91-100884MECHANICAL PERMIT
CITY OF
FEDERAL WAY BUILDING PERMIT
91"/008 -may
BUILDING INSPECTION
941-1555
91-842 M
ANTHONY STIPANOVICH 33461 37TH PL SW
PERMIT NO.
OWNER'S NAME JOB ADDRESS
CONTRACTOR NORTHWEST
USI ADDRESS 1908 S. 341ST PL #9 FEDERAL WAY CONT, PHONE 661-2852
CONT. REG. NO. NORTHUS101JJ OWNER'S PHONE 274-0719 OWNER'S ADDRESS 33461 37TH PL SW 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.
LEGAL DESCRIPTION
ISSUED BY JOANNE JOHNSON
DATE OF ISSUE DATE OF APPLICATION 6-21-91
BUILDING INFORMATION
E
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 58 FT. 00 BOILER
RECEIVED
BATH'11BS
LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS
URINALS FORCED AIR FURNACE 10.00 AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS GAS POT WATER HTR. 6.50 MIS(;.AS RANGE 6.50
SINKS
MISC. CONVERSION BURNER BASIC FEE 20-00
D 00DISHWASHERS
RETURNED
DISHWASHERS
TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL 45.00
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
45.00
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
45.00
MECHANICAL PERMIT _
Account No. 010-000-322-10-004 Total Fee 45.00 '3
AMOUNT DUE
$ Receipt No.
ALL PERMITS EXPIRE 180 TER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFOR ATION
F FINISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE ME .
`S 4
OWNER OR AGENT
DATE
• Mit #
RECEIVED CITY OF FEDERA .WAY
ti:.. ;: e.1 1991
BUILDING PERMIT AMPLICATION
— Please Print —
�CATv 04- r -t kA L WAY
BOX NI NAME:
OWNER fn C SITE LOCATION L. 5
OWNER'S ADDRESS .33 S ITV PHONE — 7
DESCRIBE JOB —
THE PROPERTY IS -AWNED BY: SINGLE/MARRIED PAR NERSHIP CORPORATI
BOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG. #�id.�l.lJSl�1 LJ? -
Card MUST be presented
CONTRACTOR'S ADDRESS -50 - 35/ �L. Z�9 CITY PHONE
EXPIRATION DATE .157 — ?21
—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 PHONE /-,-, 6/
BOX 4 SEWER DISTRICT
WATER DISTRICT
BOX 5
ESTIMATED PROJECT COST
EXISTING BUILDING VALUATION
BOX 6
PROPERTY TAX ACCOUNT NUMBER
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
.0
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
OTHER
TOTAL FIXTURES
MECHANICAL APPLIANCES — BASIC FEE $
GAS PIPING, FEET _59 / $
NO.—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 $
_OTHER0CC2-al— 11 $
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 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 CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT:
DATE:
ANP -008 3/90
OFFIOSE ONLY (PLEASE DO NOT WRITE BELOW THINE)
ZONE SETBACKS: FRONT SIDE�y.,� REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL 7'
REMARKS:
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL
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:
RECEIVED
J U N 21 1991
_V ut= -HEIRVIIAIL WAY
ASSIGNED ADDRESS:
Amount
Im
PARTIAL PLAN CHECK FEE RECEIVED
Date
Receipt #
BUILDING DEPARTMENT APPROVAL
DA
DAT
DATE
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
ACCEPTED FOR FILING
CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
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
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
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 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
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.
GASPIPINGO.K_
-2
MECHANICAL INSPECTION
-1 BY -,*7.4
DATE - h 1// -1?/-- -_
O.K. TO ENCLOSE FRAMING
DATE BY
INSULATION
DATE
BY
WALL BOARD AND FIRE WALL
DATE BY
_FF
FINAL O.K. TO OCCUPY
DATE BY
DCD
PSD
D