91-100315MECHANICAL PERMIT
CITY OF BUILDINGFEDERAPERMIT
L WAY
j0, _1300 lur
BUILDING INSPECTION
941-1555
PERMIT NO. 91-
M OWNER'S NAME DAVE AUNE JOB ADDRESS 2025 S 296TH STREET
CONTRACTOR NORTHWEST WATER HEATERDDRESS 8201 DURANGO ST SW TACOMA CONT, PHONE 9.84-6404
CONT. REG. NO.
NROTHWH103R2 OWNER'S PHONE 839-9346 OWNER'S ADDRESS .20-79 S 296TH ST FEDERAL
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 OTHER
TAX ACCOUNT NO.
931510-0020 LEGAL DESCRIPTION
ISSUED BY
010 In I
JOANKE JOHNSON DATE OF ISSUE DATE OF APPLICATION 3-14-91
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
ELEC. HOT WATER HEATER
GAS PIPING -- FT. 2 00 BOILER
RECEIVED
BATHTUBS
LAUNDRY DRAINS
COMPRESSOR TANK(S)
SHOWERS
URINALS
FORCED AIR FURNACE 10.00 AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS jiOT WATER HTR. MISC.
RETURNED
SINKS
MISC.
CONVERSION BURNER BASIC FEE 20 _ nn
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL '32 _ nn
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
'39-00
TAL BLDG. FEES
Water Line OK Mechanical Inspection Notes:
PART PIC FEE
GAS PIPING OK Date By
SEPA REVIEW
WATER SERVICE
WATER MAIN CHG.
MECHANICAL PERMIT
S.B.C.C. FEE
OTHER FEES
32.00
Account No. 010-000-322-10-004 Total Fee $ 32.00 Receipt No.
AMOUNT DUE
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 FURNISHEZEIE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTSGOWNER
_4
OR AGENT
DATE- 1
CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT BUILDI41
NG IN 55ECTION
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
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
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 POT 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 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:
OWNER OR AGENT
DATE
0
SET BACKS AND FOOTINGS
DATE . .... .... ___ --BY . . . .. ......
OX TO POUR FOUNDATION WALLS
DATE _., -_BY
PLUMBING GROUNDWORK
DATE
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 . .... . ...... . . ... ....
WALL BOARD AND FIRE WALL
DATE
FINAL O.K. TO OCqUPY 5'DCD
DATE Y
PSD
FD
At oprmit# q�,-.eX�h'�-'°�
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME:
BASIC FEE $
OWNER SITE LOCATION 2 C, 2 1S'.
F
OWNER'S ADDRESS i.0 95_ "` CITY
PHONE D '" 93 W
DESCRIBE JOB ,— ll Gc-S - r� --ct
$
THE PROPERTY IS OWNED BY: SINGLE/MARRIED +x PARTNERSHIP
CORPORATION
BOX 2 CONTRACTOR'S NAME J��,� w t ', i<" 'r CONTRACTOR'S REG. # A� - -' le.._ , .�
$
Card MUST be presented
CONTRACTOR'S ADDRESS�CITY
PHONE 5Z6
EXPIRATION DATE 13 °- �~
LAUNDRY WASHER OUTLET UNIT HEATERS
—OR—
URINALS AIR COOLING UNITS, SIZE
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 r�'� K e
PHONE
BOX 4 SEWER DISTRICT WATER DISTRICT
$
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
$
BOX 6 PROPERTY TAX ACCOUNT NUMBER 13
$
LEGAL DESCRIPTION
$
(If necessary, please submit a separate page with the legal description.)
AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERM IT"APP,LIfATION IS
K.C. Plat Recording #
FEES INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM), WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UN:DE'RSIGNED,
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND
FLOOR /
3RD FLOOR / BASEMENT / DECK /
GARAGE /
BOX 8 ( SINGLE FAMILY ( ) NEW CONSTRUCTION
OWNER/AGENT: C_ Ah DATE:
( ) 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 N0. IL FURNACE, ELEC. GAS
z G $
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
F
$
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 OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERM IT"APP,LIfATION 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 UN:DE'RSIGNED,
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, UPO TH -ACCURACY OFT INFORMATION SUPPLIED TO THE CITY AS A PART OF
THIS APPLICATION.
OWNER/AGENT: C_ Ah DATE:
ANP -008 3/90
ZONE SETBACKS: FRONT_
PLANNING DEPARTMENT APPROVAL
REMARKS:
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
SIDE REAR HEIGHT LIMIT
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DATE
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL DATE
REMARKS:
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ADD/ALT NEW MULTIFAMILY (UNITS )
MULTIFAMILY ADD/ALT TENANT IMP. OTHER
OCCUPANCY TYPE OF CONSTRUCTION STORES
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION
BUILDING DEPARTMENT REMARKS:
ASSIGNED ADDRESS:
Amount
PARTIAL PLAN CHECK FEE RECEIVED
Date
Receipt #
BUILDING DEPARTMENT APPROVAL
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
BY Ah DATE Ak
Mw qw
ACCEPTED FOR FILING
W
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RECEIVED 0
ASSIGNED ADDRESS:
Amount
PARTIAL PLAN CHECK FEE RECEIVED
Date
Receipt #
BUILDING DEPARTMENT APPROVAL
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
BY Ah DATE Ak
Mw qw
ACCEPTED FOR FILING