91-101781MECHANICAL PERMIT
CITY OF
FEDERAL WAY BUILDING PERMIT
qJ -/ o/ 7 9/
BUILDING INSPECTION
941-1555
PERMIT NO. 91-1758 M OWNER'S NAME EARL WINGROVE JOB ADDRESS 32453 22 AVE SW
CONTRACTOR NORTHWEST USI
ADDRESS 1908 S 341 PL #9 FEDERAL WAY 98003 CONT. PHONE 952-5433
CONT. REG. No. NORTHUS101JJ (4/92)
OWNER'S PHONE 874-6069 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. 638670-0090
LEGAL DESCRIPTION
SUED BY ELIZABETH SNYDER
DATE OF ISSUE ? - �� DATE OF APPLICATION 12/19/91
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 41 FT. 2.00 BOILER
BATHTUBS LAUNDRY DRAINS
'ie"-me8sas CIRC HTR 6-5 TANK(S) RECEIVED
SHOWERS URINALS
_
FORCED AIR FURNACE AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS
GAS�IOT WATER HTR. MISC.INSERT 6 - SO
SINKS MISC.
RETURNED
CONVERSION BURNER BASIC FEE 20.00
DISHWASHERS TOTAL FIXTURES
NONE
UNIT HEATER TOTAL MECHANICAL 35.00 AMOUNT
NONE
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT
SUFFICE.
PERMIT FEE
AN CHECK FEE
PLUMBING FEE
INSPECTION RECORD
MECHANICAL FEE $35.00
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 35.00
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 I OR ATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WIL BE
OWNER OR AGENT
��� DATE
RSC,cjvEiD
DEC 19 1991
BOX 1 TENANT NAME:
. Per�� � I M
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
OWNER L-cQ_k_ Lk>,r\ c. C- SITE LOCATION `/ S__Z 6D
OWNER'S ADDRESS 3"JL/5 LOO a,e ",S 1 CITY PHONE S J- e -,C() K `j
DESCRIBE JOB _ Q i c,.e_ C ' c4. c
THE PROPERTY IS OWNED BY: SIN LE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME Ne�LtA-xi,_-e ,,`t CONTRACTOR'S REG. #/VL, i- 1(` 1 Tr
Card MUST be presented
CONTRACTOR'S ADDRESS 9 (
rt 3`-I ��FL. S , #Gj CITY - PHONES 5,� - `/ 3
EXPIRATION DATE 4-S-90)
—OR—
I HAVE READ CHAPTER 18.27.010 RELATING -DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON l�� n n. c _�'_�n PHONE`5P -5 `i.3 3
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST l EXISANG BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBE
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 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
M
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
THER
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 HOOD
$
i OTHERak-L, R C�, e-
$
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 T CITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMP YE$, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
GZV �
�, - j
OWNER/AGENT: � DATE:
ANP -008 3/90
MECHANICAL PERMIT
CITY OF FEDERAL WAY BUILDING PERMIT BUILDI94 IN 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
BATHTUBS
LAUNDRY DRAINS
COMPRESSOR TANK(S)
RECEIVED
SHOWERS
URINALS
FORCED AIR FURNACE AIR HANDLING UNIT
NUMBER _
LAVATORIES
DRINKING FOUNTAINS
GAS RIOT WATER HTR, MISC.
SINKS
MISC.
CONVERSION BURNER BASIC FEE
RETURNED
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
PART P/C FEE
Water Line OK Mechanics Inspect'l n
r
Notes:
SEPA REVIEW
GAS PIPING OK Date *1-/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
SET BACKS AND FOOTINGS
DATE . . ....... --BY
PLUMBING ROUGH IN
DATE _ _ BY
O.K. TO ENCLOSE FRAMING
DATE _ _____BY
FINAL O.K. TOO UPY
DATE K BY
35 oV 41
0
O.K TO POUR FOUNDATION WALLS
DATE BY
WATER LINE O.K.
GAS PIPING O.K.
INSULATION
DATE - ____...____BY
_BY
DCD
PSD
ko
10
PLUMBING GROUNDWORK
DATE BY
MECHANICAL INSPECTION
DATE --BY
WALL BOARD AND FIRE WALL
DATE By ,
IQ