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92-101016CITY OF FEDERAL WAY MECHANICAL PERMIT B I L D I N BUILDING INSPECTION U G P E R M I T 661-4140 PERMITNO. 92-1032 M OWNER'S NAME JOHN WATSON SITEADDRESs 28707 11TH AVE S CONTRACTOFNORTHWEST WATER HEATER ADDRESS 8201 DURANGO ST SW TACOMA CONT. PHONE 984-6404 CONT. REG. NO.NQRTHWH103R2 EXP. 12192 OWNER'S PHONE 941-8725 OWNER'S ADDRESS 28707 11TH AVE S FEDERAL WAY TYPEJOB: 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. 515296-0400 LEGAL DESCRIPTION ISSUED BY JOANNE JOHNSON DATE OF ISSUE DATE OF APPLICATION 7-1-4-99 BUILDING INFORMATION ONE SET BACKS: FRONT SIDE REAR HEIGHT LIMIT OCCUPANCY TYPE OF CONSTRUCTION CENSUS NO. TYPE OF HEAT BLDG. SQ. FT. STORIES PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING FT. 2 OO GAS LOGS BATHTUBS LAUNDRY DRAINS . FORCED AIR FURNACE 10--.--0.0— DUCT WORK RECEIVED SHOWERS URINALS GAS HOT WATER HTR. 6 5 0 AIR HANDLING UNIT NUMBER LAVATORIES DRINKING FOUNTAINS CONVERSION BURNER MISC. SINKS MISC. BBQ BASIC FEE 20._-:-_0..0-- RETURNED DISHWASHERS TOTAL FIXTURES DRYER TOTAL MECHANICAL 38,5�0--- AMOUNT VALUATION GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE. PERMIT FEE PLAN CHECK FEE PLUMBING FEE INSPECTION RECORD ECHANICAL FEE 38. = 0 OTAL 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 32 SO Total Fee $ 3 $ 5 � Receipt No. Q � " 1CL41� 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: f �� OWNER OR AGEN DATE J U L 13 1992 Gii`rV ()F FEDERAL WAV NALDING DEPT • Ormit #-q 1-11) 3 d- M CITY OF FEDERAL WAY BUILDING PERMIT APPLICATION — Please Print — BOX 1 TENANT NAME: FEET `= ' — 10 ' $ NO. OWNER N0. SITE LOCATION —_GAS HOT WATER HEATER $ CONVERSION BURNER $ OWNER'S ADDRESS G.v-� `,�. CITO St,v L PHONE I �7A HEAT PUMPS, SIZE $ DESCRIBE JOB I�" C' i ' Q_ AIR COOLING UNITS, SIZE $ COMMERCIAL HOOD $ THE PROPERTY IS OWNED BY: SINGL ARRIEDPARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME C4 �CONTRACTOR'S REG. #NCRT�( -N I0: TOTAL MECHANICAL FEE $ 6A Card MUST be presented 11 CONTRACTOR'S ADDRESS _ �SAso CITYC -f VYI0\. PHONE Sul _U H04 EXPIRATION DATE 2 O —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 ,C PHONE 8 p QUU BOX 4 SEWER DISTRICT U WATER DISTRICT BOX 5 ESTIMATED PROJECT COSTA_ EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER 5 �1 LC - D'� CG 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 :1 • 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 PIPIjVG, FEET `= ' — 10 ' $ NO. I FURNACE, ELEC. GASB_ $ —_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 TH5 INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION. OWNER/AGENT: ��b sL'4L� DATE: ANP -008 3/90 • 9 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: PUBLIC WORKS DEPARTMENT APPROVA REMARKS:_ SIDE REAR HEIGHT LIMIT DA DAT 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: ASSIGNED ADDRESS: PARTIAL PLAN CHECK FEE RECEIVED Amount 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 ACCEPTED FOR FILING ',,j F- �q Co �. `, RECEt.CIED ASSIGNED ADDRESS: PARTIAL PLAN CHECK FEE RECEIVED Amount 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 ACCEPTED FOR FILING CITY OF FEDERAL WAY MECHANICAL PERMIT BUILDING PERMIT =I BUILDING INSPECTION 661-4140 PERMIT NO. OWNER'S NAME J('b SITE ADDRESS CONTRACTOR i:A ADDRESS 9201 CONT. PHONE _°__404 r' S 287` 1 ITT AVE "DE CONT. REG. NO. EXP.12OWNER'S PHONE OWNER'S ADDRESS TYPEJOB: 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 n ISSUED BY DATE OF ISSUE DATE OF APPLICATION`S-$ BUILDING INFORMATION NE SET BACKS: FRONT SIDE REAR HEIGHT LIMIT OCCUPANCY TYPE OF CONSTRUCTION CENSUS NO. TYPE OF HEAT BLDG. SQ. FT. STORIES PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING FT. ++tom GAS LOGS BATHTUBS LAUNDRY DRAINS Cx *' FORCED AIR FURNACE l O. DUCT WORK RECEIVED SHOWERS URINALS GAS HOT WATER HTR. AIR HANDLING UNIT NUMBER LAVATORIES DRINKING FOUNTAINS CONVERSION BURNER MISC. RETURNED SINKS MISC. BBQ BASIC FEE DISHWASHERS TOTAL FIXTURES DRYER TOTAL MECHANICAL - 1ti 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 g�.'` �TAL BLDG. FEES Water Line OK Mechanical Inspection Notes: PART P/C FEE SEPA REVIEW GAS PIPING OK Dated L-f)By (�� WATER SERVICE WATER MAIN CHG. S.B.C.C. FEE OTHER FEES MECHANICAL PERMIT AMOUNT DUE Total Fee $ Receipt No. I �^ ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSU n I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERA WAY REQUIREMENTS WILL BE MET: +� OWNER OR AGENT DATE