90-100195CITY OF
Ff-DERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
BUILDING INSPECTION
941-1555
PERMIT NO. 90-265 M
OWNER'S NAME RICHARD. GARALD D JOB ADDRESS '19145 i lRn AVI NTTF. S _ W _
CONTRACTOR BASIC
FIRE PROTECTIQNRESS 10719 "A" STREET S. VA" TACOMA 98444 CONT. PHONE 535-1163
CONT. REG. NO. AS _T*
_35RT. OWNER'S PHONE 874-3305 OWNER'S ADDRESS 32145 33RD AVENUE S.W.
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
Wiz- DATE OF ISSUE -tic,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 -4 -'0 BOILER
RECEIVED
BATHTUBS
LAUNDRY DRAINS
COMPRESSOR TANK(S)
SHOWERS
URINALS
FORCED AIR FURNACE AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS HOT WATER HTR. — $650 MISC. DRYERRETURNED O
SINKS
MISC.
CONVERSION BURNER BASIC FEE
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL 36 5
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 36.50
TAL BLDG. FEES
Water Line OK Mechanical Inspection Notes:
PART PIC FEE
SEPA REVIEW
GAS PIPING OK Date By
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES
MECHANICAL PERMIT
AMOUNT DUE
a�
Account No. 010-000-322-10-004 Total Fee $ 3 J� Receipt No. S
p
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
- -1�' -��1�_ DATE
•
0
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 OWNER Cr JOB LOCATION �C / ' J _9.- '
OWNER'S ADDRESS 3 ;3.2 6'L5iQ! CITY F PHONE.9T,-1 - 3 k2j—
DESCRIBEJOB -r,NS_TAkA"rC7A1 .0- Hy/"WAL,1 I' HecC%z:�r kNn% 12,f)` Cp
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME AS i C P Rr't ri CONTRACTOR'S REG. #_9 Sz'T*-2y6;
_ r
Card MUST be presented ��
CONTRACTOR'S ADDRESS U 7/ (' fI S//f .S L?. i4 CITY /%� C'� PHONED" -2 /%ro 1
EXPIRATION DATE
—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
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.)
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 $ 2-0-00
N0. WATERCLOSETS
GAS PIPING, FEET
$ '7.5-d
BATHTUBS
N0. FURNACE, ELEC. GAS
$
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 VAly ff
$
DRAINS
$
OTHER
$
TOTAL FIXTURES
$
TOTAL MECHANICAL FEE
$ 3E rc�
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 VVH19.1j PERMIT APPLICCATION IS MADE %-
�
OWNER/AGENT: ��� == �'r `� �Lf
DATE:
ANP -006 2/90
0
Ll
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE SETBACKS: FRONT SIZE
REAR
HEIGHT LIMIT-`
PLANNING DEPARTMENT APPROVAL
REMARKS:
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL
DATE
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL
DATE
REMARKS:
TYPE OF JOB: NEW RESIDENCE S. ADD/ALT
NEW INDUSTRIAL
IND. ADD/ALT
NEW COMMERCIAL COMM. AICD/ALT
NEW MULTIFAMILY
(UNITS )
MULTIFAMILY ADD/ALT TENANT IMP.
ROOF 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
EBUILDING PERMIT NO. PLAN CHECK FEE RECD
RECEIPT NO.
PERMIT FEE PLAN CHECK FEE - -
- - - - - PLUMBING FEE
- - - - - - - MECH. FEE 3C, y
TOTAL FEES SBCC SURCHARGE
ENERGY SURCHARGE AMOUNT DUE '.36-2_0
BUILDING DEPARTMENT APPROVAL -----------------------------
DATE
REMARKS:
ASSIGNED ADDRESS:
RECEIVED
ACCEPTED FOR FILING
MECHANICAL PERMIT
CITY OF FEDERAL WAY BUILDING PERMIT BUILDI94 IN SSECTION
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 HOT WATER HTR. MISC.
SINKS
MISC.
CONVERSION BURNER BASIC FEE
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
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
O.K TO POUR FOUNDATION WALLS
DATE _.._ _BY _..
PLUMBING GROUNDWORK
DATE _.--. — BY
PLUMBING ROUGH IN
DATE __— --_ BY ----...
WATERLINE O.K.
GAS PIPING O.K._.-'Vv�o
_....- __—._...
l
MECHANICAL INSPECTION
DATE _ '__ 1 _-BY
O.K. TO ENCLOSE FRAMING
DATE _ — BY _
—
INSULATION
DATE
BY __
WALL BOARD AND FIRE WALL
DATE .._.BY
FINAL O.K. TO OC UPY
DATE � � BY
DCD
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