90-100720r
CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
BUILDING INSPECTION
941-1555
9b'1bb72-n
PERMIT NO. 90-1294M OWNER'S NAME LOTZEGSELLE JOB ADDRESS 3 0 9 0 R 3A AVE gW
CONTRACTOR SI REFRIGERATION
ADDRESS 420 3% AVE NTMI AUBURN CONT. PHONE939-9368
CONT. REG. NO SIREF16106 7
A I OWNER'S PHONE NA OWNER'S ADDRESS RAMP.
TYPE JOB: NEW RESIDENCE ADDITION
T NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTIFAMILY (UNITS ) MULTI. ADD.
SIGN GRADING OTHER MRCHANTCAT, ONT.Y
TAX ACCOUNT NO. NA
LEGAL DESCRIPTION NA
ISSUED BY ELIZABETH SNDYER
DATE OF ISSUE e DATE OF APPLICATION 813190
BUILDING INFORMA ON
. JNE NA OCCUPANCY
NA TYPE OF CONSTRUCTION MECHANICAL ONLY BLDG. SO. FT. NA
SET BACKS: FRONT NA
SIDE NA REAR NA STORIES Nn HEIGHT LIMIT j
PLUMBING NO.
NO.
MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS ELEC. HOT WATER HEATER
GAS PIPING 30 FT. 2-00 BOILER
R
RECEIVED
BATHTUBS LAUNDRY DRAINS
COMPRESSOR TANK(S)
SHOWERS. URINALS
FORCED AIR FURNACE i n _ n0 AIR HANDLING UNIT
NUMBER
LAVATORIES DRINKING FOUNTAINS
GAS HOT WATER HTR. 6 S0 MISC.
SINKS MISC.
CONVERSION BURNER BASIC FEE 20 r�A
RETURNED
DISHWASHERS TOTAL FIXTURES 19ONE_
UNIT HEATER TOTAL MECHANICAL :jA F8
AMOUNT NONE
VALUATION NONE
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
INSPECTION RECORD
MECHANICAL FEE $_-Ag _ S O
TAIL BLDG. FEES
1ffRT
Water Line OK Mechanical Inspection Notes:
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 $38.50
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
>ti +} DATE
ti
RECEIVED Is %nit # C C ,7-(m.
A�5 0 3 1990 CITY OF FEDERAL WAY
CITY OFJERALWAy BUILDING PERMIT APPLICATION
BUILDING DEPT. — Please Print —
BOX 1 TENANT NAME:
OWNER 9�1 SITE LOCATION_ -307 0
OWNER'S ADDRESS CITY PHONE
DESCRIBE JOB T c -A A Z �.
THE PROPERTY IS OWNED BY: SINGLE/MARRIED V"__1 PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S.NVAME CONTRACTOR'S REG. # S I. 4j� % 1 b 14
S r .-5—j_)` d `� S� �` 1 Card MUST be prese tedd
CONTRACTOR'S ADDRESS ��,� -� 1c1 CITY '�11 xI PHONE �d'
EXPIRATION DATE
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 .RW 0, �13: 7 �V,'/ PHONE ,
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______1_ GARAGE /
N
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)
MECHANICPL APPLIANCES
— BASIC FEE $
N0. WATERCLOSETS
GAS PIPING, FEET —3 0
$
BATHTUBS
N0. FURNACE, ELEC. GASB $
SHOWERS
XGAS 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
$
$i
TOTAL FIXTURES
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: ��.��i+rt"—` DATE:
ANP -008 3/90
MECHANICAL PERMIT
CITY OF BUILDING PERMIT BUILDING INSPECTION
FEDERAL WAY 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 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
MECHANICAL FEE
TOTAL BLDG. FEES
Water Line OK MecPaniF al Inspection
Notes: C L�Pro0d
v_ dew
PART P/C FEE
SEPA REVIEW
GAS PIPING OK Date /o - ZS- /�'Y B (CC__
f
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.
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 .K TO OCCUPY
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