90-101393CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
9a-16/3 S 3
BUILDING INSPECTION
941-1555
PERMIT NO. 90-1609M
OWNER'S NAME KENNETH HAMILTON JOB ADDRESS 28425 MILITARY RD S
CONTRACTOR NORTHWEST
UST ADDRESS 1908 SW 341 PL #9 FEDERAL WAY CONT. PHONE 661-2852
CONT. REG. NO. NORTHUS10
1 J.T 4/91 (OK) OWNER'S PHONE 941-5347 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. 332204-9077
LEGAL DESCRIPTION NA
ISSUED BY
_ DATE OF ISSUE DATE OF APPLICATION 10/4/90
BUILDING INFORMATION
ONE NA
OCCUPANCY NA TYPE OF CONSTRUCTION MECHANICAL BLDG. SO. 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 I() FT. 9-00 BOILER
RECEIVED
BATHTUBS
LAUNDRY DRAINS
COMPRESSOR TANK(S)
SHOWERS
URINALS
FORCED AIR FURNACE AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS POT WATER HTR. 6 - SO MISC.
SINKS
MISC.
CONVERSION BURNER BASIC FEE 20- n0
RETURNED
DISHW, -LIERS
TOTAL FIXTURES NONE
UNIT HEATER TOTAL MECHANICAL 9R _ sn
AMOUNT NOVIR
VALUATION NONF.
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
INSPECTION RECORD
CHANICAL FEE $98
_ 50
TAL BLDG. FEES
f
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 $28.50
Account No. 010-000-322-10-004 Total Fee $ 28.50 Receipt No.
ALL PERMITS EXPIRE 180 DAY
TER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION
URNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET.
r -"
OWNER OR AGENT
DATE
RECEIVED
OCT 41990
CI BUUIAY
BUILDING DEPT.
BOX1 TENANT
ermit
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
OWNER �,111`61/7 /-&?12), /1r/-1 SITE LOCATIO 0,Q_ ' �5 46 " a.2c '
OWNER'S ADDRESS CITY PHONE
DESCRIBE JOB
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME ,,fir" / /.t' -S T L% _G CONTRACTOR'S REG. # XVI / b'_' 1�%/`T.T
//Card MUST be presented
CONTRACTOR'S ADDRESS %�G� J`—G�s% CITY- /-� G%�C� PHONE GIG�Jr�Z
EXPIRATION DATE
—OR—
I HAVE READ CHAPTER 18.27.010 REI AT,
(T400FFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON / Z' /—S Z --i i7 PHONE � }
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER (- —Z . � Z �L 7 7
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
BOX 9 PLUMBING FIXTURES (including rough ins) MECHANICAL APPLIANCES — BASIC FEE $ &,<<
N0. WATERCLOSETS GAS PIPING, FEET $
BATHTUBS NO. FURNACE, ELEC. GAS $ <
SHOWERS _GAS HOT WATER HEATER $
LAVATORIES CONVERSION BURNER $ =A
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 $
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 ASTO 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 AGAINSI THE CIT OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLOYEES, OPON THE ACCUU-CY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT:
DATE: l0 7 —
ANP -008 3/90
MECHANICAL PERMIT
CITY OF BUILDING INSPECTION
FEDERAL WAY 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
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
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
PLUMBING FEE
INSPECTION RECORD
MECHANICAL FEE
TOTAL BLDG. FEES
Water Line OK Mechanical Inspection Notes:
PART RFEE
SEPA REVIEW
GAS PIPING OK Date �C 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 $ 29.450 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.
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 Q.K. TO OCCUPY
DATE B _......._1 . .....
DCD
PSD
I'D
. .
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