90-101264CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
�0 - /a1 3(y
BUILDING INSPECTION
941-1555
PERMIT NO. 90-1463
M OWNER'S NAME TERRY PRF.THER JOB ADDRESS 34331 27TH AVENUE
SW
CONTRACTOR 11AROLDS
SUPPLY & REPA:EFDRESS 15 S SOiiTH 16 TH TACOMA CONT. PHONE 472-2896
CONT. REG. NO. HAROLSR136
LD OWNER'S PHONE OWNER'S ADDRESS 34331 27TH AVE SW
FEDERAL WA
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 JOANNE
JOHNSON DATE OF ISSUE 7 DATE OF APPLICATION 9-7-90
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
BATHTUBS
ELEC, HOT WATER HEATER
LAUNDRY DRAINS
GAS PIPING . 10 FT. 2.00 BOILER
COMPRESSOR DRYEF*NK(S) 6.50
RECEIVED
SHOWERS
URINALS
FORCED AIR FURNACE AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS HOT WATER HTR. MISC.
SINKS
MISC.
CONVERSION BURNER BASIC FEE 20.0
RETURNED
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL 28.50
AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT
SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
INSPECTION RECORD
CHANICAL FEE
28.50 --
TAL BLDG. FEES
w
Water Line OK Mechanical Inspection Notes:
ART PIC FEE
CEPA REVIEW
GAS PIPING OK Date By
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES
MECHANICAL PERMIT
AMOUNT DUE
22 5n
Account No. 010-000-322-10-004 Total Fee $ 28.50 Receipt No.
/2-72 /Luh
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 MEL IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE ME
OWNER OR AGENT
DATE_ �7 _
RECEIVE[
SEP Q 7 1990
CITY OF: FEDERAL WAY
BUILDING D1 1)T,
BOX 1 TENANT NAME:
0
*mit # I A -Lo -�) h ------
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
OWNER etf v V,( otk P,(, CIT SITE LOCATION (" 1 u
OWNER'S ADDRES ` :3 �` d CITY I ' PHONE
DESCRIBE JOB - Z � i C'�
THE PROPERTY IS OWNED BY: SINGLE/MARRIED 7K PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME
CONTRACTOR'S REG. #
" ' ✓I - Card MUST be presented
CONTRACTOR'S ADDRESS S eA4" CITY I Cc C6dyeC PHONE_A1101A !2Z2 -2f&
EXPIRATION DATE = /9-90 C HAVE READ CHAPTER 18.27.010 RELqATG 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 al -e-11 PHONE L/'72-299&
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 P82ff TY TAX ACCOUNT_N_ MBER
LEGAL DESCON
(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 -------J— GARAGE /
BOX 8 (-4 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 /d $
BATHTUBS
SHOWERS
LAVATORIES
SINKS
DISHWASHERS
ELECTRIC HOT WATER HEATER
LAUNDRY WASHER OUTLET
URINALS
DRINKING FOUNTAINS
SUMPS, SPRINKLER VACUUM BREAKERS
DRAINS
OTHER
TOTAL FIXTURES
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
$
BOTHER �c_`s'v el,-
$
$
$
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 ME CITY AS A PART OF THIS APPLICATION
OWNER/AGENT:
DATE:
ANP -008 3/90
MECHANICAL PERMIT
CITY OF
FEDERAL WAY BUILDING PERMIT 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
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 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
FEE
jWANICAL
L 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
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:
f
OWNER OR AGENT
DATE
0
SET BACKS AND FOOTINGS
DATE BY
OX TO POUR FOUNDATION WALLS
DATE _ ...... . ... .. __BY .... .... . . ...... . ... ... _
PLUMBING GROUNDWORK
DATE BY
PLUMBING ROUGH IN
DATE ... . ... ... __ __BY . .......
WATER LINE OX.
GAS PIPING
. .....
. . ........
..... . . ......
MECHANICAL INSPECTION
DATE . .... . . . ..... ... ___ -,.,.,-BY
-
O.K. TO ENCLOSE FRAMING
DATE __-__._-__BY ... ... . . ..... .. . . .. ..... ... .
INSULATION
DATE ... . ......... .
. ... .... BY
. .. ....
WALL BOARD AND FIRE WALL
DATE
. . .. .. .... ...
FINAL O.K. TO OCCUPY
DATE. ...... ... . . ... ... _BY . . ..... . ..
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