90-101610r
CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
BUILDING INSPECTION
941-1555
90- ion (0gyp
PERMIT NO. 90-1816M OWNER'S NAME RAYMOND ALBRINGER
JOB ADDRESS 5 10 AVE.
S
CONTRACTOR NORTHWEST USI
ADDRESS 1908 S 341 PT. #9 FEDERAL
WAY
CONT. PHONE 661-29ti2
CONT. REG. NO. NORTHUS101JJ 4/91
OWNER'S PHONE 941-7647
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. 609390-0140
LEGAL DESCRIPTION NA
ISSUED BY ELIZABETH SNYDER
DATE OF ISSUE
v DATE OF APPLICATION 11121190
BUILDING INFORMATION
ZONE NA OCCUPANCY
NA TYPE OF CONSTRUCTION
MECHANICAL
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 4 FT.
2-00 BOILER
RECEIVED
BATHTUBS LAUNDRY DRAINS
COMPRESSOR
TANK(S)
SHOWERS URINALS
FORCED AIR FURNACE
10-00 AIR HANDLING UNIT
NUMBER
LAVATORIES DRINKING FOUNTAINS
GAS POT WATER HTR.
6 _ 50 MISC.
RETURNED
SINKS MISC.
CONVERSION BURNER
BASIC FEE 20-0
DISHWASHERS TOTAL FIXTURES NONE UNIT HEATER
TOTAL MECHANICAL 18-5Q
AMOUNT
NONE
VALUATION NONE
GAS PIPING TEST MUST BE WITNESSED
BY INSPECTOR. AFFIDAVIT WILL NOT
SUFFICE.
PERMIT FEE
LAN CHECK FEE
PLUMBING FEE
INSPECTION RECORD
MECHANICAL FEE $38.50
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 $38.50
Account No. 010-000-322-10-004
Total Fee $ 38.50
Receipt No.
y G
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 IN
REQUIREMENTS WILL,8
ION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
"NER OR AGENT
{`C'�!�� DATE
4
Perr>l #(�-) U r U 2 6z:j
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME:
OWNER !' SITE LOCATIO
OWNER'S ADD SS CITY PHONE -72,1' y 2
DESCRIBE JOB A*ot7??r
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME �dy' f.!/��1f" AISCONTRACTOR'S REG. #&W�/Y US 10
_ Card MUST be presented
CONTRACTOR'S ADDRESS / ���` L CITY l�"e c� lU L )I PHONE to ro 1 9 Eo)—
EXPIRATION DATE Y' /
—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 DeAlvviJ 441 PHONE 6.4/—�--
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER &0
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 / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK------/— GARAGE /
BOX 8 ( ) SINGLE FAMILY
( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = )
( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL
TOTAL AREA OF PROPERTY
SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES — BASIC
FEE $
N0. WATERCLOSETS
GAS PIPING, FEET �f
$
BATHTUBS
NO.FURNACE, ELEC. GAS
$
SHOWERS
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
OTHER
$
DRAINS
$
OTHER
$
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 EMPLOYED. UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNERIAGENT: l DATE: // / ` RL
ANP -008 3/90
MECHANICAL PERMIT
CITY OF BUILDING PERMIT BUILDING INSPECTION
FEDERAL WAY 941-1555
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
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
INSPECTION RECORD
MECHANICAL FEE
4_
f��/1
TOTAL BLDG. FEES
Water Line OK Mech nical, Inspection Notes:
C1 �
-F( k 0 tc�
PART P/C FEE
SEPA REVIEW
o f
GAS PIPING OK Datel2-;l/ 0 By t��—
Z
WATER SERVICE
V1 A4( K G eqr-d11C
u
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-_.- ov
PLUMBING ROUGH |m
DATE.___ BY
Ox.TOENCLOSE FRAMING
DATE o/____--_
FINAL O.K.TO OCCUPY
{)KTOPOUR FOUNDATION WALLS
WATER LINE OX.
GAS PIPING Oa____-____��_
INSULATION
DATE BY
DCD
E
PSD
PLUMBING GROUNDWORK
DATE
MECHANICAL INSPECTION
DATE av
WALL BOARD AND FIRE WALL
oxrs BY
a
mc