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91-100282CITY OF FEDERAL WAY MECHANICAL PERMIT B�'�°'94 IN 55ECTION BUILDING PERMIT 9l—i1,n_-)s;�l 91-281 M LYNN WELCH 32231 25TH AVE SW PERMIT NO. OWNER'S NAME JOB ADDRESS CONTRACTOR PACIFIC GAS HEATING & AA[�SS 2702A 112TH ST R TACOMA CONT. PHONE 536-7997 CONT. REG. NO. PACIFGH110ME 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-FAMILYUNITS ) MULTI. ADD. SIGN GRADING OTHER 873180-0390 TAX ACCOUNT NO. LEGAL DESCRIPTION ISSUED BY JOANNE JOHNSON DATE OF ISSUE I DATE OF APPLICATION 3-4-91 BUILDING INFORMATION AM 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. 2.00 ESPACE HTR 6.50 RECEIVED BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S) SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER LAVATORIES DRINKING FOUNTAINS GAS.POT WATER HTR. 2 nGAS LOGS 13-00 RETURNED SINKS MISC. CONVERSION BURNER BASIC FEE 20-00 DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL 41-90 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 41 _ 90 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 41.50 Account No. 010-000-322-10-004 Total Fee $ 41.50 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 F JRNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET:t_ .�--- `" Y �'� OWNER OR AGENT` % DATE Permit # 9 1- _-) LIT CITY OF FEDERAL WAY BUILDING PERMIT APPLICATION — Please Print — BOX 1 TENANT NAME: OWNER SITE LOCATION rL OWNER'S ADDRESS 1 1 �� ��� . �_ CITY PHONE DESCRIBE JOB 0 tel" l ) 36"Zo THE PROPERTY IS OWNED BY: SINGLE/MARRIED t/ PARTNERS IP CORPORATION BOX 2 CONTRACTOR'S NAME 4 CONTRACTOR'S REG. #. Card MUST be CONTRACTOR'S ADDRESS 11CI A - i 1 �,� ;1� �. CITY -T -k oy-,,- t'- PHONE EXPIRATION DATE 7 5 -9 / W1110M 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� h � `a , � ..t - ��� -�C: i� PHONE 4 % 9 97 BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER 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 :IIYAL0] 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 7&' $ 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 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: DATE: J ANP -008 3/90 CITY OF FEDERAL WAY MECHANICAL PERMIT BUILDING PERMIT I BUILDING INSPECTION 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 ZONE NE OCCUPANCY TYPE OF CONSTRUCTION BLDG, SQ. FT. BACKS: FRONT SIDE REAR STORIES HEIGHT LIMITUMBING 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�iOT 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 UMBING FEE INSPECTION RECORD CHANICAL FEE TOTAL BLDG. FEES Water Line OK Mechanical Inspection Notes: PART PIC FEE ` SEPA REVIEW GAS PIPING OK ��� Date / yj&By /73 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 0 0 SET BACKS AND FOOTINGS DATE ___ __ -...,.--.BY O.K TO POUR FOUNDATION WALLS DATE ...... . .. ..... __ _ BY __ . .... .. PLUMBING GROUNDWORK DATE ........BY PLUMBING ROUGH IN DATE . .. . . . .... .. WATER LINE O.K. . .. .... __ . .. .... GAS PIPING . ... ... . ..... .. 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 DCD PSD FID C U kkk� d7_lt A IL 7-C;s Z/—gzv v