92-100790CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
9 a- ioa7s0
BUILDING INSPECTION
941-1555
PERMIT NO. 92-0838 M OWNER'S NAME JOE BELCHER JOB ADDRESS 33011
26TH PL SW
CONTRACTOR
ABC GAS INSTALLATIOMDRESS 9923 64TH AVE CT E PUYALLUP
CONT. PHONE 845-7482
CONT. REG. NO. ABCGAI113N3 9/92 OWNER'S PHONE 927-1608 OWNER'S ADDRESS 33011
26TH PL SW FEDERAL 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.
894530-0350 LEGAL DESCRIPTION
ISSUED BY
JOANNE JOHNSON DATE OF ISSUE DATE OF APPLICATION 5-29-92
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 5 FT. 2-0O BOILER
RECEIVED
BATHTUBS
LAUNDRY DRAINS
COMPRESSOR TANK(S)
SHOWERS
URINALS
FORCED AIR FURNACE AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS�10T WATER HTR. 6 _ Sn MISC.
SINKS
MISC.
CONVERSION BURNER BASIC FEE
Q0
-2k,0-0
RETURNED
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL
28-5
AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR.
AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
FEE
INSPECTION RECORD
0cUMBING
CHANICAL FEE
28.50
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.
MECHANICAL PERMIT
ii l
l t�
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
28.50
Account No. 010-000-322-10-004 Total Fee $ 28.50 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:
r.. /
`�
OWNER OR AGENT
DATE
RECEIVED
MAY 2 g 1992
0'IY OWRAL Waw
• e•
;t # 9 a - W
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME:�-
OWNER SITE LOCATION
OWNER'S ADDRESS ' 0 / L iu CITY— ��,� �a � �� PHONE F2 —�G u �►'
DESCRIBE JOB
THE PROPERTY IS OWNED BY: SINGLE/MARK D PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME C� �, . L-%�ONTRACTOR'S REG. # `=� /S C 6-r7 L k 1'? N }'
Card MUST be presented
CONTRACTOR'S ADDRESS E- CITY PHONES
EXPIRATION DATE ti
OR —
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINI ONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON PHONE
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER ? P/ ti -3
LEGAL DESCRIPTION
(It 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
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES —
BASIC FEE $
N0. WATERCLOSETS
GAS PIPING, FEET
$
BATHTUBS
N0. FURNACE, ELEC. GAS
$
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
$
KINKING FOUNTAINS
COMMERCIAL HOOD
$
SUMPS, SPRINKLER VACUUM BREAKERS
OTHER
$
DRAINS
$
OTHER
$
TOTAL FIXTURES
$
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 T -a CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: `'�i l=u��-ti �. DATE:
ANP -008 3/90
CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDINGPERMIT BUILDI941!1 SSECTION
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. 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 POT WATER HTR. MISC.
RETURNED
SINKS
MISC.
CONVERSION BURNER BASIC FEE
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER TOTAL MECHANI
AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSP
F WILL NOT SUFFICE.
PERMIT FEE
1
PLAN CHECK FEEIN
LUMBING FEE
INSP
ECHANICAL FEE/
TOTAL BLDG. FEES
Water Line OK Mechanic
NO.
PART PIC FEE
SEPA REVIEW
GAS PIPING OK Date
WATER SERVICE
—
�Q►
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES
MECHANICAL PERMIT
AMOUNT DUE
Account No. 010-000-322-10-004 `
-°..tal Fe
Receipt No.
ALL PERMITS EXPIRE 180 DAYS
AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMIX PIRE ONE YEAR
AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWL4VGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET:
OWNER OR AGENT
DATE
0 •
SET BACKS AND FOOTINGS
DATE
OX TO POUR FOUNDATION WALLS
DATE . . . . ..... . . . ......BY
PLUMBING GROUNDWORK
DATE . ...... . . ... .. __.BY
PLUMBING ROUGH IN
DATE BY . . . ..... .
WATER LINE O.K. __ . .... . . ...... . .. ...
GAS PIPING Q.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-,,..-- . _BY-
DCD
PSD
FD
. .... . .. ... ..