90-100227CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT BUILDING 941-I
SSSECTION
PERMIT NO. 90-0308M (2) OWNER'S NAME PAULA HOFFMAN JOB ADDRESS 33244 39
AVE SW
CONTRACTOR BASIC INSTALLATION ADDRESS 10719 A ST S #A TACOMA
CONT. PHONE
9;3r,-11 63
CONT. REG. NO. BASIC*235R1 291 OWNER'S PHONE 228-5813 OWNER'S ADDRESS SAME. AS SITE.
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 ONLY
TAX ACCOUNT NO. NA LEGAL DESCRIPTION NA
ISSUED BY ELIZABETH SNVDRR DATE OF ISSUE DATE OF APPLICATION 4.111190
BUILDING INFORMATION
ONE NA OCCUPANCY NA TYPE OF CONSTRUCTION NA
BLDG, SO. FT.
NA
SET BACKS: FRONT NA SIDE NA REAR Nps STORIES NA
HEIGHT LIMIT
NA
PLUMBING NO. NO.
MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS ELEC. HOT WATER HEATER
BATHTUBS LAUNDRY DRAINS
GAS PIPING FT. BOILER
COMPRESSOR TANK(S)
RECEIVED
SHOWERS URINALS
FORCED AIR FURNACE AIR HANDLING UNIT
NUMBER
LAVATORIES DRINKING FOUNTAINS
GAS HOT WATER HTR. 6-50 MISC.
SINKS MISC.
CONVERSION BURNER BASIC FEE 20 00
RETURNED
_
DISHWASHERS TOTAL FIXTURES NONE_
UNIT HEATER TOTAL MECHANICAL 24. SQ
I 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 2650
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
MECHANICAL PERMIT
AMOUNT DUE $26-50
Account No. 010-000-322-10-004 Total Fee $ �� . �
Receipt No.
(/ L 7
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 RE MET:
.)
OWNER OR AG C = �✓�c* �. DATE
C�)
CITY OF FEDERAL WAY �9/�Qq'�< y0
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 OWNER /i aL A /-ie Alh.4 JOB LOCATION � � 3 Y A L -
OWNER'S ADDRESS `3 '_ y� 3f All S Jv CITY _
, PHONE
DESCRIBE JOB :;C-'Y57.4�<)V&A'rel,
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME &4 / L! �7 44ACONTRACTOR'S REG. # SiC"K
La resen ed
CONTRACTOR'S ADDRESS, l O CITY /ReC Af h PHO S "7lrc�
EXPIRATION DATE
—OR—
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
BOX 9 PLUMBING FIXTURES (including rough -ins)
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
LAVATORIES
CONVERSION BURNER
(If necessary, please submit a separate page with the legal description.)
BOX 7
BUILDING SQUARE FOOTAGE:
3RD FLOOR /
(Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
BASEMENT / DECK / GARAGE /
BOX 8
( ) SINGLE FAMILY
( ) MULTIFAMILY (NO. OF UNITS =
( ) COMMERCIAL/INDUSTRIAL
( ) NEW CONSTRUCTION
) ( ) EXISTING STRUCTURE
TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHAf�JCAL APPLIANCES —
BASIC FEE $ 2(_
N0. WATERCLOSETS
GAS PIPING, FEET ��"
$
BATHTUBS
NO. 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
$
D AINS
$
THER
$
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 PER-
FORM THE WORK FOR PERMIT APPLICATION IS
MADE.
%%WHICH
OWNER/AGENT:
ANP -006 2190
ZONE SETBACKS:FRONT_
PLANNING DEPARTMENT APPROVAL
REMARKS:
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
SIZE 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.
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 REC'D
RECEIPT NO.
PERMIT FEE
PLAN CHECK FEE - -
- - - - - PLUMBING FEE
- - - - - - - MECH. FEE
TOTAL FEES
SBCC SURCHARGE
ENERGY SURCHARGE
AMOUNT DUE
BUILDING DEPARTMENT APPROVAL -----------------------------
DATE
REMARKS:
ASSIGNED ADDRESS:
RECEIVED
APR. 1 1 1590
@ OF FC0-ERAL WAY
RECEIVED
ACCEPTED FOR FILING
CITY OF
FEDERAL WAY
MECHANICAL: PERMIT
BUILDING PERMIT BUILDING
941!N 55ECTION
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 APPS !CATIO.1
BUILDING INFORMATION
T
OCCUPANCY TYPE OF CONSTRUCTION
BI_Gea. SO. F?__
S ACKS: FRONT
SIDE REAR STORIES
HEIGHT LIVI"i �..—,
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 WIT`TESSED BY INSPECTOR.
AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEEISPECTION
RECORD
MECHANICAL FEE
0L BLDG. FEES
Water Line OK � Mechanical Inspection
Notes:
f P/C FEE
SEPA REVIEW
GAS PIPING OK Date y-/�- By /l
O/U '6712,441 �
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