92-100759MECHANICAL PERMIT
CITY OF
FEDERAL WAY BUILDING PERMIT
BUILDING INSPECTION
941-1555
q')- /A,,C 3
PERMIT NO. 92-0819 M
OWNER'S NAME HAWN JOB ADDRESS 35311 19TH AVE SW
CONTRACTOR RENNIE
SHEET METAL IN DRESS 4820 S WASHINGTON TACOMA CONT. PHONE 472-4099
CONT. REG. NO. REMISZ4110QN OWNER'S PHONE 838-5569 OWNER'S ADDRESS 35311 19TH AVE SW F niFRAT. WAY
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. 926975-0090 LEGAL DESCRIPTION
ISSUED BY JOANNE JOHNSON DATE OF ISSUE lu DATE OF APPLICATION 5-71 -g7
BUILDING INFORMATION
ZONE
OCCUPANCY TYPE OF CONSTRUCTION BLDG. 80. FT.
SET BACKS: FRONT
SIDE REAR STORIES HEIGHT LIMIT
UMBING NO.
NO. MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS
ELEC. HOT WATER HEATER GAS PIPING FT. 2-0 BOILER
RECEIVED
BATHTUBS
LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS
URINALS FORCED AIR FURNACE 1 n _ n n AIR HANDLING UNIT
NUMBER
LAVATORIES
SINKS
DRINKING FOUNTAINS GAS jiOT WATER HTR. 6-5 (1 MISC.
MISC. CONVERSION BURNER BASIC FEE 70�OA
RETURNED
DISHWASHERS
TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL 38 !j
AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
UMBING FEE
INSPECTION RECORD
CHANICAL FEE
38.50
TOTAL BLDG. FEES
Water Line OK Mechanical Inspection Notes:
PART P/C FEE
A REVIEW
GAS PIPING OK Date By
ATER SERVICE
WATER MAIN CHG.
f
S.B.C.C. FEE
OTHER FEES
MECHANICAL PERMIT 9
AMOUNT DUE
38.50
Account No. 010-000-322-10-004 Total Fee $ 38.50 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, `�
Z
- /!t/Ir� 2/ DATE _
10 Peen !2 Y/ 9
0 0
RECEIVED BY
COMMUNITY DtVELOPMENT bt-PARTMINT CITY OF FEDERAL WAY
MAY 2 g 1992 BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME:
OWNERS
OWNER'S ADDRE11
DESCRIBE JOB j
THE PROPERTY IS OWNED BYE
BOX 2 CONTRACTOR'S NAME
SITE LOCATION
— CITY_ PHONE 939— i5 -
fit
fit
PARTNERSHIP
CORPORATION
CONTRACTOR'S REG.
Card MUST be presented
CONTRACTOR'S ADDRESS CITY r PHONE 471-4%q 41
EXPIRATION DATE
lsTle
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 4 — K► PHONE
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER O
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 I
3RD FLOOR_____1_ BASEMENT_____J_ DECK t GARAGE
BOX 8 ( ) SINGLE FAMILY
( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = )
( ) EXISTING STRUCTURE
( ) COMM ERCIAUINDUSTRIAL
TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES — BASIC FEE $
N0. WATERCLOSETS
GAS PIPIVG, FEET $
BATHTUBS
N0. FURNACE, ELEC. GAS t!!� $
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 $
1 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.
_
�/. /C/
j
5'z/'`C �_
OWNER/AGENT:
DATE:
ANR006 3/90
CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDINGPERM I T BUILDI941!N 55ECTION
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
'IMUMBING
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
LUMBING FEE
INSPECTION RECORD
ECHANICAL FEE
TOTAL BLDG. FEES
Water Line OK Mechanical Inspection Notes:
PART PIC EE
PA REVIEW
GS PN � AY
APIPING OK �� Date
ATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
MECHANICAL PERMIT
Account No. 010-000-322-10-004 Total Fee $ 38 50 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 BY
OX TO POUR FOUNDATION WALLS
DATE BY
PLUMBING GROUNDWORK
DATE BY
PLUMBING ROUGH IN
DATE BY
WATER LINE O.K.
GAS PIPING O.K. 2
MECHANICAL INSPECTION
DATE _BY
O.K. TO ENCLOSE FRAMING
DATE BY
INSULATION
DATE BY
WALL BOARD AND FIRE WALL
DATE BY
FINAL O.K. TO OCCUPY
DATE � BY _� __
DCO
PSD
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