4,4A/461C4 9-2.T-55t-941Ce
(The individual to receive and MAILING
respond
ADDRESS E-MAIL
respond to all correspondence /272 N7 Nori-4--(4-, A..),4!-' '..z$1& ( '/CL.6} gaic{f J /3(,(!(,),L3zb
concerning this application) CITY STATE ZIP FAX
Z-elf. ;,.e. IA,4- 40 oo
NAME ,.,
PROJECT FINANCING L'�F'OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27095)
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge,the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit do s not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or enviror a al laws.
I further agree to 7 /harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in
the investigation • .d.• tense of such claim), which may be made by any person,including the undersigned,and filed against the city,
but only where _ c. •im arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information su•.•li-i '. the city as a part of this application.
SIGNATURE: f"r DATE
9/9 71/. ..
PRINT NAM:. JIRAD,,,t i.su 1 Y AitaKA 4 /Ui w4... AA/4mA i)t.C,C;titE f?t-1-jL/ 1/1/6
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application
t , r.. / , gtJcivci To CNC-W-P tir../4-/-fi\i /W,
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $ 900
•
each type F_.a.re
Indicate how many of of r.=� •,r to be installed or relocated as part of this project.Do not include existing fixtures to remain.
AIR HANDLING UNITS 7 FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS / HOODS(c....,....1)
BOILERS FURNACES HOT WATER TANKS(Gas(
TT COMPRESSORS GAS LOG SETS REFRIGERATION SYST 1 Q// I
DUCTING GAS PIPING WOODSTOVES 11
Aolot^
( V"U,. n,
PLUMBING PERMIT � �OF•L� alr�o WO--
$
Indicate how many of each type of fixture to be installed or relocated as part of this project.Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower combo( LAVS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(1Gtchen/utility( WATER HEATERS(Electric(
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
!
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes❑ No ❑ Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
�i AREA DESCRIPTIONt�� (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
1111 i:V+ A=L3'ywta ,.a: a r.,h.-i Yuri...,# "rT'# tt,a'.,n,;..y.,:,,v :`....'L:',"',*:-*
'.±',,� --- --------_--- •- ------------------
=.yf=. ,,;. .,. n..' q .F'. ,„,,- '31.'. ,,.'ex;. ..:uz_..tr.1:, ; :!,i1Y_M1_.._:..">!., Y..7,t1,: ....._____ _______
FIRST FLOOR(or Mobile Home)
' ,a, .'„`!! t' ra t, t..'1t JY.. ,1n �`: ''''',4-1.:.'';'4'.. A .l. p'+:"r�/.'4' i "`! Ffz _w'K;4'.'.Jy` ._.""_ __ ___..._..
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r" ,'<„ 'i "• ,../if., <.,." 3" �' :-.4.0 .1.5.
COVERED ENTRY
c, , � � � � ^ ',+ q s„;1+zs}`r•t,, 'Y tt..ti'�„4`, t�' �.... � t< '-''.a.1 :''..F3.-i',.-1-.'V-2';'-',
rwj.:y��-$ -�.
.� ..;, . :'�W�. .1,,' y P KR t,r �'' t, „�,,-. 4.' .€;4.' .ar
„
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GARAGE 0 CARPORT ❑
. ,,a .1' ;,3 r`' ',+'.r4:N ).y ':t" t ''' •'re• ,;.;' ' .r, •fA' -'ter ^" ;1:iil'
, .�` ''`.•;: i -
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EXISTING PROPOSED TOTAL
Area Totals
ESTIMATED SELLING PRICE$ I #OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION
Area in Construction #of
Snuare Feet Occupancy Group(s) Additional Information
04......./ea
'''''r ',s 1"41' 44' r s� . :u. ,,ty -!, ' '' tV°"s .5`)_ • ;'t,*''"'.. _'ki,,{.,",, 1 , y ,,,t-;,t,. iri;!a ,.
`a1a'rr„.`)• '-:,t,'.,,
.a '1.,, i,.i{.- :.A,'i"-,‘;,----,%.7..,,:,,,..:;,-44„,:;>1: . '.;' a T �yE '4,a-. '.?.G `-,,If: °�y",f.i,,# 'Y.<:: ..:+",to>.., -. �x".:.^(kt,_ .,_
-,„1,,,`,",!:��: ;.Sa- 7: ft: iL't7r.:f• .ia�,;r.�%.e:-.• k:a�K•vi: � �^'�,'�••-.•
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ADDITION I I k I
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area in Occupancy Group(s) Construction #of Additional Information
S.uare Feet .e Stories
�%?;:" : `+I i i'r�'-e ..**,4:,.;.'f'''^ ,,;4.14., ,�,F„!. '',,,*.,-,r.-;4„+,.. _ -.:i :•:-:,:t..-
_- -:t. �.;1, itivt, :,•••,',, r dr'^:,.,_ .4 t`_A;.._A x- ,
-`;1'. ` !+`: ,or, c3 '? 1kii;:44 ::,," '',4,,.,'.:.x: #-s-,.- ."T",,"a,. ' , ,1,. sw+ .f'.�y-_..:t. •�.-^ -
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TENANT
.
TENANT AREA ONLY
:',,,:-*41",..,'r; • �.” • ,:,,,,4,,:j"-41',.;.': i'f' •: _ • ��, -' . fi-" �Ci."IpS.•i�{t ; i s . � ` �sJ�.�iAsy4'� ` 'e, • ) yrS"M
"
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Bulletin#100—January 29,2016 Page 2 of 2 k:\Handouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
Indicate how many of each type of fixture to be installed or relocated as part of this project.Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT
Indicate how many of each type of fixture to be installed or relocated as part of this project.Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo) LAVS(Hondsinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(siecinc)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes X No ❑Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BAS
FIRST FLOOR(or Mobile Home) (OirS. L
err
FLOOR
COVERED ENTRY Ci V 6
GARAGE ?,g CARPORT ❑ 1/662 960
OTHER,(describ f
Area TotalsEXISTING PROPOSED TOT
� e ( xr
ESTIMATED SELLING PRICE$ I #OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION Area in Occupancy Group(s) Construction #of Additional Information
Square FeetType Stories
NEW BUILI3ING 3 4 7 t
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area in Occupancy Group(s) Construction #of Additional Information
Square FeetTy
TOTAL
eStories
TENANT AREA ONLY
Bulletin#100—January 29,2016 Page 2 of 2 k:\Handouts\Permit Application