91-100044MECHANICAL PERMIT
CITY OF BUILDINGFEDERAL WAY PERMIT
BUILDING INSPECTION
941-1555
91-0009M SALLY KELLY 31910 34 PL
SW #7
PERMIT NO. OWNER'S NAME
JOB ADDRESS
NW WATER HEATER
8201 DURANGO ST SW TACOMA
984-6404
CONTRACTOR
ADDRESS
CONT. PHONE
CONT. REG. NO. NORTHWH103R2 12/91
OWNER'S PHONE 952-4597 OWNER'S ADDRESS SAME
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 MECHANICAL
TAX ACCOUNT NO. 698000-0310
LEGAL DESCRIPTION NA
ISSUED BY ELIZABETH SNYDER
DATE OF ISSUE I I % DATE OF APPLICATION 113/91
BUILDING INFORMATION
ZONE NA OCCUPANCY
NA TYPE OF CONSTRUCTION MECHANICAL
BLDG, S0. FT. NA
SET BACKS: FRONT NA SIDE NA REAR NA STORIES NA
HEIGHT LIMIT NA
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 10.00 AIR HANDLING UNIT
NUMBER
LAVATORIES DRINKING FOUNTAINS GAS RIOT WATER HTR. MISC.
RETURNED
SINKS MISC.
CONVERSION BURNER BASIC FEE 90-00
DISHWASHERS TOTAL FIXTURES
NONE UNIT HEATER TOTAL MECHANICAL 30 - f)0
AMOUNT NnNF
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 $.30-00
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 $30.00
Account No. 010-000-322-10-004 Total Fee $ 30.00
5
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 B
IS TRUE A�CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS W
OWNER OR AGENT
��
DATE
Permit # 7 ` Q G �1
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME:
OWNER ' SITE LOCATION ARkC LTJ C %a VI
OWNER'S ADDRESS L; CITY=k d LU 04 PHONE L159 g
DESCRIBE JOB ` CI C D Y"Y
THE PROPERTY IS OWNED BY: SING E/MARRIED J PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME IV,I V U alt tA, '14L � CONTRACTOR'S REG. # N00 `UJI 16`3
Card MUST be presented
CONTRACTOR'S ADDRESS g1-30) at -U UVm C) �S t"C1� ITY I 0-CC'yy--)CA_ PHONE 924—ILO 4 Oy
EXPIRATION DATE lZ---ZZ-
1'
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 t 11L LC i_ `L.fy _ 1 k PHONE 'LL -i - U, t_j C
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER Ci "
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 (\4 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)
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 ( `$
NO. r FURNACE, ELEC. GAS
k. $
_GAS HOT WATER HEATER
$
CONVERSION BURNER
$
BOILER, SIZE BTU
$
AIR HANDLING UNITS
$
HEAT PUMPS, SIZE
$
UNIT HEATERS
$
AIR COOLING UNITS, SIZE
$
COMMERCIAL HOOD
$
OTHER
$
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: X Jl C ��� ��7 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:
3ECEI -
.iAN- 3 1931
'OF F=EDERAL WAv
WILD!NG DEPT
RECEIVED
ASSIGNED ADDRESS:
PARTIAL PLAN CHECK FEE RECEIVED
Amount Date Receipt #
BUILDING DEPARTMENT APPROVAL
BY 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
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.--
DD. _NEW
NEWMULTI -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 �iOT 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
LUMBING FEE
INSPECTION RECORD
ECHANICAL 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 -- - --
PLUMBING ROUGH IN
DATE __ BY
O.K. TO ENCLOSE FRAMING
DATE - BY
FINAL O.K. TO OCCUPY
DATE
I "I Z _ t I rn r_ 11\
•
OX TO POUR FOUNDATION WALLS
DATE —.. ._ BY —_ ... ..—
WATER LINE O.K. _
GAS PIPING O.K..._
INSULATION
DATE _— —......BY
DCD
PSD
PLUMBING GROUNDWORK
DATE BY
MECHANICAL/INSPECTION
DATE L 1.—.____BYMZ/j, __ _
WALL BOARD AND FIRE WALL
DATE —..._—___ BY
FD