91-101502CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
BUILDING INSPECTION
941-1555
PERMIT NO. 91 -1 470 M
OWNER'S NAME EFtLING p L(MiA JOB ADDRESS 33419 26TH PT, SW
CONTRACTOR NORTHWEST WATER HEATERADDRESS 8201 DURANGO STREET SW TACOMA CONT. PHONE 984-6404
CONT. REG. NO. NORTHWFTI
0IR2 OWNER'S PHONE 874-4322 OWNER'S ADDRESS 33412 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. 010060-0100
LEGAL DESCRIPTION
ISSUED BY JOANNE
JOHNSON DATE OF ISSUE DATE OF APPLICATION 10-17-91
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 6.5 0
NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS POT WATER HTR. FTPEPLACE INSERT
RETURNED
SINKS
MISC.
CONVERSION BURNER BASIC FEE ,n _ n0
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL 26 _ SO
AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
ERMIT FEE
LAN CHECK FEE
PLUMBING FEE
INSPECTION RECORD
MECHANICAL FEE
26-90
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
OTHER FEES
MECHANICAL PERMIT
AMOUNT DUE
26.50
Account No. 010-000-322-10-004 Total Fee $ 26.50 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
ION FURNISHED AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS L BE MET:
3
OWNER OR AGENT
DATE-
• Perm* ! 1 _ / y.;/ O ��
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1
TENANT NAME: G v, L i r` � v jat,c
GAS PIPING, FEET
$
OWNER '�- !`'� c�' e�!c� SITE LOCATION
$
GAS HOT WATER HEATER
OWNER'S ADDRESS 96' S � CITY
PHONE T7 - 3 P1,72
$
DESCRIBE JOB ivJ ,et,'f - 4J,- 6 k W P(6-e_,e_ Tcks
$
AIR HANDLING UNITS
THE PROPERTY IS OWNED BY: SINGLE/MARRIED �_ PARTNERSHIP
CORPORATION
BOX 2
CONTRACTOR'S NAME PE r CONTRACTOR'S REG. # A%e /;WAV
$
�� d r �e�`�-`'ir2% �' 1
CardMUSTbe presented
-� V'C
COMMERCIAL H
CONTRACTOR'S ADDRESS CITY �"`�'�
PHONE 7
$
EXPIRATION DATE <3-.�
$
—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 fAki (&C—
PHONE 5�_- TIC
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5
ESTIMATED PROJECT COST 3 SQ EXISTING BUILDING VALUATION
BOX 6
PROPERTY TAX ACCOUNT NUMBER d/ C(0 G 0 O i 616
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
(vl--SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( v�'E_XISTING 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
$
GAS HOT WATER HEATER
$
CONVERSION BURNER
$
BOILER, SIZE BTU
$
AIR HANDLING UNITS
$
HEAT PUMPS, SIZE
$
UNIT HEATERS
$
AIR COOLING UNITS, SIZE
$
COMMERCIAL H
$
OTHER -�C'a� , �,1. 6 ('D c:;
$
Ft'., r- /4,-c e- i` c� s t��'
$
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 WERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLOYEES, ON T E CURACY OF THE FORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
C
OWNER/AGENT: DATE: 41 ���
ANP -008 3/90
CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING INSPECTN
BUILDING PERMIT 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
IZSPCEIL
OCCUPANCY TYPE OF CONSTRUCTION
BLDG. SO. FT.
T BACKS: FRONT
SIDE REAR STORIES
HEIGHT LIMIT
UMBING 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
CHANICAL FEE
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
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
9
L -1
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 PI PING 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
DCD
PSD
FD