90-101472CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
q6-/0/yea
BUILDING INSPECTION
941-1555
90-1694 M MARY HOLTZ 32344 10TH AVE S
PERMIT NO.
OWNER'S NAME JOB ADDRESS
NORTHWEST WATER HEATFA 8201 DURANGO ST SW TACOMA CONT, PHONE 984-6404
CONTRACTOR
DRESS
NORTHWHI37KJ 941-1296 31344 10 AVE S FEDERAL WAY
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.
150240-0300 LEGAL DESCRIPTION
ISSUED BY JOANNE JOHNSON DATE OF ISSUE DATE OF APPLICATION 10-22-90
BUILDING INFORMATION
E
OCCUPANCY TYPE OF CONSTRUCTION BLDG. SQ. FT.
T 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 10.0 AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS GAS RIOT WATER HTR. MISC.
RETURNED
SINKS
MISC. CONVERSION BURNER BASIC FEE 90-0
DISHWASHERS
TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL '10 _ nn
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
'10-00
qAL BLDG. FEES
Water Line OK Mechanical Inspection Notes:
ART 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
30.00
Account No. 010-000-322-10-004 Total Fee $ 30.00 Receipt No.
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE 1F NOW K IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE IN ATI FURNI D BY ME RUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WIL
E MET:
OWNER OR AGEN
DATE l
* 0
9-)- IL
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 OWNER `C JOB LOCATION , ICS`-'") C l <J .
OWNER'S ADDRESS 10' CITY rLd PHONE 9 q I aCA to
DESCRIBE JOB
THE PROPERTY IS OWNED BY: SINGLE/M RRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME N ClA%'1 LUSA W001—A `tLC 1 +D.A CONTRACTOR'S REG. # N 612-44) u_)h 13 Q KT
Card MUST be presented
CONTRACTOR'S ADDRESS 5XV1� QJl'iQ0 4 `)UJCITY `Irl 00M PHONE Cid Lk _L( `-{Ct
EXPIRATION DATE 1_C�' nom'
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 ` Gi. PHONE _L _ L'tC'
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER i5n�)LI� O - n3cxD _
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (N0. OF UNITS = ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9
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
MECHAN CAL APPLIANCES — BASIC FEE $
GAS PIPING, FEET $
NO. I 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 PER-
FORM THE WORK FORXHICH PERMIT APPLICATION IS,MADE. _
OWNER/AGENT:
DATE: 10 �a -,
ANP -006 2/90
CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT BUILDI94 � 555ECTION
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. SQ. 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 rIOT 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
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
-
PLUMBING GROUNDWORK
O.K TO POUR FOUNDATION WALLS
SET BACKS AND FOOTINGS
B
DATE -
_ __
DATE-- --- --.--BY---
DATE _-- --_ -__-
MECHANICAL INSPECTION
_
ROUGH IN
WATER LINE O.K. _-.-- -- -
-
._ { - -
PLUMBING
GAS PIPING O.K._ - __ _-
..&�..--...BY
DATE --.. -- -- BY __-_-_.._-.._
WALL BOARD AND FIRE WAIL
O.K. TO ENCLOSE FRAMING
INSULATION
BY -
BY -.__-
DATE -
._ -
BY
_._-_
DATE
DATE _ ----
FD
FINAL O.K. TO OCCUPY
DCD PSD
DATE--