90-100424CITY OF
FEDERAL 'WAY
MECHANICAL PERMIT
BUILDING INSPECTION
BUILDING PERMIT
Gin. 1/1 [�
iv
PERMIT NO. 90-585 M OWNER'S NAME SHIRLEY M SERVIS JOB ADDRESS 30604 11TH AVENUE S
CONTRACTOR REEKIE' S HEATING & COMWARESS 2534 TACOMA AVENUE S TACOMA CONT. PHONE 627-4417
CONT. REG, NO. REEKICR127M6 OWNER'S PHONE 941-3764 OWNER'S ADDRESS 30604 11TH AVENUE S.
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.
LEGAL DESCRIPTION EXISTING HOUSE
ISSUED BY JOANNE JOHNSON DATE OF ISSUE S 0Od DATE OF APPLICATION 5-14-90
BUILDING INFORMATION
NE
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. 2_0 BOILER
BATHTUBS
LAUNDRY DRAINS
COMPRESSORTANKS)
RECEIVED
SHOWERS
URINALS
FORCED AIR FURNACE AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS HOT WATER HTR. 6 _ SO MISC. BBQ GRILL -6-5(
SINKS
MISC.
CONVERSION BURNER BASIC FEE 7 n n
RETURNED
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL 0
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
35, 00
TAL 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
-
Account No. 010-000-322-10-004 Total Fee $ 35.00 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 AGEN
,
C kL DATE ��' l S1. ` oL(�
• armit # 90 STS
RECEIVED CITY OF FEDERAL WAY
MAY I -t $90 BUILDING PERMIT APPLICATION
CITY 4F FEDERAL WAY — Please Print —
RI III r)lNC3 11F:DT
BOX 1 TENANT NAME:
OWNER A SITE LOCATION v�0
OWNER'S ADDRESS
DESCRIBE JOB i n -}� � C e - ` CITY 'PHONE!Q(4 I - <�1(ay
E
THE PROPERTY IS OWNED BY: SINGLE/ ARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME �R .Ir t 6,� i , _{ g 0 )00 1) Iti_t ,,i CONTRACTOR'S REG. #_R FYk l l' G I
Card MUST to presented
CONTRACTOR'S ADDRESS Q S_3 -11 ('�� c'Yv� <' a-uLa.< CITY 1 C rn PHONE ( 3. ) ` (-(t
EXPIRATION DATE (-c 19 _cam
—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 PERSONt �.') t� a 1� i'
-- PHONE iv Q ((' i
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBE
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_____j GARAGE_____j
BOX 8 (f ) SINGLE FAMILY
( ) MULTIFAMILY (NO. OF UNITS = )
( ) COMMERCIAL/INDUSTRIAL
:1 •j
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
( ) NEW CONSTRUCTION
(° ) EXISTING STRUCTURE
TOTAL AREA OF PROPERTY
MECHANICAL APPLIANCES —
BASIC FEE $
GAS PIPING, FEET
$
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 (-�s P) CA C� f c l J
$
$
TOTAL MECHANICAL FEE
$
FT
,A0.w
/- . 3
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:
DATE: E_ 14 - 0
ANP -008 3/90
CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT BUILDING 941-I
SSSECTION
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
OCCUPANCY TYPE OF CONSTRUCTION
BLDG. SO. FT.
SMACKS: 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
SINKS
DRINKING FOUNTAINS
MISC.
AS HOT WATER HTR.
CONVERSION BURNER BASIC FEE --!
RET�YRNED
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
BLDG. FEES
Water Line OK Mechanical Inspection
Notes: V ( a
F PIC FEE
SEPA REVIEW
GAS PIPING OK Date
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