92-100777CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
9.1. 1007,77
BUILDING INSPECTION
941-1555
PERMIT NO. 92-0817 M OWNER'S NAME SALLY CARPENTER JOB ADDRESS A142K 78,711 PT, SW
CONTRACTOR RENNIE SHEET METAL INC ADDRESS 4820 S. WASHINGTON TACOMA CONT. PHONE 472-4099
CONT. REG. NO. RENNISM110QN
OWNER'S PHONE 838-0262 OWNER'S ADDRESS 31425 28TH PL SW PimyRAT, 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 OTHE
TAX ACCOUNT NO. 150330-0240
LEGAL DESCRIPTION
UED BY JOANNE JOHNSON
DATE OF ISSUE DATE OF APPLICATION g;-26-42
BUILDING INFORMATION
ZONE 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
BATHTUBS LAUNDRY DRAINS
GAS PIPING FT. 2-0 n BOILER
COMPRESSOR TANK(S)
RECEIVED
SHOWERS URINALS
FORCED AIR FURNACE 10-0 AIR HANDLING UNIT
NUMBER
LAVATORIES DRINKING FOUNTAINS
SINKS MISC.
GAS POT WATER HTR. MISC.
CONVERSION BURNER BASIC FEE - 21,
A .� 0
RETURNED
DISHWASHERS TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL -32,"
AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
FEE
INSPECTION RECORD
9IUMBING
ECHANICAL FEE 32.00
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.
MECHANICAL PERMIT
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE 32.00
Account No. 010-000-322-10-004 Total Fee $ 32.00 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
OWNER OR AGENT—s.
DATE Z�
RECEIVED BY
COMMUNITY DEVELOPMENT DEPARTMW
CITY OF FEDERAL WAY
MAY 2 6 1992 BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME:
OWNER r• SITE LOCATION
OWNER'S ADDR CITY.yr (�( itl�l PHON --O x
DESCRIBE JOB N
THE PROPERTY IS OWNED 141' SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG. #aM_'SM t —0 K)
Card MUST be presented
CONTRACTOR'S ADDRESS L%4.!.kIN CITY HONE N-1-1-4099
EXPIRATION DATE
—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 th ULPk —e f3 PHONE 4472-1-10 g
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER 15-6330— 0140
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_____1_
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES — BASIC FEE $
N0. WATERCLOSETS
GAS PIPING, FEET $
J
BATHTUBS
NO. 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
OTHER $
DRAINS
$
OTHER
$
TOTAL FIXTURES
$
TOTAL MECHANICAL FEE $
1 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 OFTHE ABOVE PREMISESTO 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 CITYAS A PART OF THIS APPLICATION.
OWNER/AGENT: .� �. �., r
DATE: 5-'� I-7//S��--
ANP -006 3/90
61TY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
BUILDING INSPECTION
941-1555
PERMIT NO.
OWNER'S NAME JOB ADDRESS
ADDRESS CONT PHONE
CONTRACTOR
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
DATE OF ISSUE DATE OF APPLICATION
ISSUED BY
BUILDING INFORMATION
ONE
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 �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
INSPECTION RECORD
PLUMBING FEE
ECHANICAL FEE
Water Line OK Mechanical Inspection Notes:
DTAL BLDG. FEES
PART PIC FEE
GAS PIPING OK Date 4L By %o M
SEPT REVIEW
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
MECHANICAL PERMIT
OTHER FEES
Account No. 010-000-322-10-004 Total Fee $ Receipt No.
AMOUNT DUE
_
EXPIRE 180 DAYS
AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
ALL PERMITS
t
ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
I CERTIFY THAT THE INFORMATION
FURNISHED BY
REQUIREMENTS WILL BE MET:
� ISA
OWNER OR AGENT
DATE
SET BACKS AND FOOTINGS
DATE BY
O.K TO POUR FOUNDATION WALLS
DATE BY
PLUMBING GROUNDWORK
DATE BY
PLUMBING ROUGH IN
DATE BY
WATER LINE O.K.
GAS PIPING O.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
l
DATE lam% li. BY
RCD
PSD
FD