91-100320MECHANICAL PERMIT
CITY OF BUILDING PERMIT BUILDING INSPECTION
FEDERAL WAY 941-1555
QJ_ A0:2.3 d
PERMIT NO. 91-295 M
OWNER'S NAME DAVID ASHLEIF JOB ADDRESS 31 831 25TH AVE SW
CONTRACTOR PACIFIC CCAS
HF.ATTNC & AMRESS 9709A 1 1 7TH ST E TACOMA CONT. PHONE _536-7997
CONT. REG. NO. PACTFCCHI
1 OMF. OWNER'S PHONE 874-4269 OWNER'S ADDRESS 31 831 25TH AVE SW FF]DiFRAr• 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. 193840-0360
LEGAL DESCRIPTION
ISSUED BY JOANNE JOHNSON
DATE OF ISSU 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 39 FT. 2.00 BOILER
RECEIVED
BATHTUBS
LAUNDRY DRAINS
COMPRESSOR TANK(S)
SHOWERS
URINALS
FORCED AIR FURNACE i n n0 AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS�iOT WATER HTR. 6.50 MISC.
RETURNED
SINKS
MISC.
CONVERSION BURNER BASIC FEE n 00
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL 3250
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 38-50
TOTAL 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
50
MECHANICAL PERMIT
Account No. 010-000-322-10-004 38.50
38
AMOUNTDUE
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 PLtRNISHED 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
Permit
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1
TENANT NAME: \ �j t 6 � �.�rt
OWNER _ SITE LOCATION
OWNER'S ADDRESS CITY a , ``'
PHONE - L"6_
DESCRIBE JOB zna4ct 6 n -- <i+ /i - a�
THE PROPERTY IS OWNED BY: SINGLE/ RRIED '� PARTNERSHIP
CORPORATION
BOX 2
CONTRACTOR'S NAME CONTRACTOR'S REG.
Card MUST be present
CONTRACTOR'S ADDRESS �D . r � `�- CITYY�fd. ti^i�rL-
PHONE >_� 79(]
EXPIRATION DATE
—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 ( i� )PHONE
i� -L % C1 r 1
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5
ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6
PROPERTY TAX ACCOUNT NUMBER HA`t4C) - L a -U 6
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 = ) (14 -EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY
SQ FT
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 PIPING, FEET < z'i I $
NO. 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 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: -�f . I � � (z 7 DATE:
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
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. 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.
AFFIDAVITWIL
c
*WIN.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
INSPECTI
CHANICAL FEE
TAL BLDG. FEES
Water Line OK Mechanical Inspec
NO
PART PIC FEE
VFW
SEPA REVIEW
GAS PIPING OK Date By
WATER SERVICE
D�
WATER MAIN CHG.
S.B.C.C. FEE
allops 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 WAY1
r
REQUIREMENTS WILL BE MET:
OWNER OR AGENT
DATE
0 0
SET BACKS AND FOOTINGS
DATE- -_ _ - --BY
OX TO POUR FOUNDATION WALLS
DATE ...... . ... ... BY
PLUMBING GROUNDWORK
DATE. -....BY .
PLUMBING ROUGH IN
DATE____ _____BY
WATERLINE O.K.
GAS PIPING 0, K.
. ... ...
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 -_SVq/ BY WA
DCD
PSD
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