90-100504MECHANICAL PERMIT
CITY OF
FEDERAL WAY BUILDING PERMIT
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BUILDING INSPECTION
941-1555
90,)00s0y
90-
CHAFFEY CORP
2829 SW 342ND PLRELIABLM—STM
PERMIT NO.
TWNEERR'�NAME JOB ADDRESS
120TIl - 6868
CONTRACTOR
11447
ALL ADDRESS
AVE NE1C1 50T Pkj�]AI
REL
CONT. REG. NO.
-
OWNER'S PHONE OWNER'S ADDRESS 1�1
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.
LOT 4/ GROUSE FL)INTE
LEGAL DESCRIPTION
JOANNE JOHNSON
ISSUED BY
DATE OF ISSUE DATE OF APPLICATION
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. 2.00BOILER
BATHTUBS
LAUNDRY DRAINS COMPRESSOR TANK(S)
RECEIVED
10 00
SH�WERS
.
URINALS FORCED AIR FURNACE AIR HANDLING UNIT
NUMBER
6.50
LAVATORIES
DRINKING FOUNTAINS GAS HOT WATER HTR. MISC.
SINKS
MISC. CONVERSION BURNER BASIC FEE 6
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
PLUMBING FEE
INSPECTION RECORD
CHANICAL FEE 38.50
OTAL 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 38.50
MECHANICAL PERMIT 38.50
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:
L A;?
OWNER OR AGENT
DATE
/
RECEIVED
�qI �
MAY 2 3 13310
0ITY OF FEDERAL WAY
CITY OF FEDERAL WAY BUILDING DEPT
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 OWNER ChaffedorationJOB LOCATION 2829 Sul 342nd Pl Lot 47
OWNER'S ADDRESS P_O. Box 560 CITY Kirkland PHONE 822-5981
DESCRIBE JOB New in.tallatin mechanir•al system fL ac ,Imo, Ras piping
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION X
BOX 2 CONTRACTOR'S NAME _ Rel i ahl e Sheet Metal CONTRACTOR'S REG. # RR -LT -AS -144- 7RS
Card MUST be presented
CONTRACTOR'S ADDRESS 11447 120th Ave NE CITY Kirkland PHONE 823-6868
EXPIRATION DATE 12/90
Effiffim
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 Johnson PHONE 823-6868
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUM
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 (X) SINGLE FAMILY (X) 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 $ 20.00
N0. WATERCLOSETS
GAS PIPING, FEET miner 100'
$ 2 on
BATHTUBS
NO. 1 FURNACE, ELEC. GASB_
$ 10 0000
SHOWERS
I_GAS HOT WATER HEATER
$ —658
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
$ zQ sn
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 PER-
FORM THE WORK FOR WtiICH_PERf4flT APPLICATION IS MADE.
OWNER/AGENT:
DATE: 5121/90
ANP -006 2/90
MECHANICAL PERMIT
CITY OF
FEDERAL WAY BUILDING PERMIT
/P1 h/(-,
BUILDING INSPECTION
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
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 HOT 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
HANICAL FEE
L 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
AMOUNT DUE
MECHANICAL PERMIT
Account No. 010-000-322-10-004 Total Fee $
Receipt No.
A iA,. t
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 10
SET BACKS AND FOOTINGS
DATE _ __ BY . . ....... -
OX TO POUR FOUNDATION WALLS
DATE BY _ ___
PLUMBING GROUNDWORK
DATE ... . . . ...... . -__ __ BY .. .... . . .. ... ..
PLUMBING ROUGH IN
DATE .... . ........ __ - - BY . .......
WATERLINE O.K.
GAS PIPING O.K._._
. .. . . .... ... .
. . .... .... ____ .
. ....
MECHANICAL INSPECTION
DATE _ . .. ... --BY
O.K. TO ENCLOSE FRAMING
DATE
INSULATION
DATE .... . ... .... . .... ...
. ........BY
WALL BOARD AND FIRE WALL
DATE __- ..
FINAL O.K. TO OCCUPY
DATE _BY . .... .
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