91-100079MECHANICAL PERMIT
CITY OF
FEDERAL WAY BUILDING PERMIT
5)- /006-79
BUILDING INSPECTION
941-1555
90-0059M
CHAFFEY CORP 34339 27 AVE SW
PERMIT NO.
OWNER'S NAME JOB ADDRESS
CONTRACTOR RELIABLE
SHEET METAL ADDRESS 11447 120 AVE NE KIRKLAND CONT. PHONE 823-6868
CONT. REG. NO. RELIASM345LF
1291 OWNER'S PHONE 822-5981 OWNER'S ADDRESS SAME
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 MECHANICAL
TAX ACCOUNT NO. 294450-0720 LEGAL DESCRIPTION NA
ISSUED BY ELIZABETH
SNYDER DATE OF ISSUE r DATE OF APPLICATION 1.114.19 1
BUILDING INFORMATION
NE NA
OCCUPANCY NA TYPE OF CONSTRUCTION MF.[_H ONLY BLDG. SQ. FT. NA
SET BACKS: FRONT NA
SIDE NA REAR NA STORIES NA HEIGHT LIMIT NA
PLUMBING NO.
NO.
MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS
ELEC. HOT WATER HEATER
GAS PIPING FT. 9-00 00 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. DRYER 6 50
RETURNED
SINKS
MISC.
CONVERSION BURNER BASIC FEE 24 -0 -0 --
DISHWASHERS
TOTAL FIXTURES NONF.
UNIT HEATER TOTAL MECHANICAL 35.()0
AMOUNT NONE
RANGE ( 1 )
VALUATION NONE.
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
INSPECTION RECORD
ECHANICAL FEE $15
, 00
TAL 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 $35
_ nn
Account No. 010-000-322-10-004 Total Fee $ 35.00 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
Permit # �o O S 1
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1
TENANT NAME:
OWNER Chaffey Corporation
SITE LOCATION 34339 27th Ave
S.W.
OWNER'S ADDRESS _ P.O. Box 560
CITY Kirkland PHONE
822=5981
DESCRIBE JOB Adding gas ming for range
& dryer
THE PROPERTY IS OWNED BY: SINGLE/MARRIED
PARTNERSHIP CORPORATION X
BOX 2
CONTRACTOR'S NAME RPl i ahl P Sheet Metal
CONTRACTOR'S REG. #
RELIASM345LF
Card MUST be presented
CONTRACTOR'S ADDRESS 11447 120th Ave NE
CITY Kirkland PHONE
823-6868
EXPIRATION DATE 12/91
—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 Verrene
PHONE
823-6868
BOX 4 SEWER DISTRICT
WATER DISTRICT
BOX 5
ESTIMATED PROJECT COST
EXISTING BUILDING VALUATION
BOX 6
PROPERTY TAX ACCOUNT NUMBER 2944500720
LEGAL DESCRIPTION
(If necessary, please submitparate 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
(x) 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)
MECHA ICA 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
$
DRINKING FOUNTAINS
COMMERCIAL HOOD
$
SUMPS, SPRINKLER VACUUM BREAKERS
0 HER
$
itDRAINS
OTHER
$
$
TOTAL FIXTURES
$
'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 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:
ANP -008 3/90
CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING INSPECTION
BUILDING PERMIT
/
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 ZrJ 7' 7,1
/
ISSUED BY
DATE OF ISSUE DATE OF APPLICATION
BUILDING INFORMATION
NE
OCCUPANCY TYPE OF CONSTRUCTION
BLDG. SO. 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�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
PLUMBING FEE
INSPECTION RECORD
ECHANICAL FEE
TAL BLDG. FEES
Water Line OK Mechanical Inspection Notes:
PART P/C FEE
SEPA REVIEW
GAS PIPING OK 1�-3� y' l A5 Date f- 3' r By 11,13
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 $ 1
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
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.___/MECHANICAL
GAS PIPING O.K.--_-7_3/__V
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
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