90-100113CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING
PERMIT
BUILDING INSPECTION
941-1555
GA _ /An I/ 7
PERMIT NO. 90-01
55m OWNER'S NAME KRDRATH JOB ADDRESS 31428 28 PL SW
CONTRACTOR NQRTHWF.ST
WTR HTR ADDRESS 8201 DURANGO ST SW TACOMA CONT, PHONE 627-4A 48
CONT. REG. No._NORTHWH13%Fu7
12/90 OWNER'S PHONE NA OWNER'S ADDRESS SAME AS SITE �Og,ESS
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 MECHANIC—
A-1-TAX ACCOUNT NO. 11a
LEGAL DESCRIPTION STA
ISSUED BY ]ELIZABETH
-SN-YD-ER- DATE OF ISSUE DATE OF APPLICATION �T22T �A
BUILDING INFORMATION
E N --A-
OCCUPANCY NA TYPE OF CONSTRUCTION NA BLDG. SO. FT_��
SET BACKS: FRONT
NA SIDE NA REAR NA STORIES NA HEIGHT LIMIT_ N
PLUMBING NO.
NO. MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS
ELEC. HOT WATER HEATER GAS PIPING FT. BOILER
BATHTUBS
LAUNDRY DRAINS COMPRESSORTANK(S)
RECEIVED
SHOWERS
URINALS FORCED AIR FURNACE 10 • 00 AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS GAS HOT WATER HTR. MISC.
SINKS
MISC. CONVERSION BURNER BASIC FEE 20.00
RETURNED
DISHWASHERS
TOTAL FIXTURES NONE UNIT HEATER TOTAL MECHANICAL 30.00
AMOUNT NONE
ALUATION
NONE
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
INSPECTION RECORD
MECHANICAL FEE
30.00
IISTAL 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 r
AMOUNT DUE
¢an nn
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 THEORMATION
FURNIS ED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL B
MET:
OWNER OR AGENT
DATE oC 7�
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 OWNER rx 10 G t
OWNER'S ADDRESS �' <
DESCRIBE JOB Ty)S ti ' Cif - nr
THE PROPERTY IS OWNED BY: SINGLE/MARRIED
BOX 2 CONTRACTOR'S NAME
JOB LOCATION r C,' 1
CITY FC d `'UC y` PHONE
PARTNERSHIP CORPORATION k -
CONTRACTOR'S REG. #
Card MUST be presented
CONTRACTOR'S ADDRESS d� ( v .� n�� S !rV CITY /� �" a M II PHONE 62 % ✓C>��
EXPIRATION DATE
1'
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 Ir i e k 7. t r ", PHONE -, "
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.)
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
BOX 9 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 $
N0. FURNACE, ELEC. GAS „X $
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 PER-
FORM THE WORK MR WHICH PE5i�APPLIC�TIqN IS MADE.
OWNER/AGENT:
DATE: S�
ANP -006 2/90
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
OCCUPANCY TYPE OF CONSTRUCTION
BLDG. SQ. FT.
S ACKS: 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 HOT 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
PLUMBING FEE
INSPECTION RECORD
MECHANICAL FEE
9L BLDG. FEES
Water Line OK Mechanical Inspection
Notes:
r i P/C FEE
SEPA REVIEW
GAS PIPING OK `�-- Date t% -I 5 `y'By /73
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
MECHANICAL PERMIT
Account No. 010-000-322-10-004 Total Fee S
Receipt No.
p
#
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
PLUMBING ROUGH |N
DATE BY
O.K.T0 ENCLOSE FRAMING
DATE BY
FINAL Oa.TOOCCUPY
DATE . ..... - _BY
0
0
/'-- -/--I/t /2/