90-100764MECHANICAL PERMIT
CITY OF
FEDERAL WAY BUILDING PERMIT
BUILDING INSPECTION
941-1555
9a - i00 -7(y
90-1137 M
DRENA PAULSON 33312 33 PL SW
PERMIT NO.
OWNER'S NAME JOB ADDRESS
BOB ' S GAS
INSTALLATION 9008 24TH AVE E TACOMA 531-4719
CONTRACTOR
ADDRESS CONT PHONE
BOBSGIR220QN 838-5164 33312 33RD PL SW FEDERAL WA
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.
NA LEGAL DESCRIPTION NA
ISSUED BY JOANNE JOHNSON DATE OF ISSUE DATE OF APPLICATION 7-9-90
BUILDING INFORMATION
NE
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. 3.50- BOILER
RECEIVED
BATHTUBS
LAUNDRY DRAINS
COMPRESSOR TANK(S)
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 20.0'0
RETURNED
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL 30.00
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 '30-00
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
MECHANICAL PERMIT S
X30—
AMOUNT DUE 30.00
Account No. 0.10-000-322-10-004 Total Fee $ 30. 00 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 MET:
.� `�
OWNER OR AGENT,
DATE ,
RECEIVE'
IiJUL 1 2X90 CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 OWNER f f j ` {'l�'SC=�. JOB LOCATION 23 �I Z -
OWNER'S ADDRESS2. 3 3 V l Sr A 2 CITY R'tx Lk L,!�
DESCRIBE JOB I k.' S—,W t� / '$ sikt'417 `'—
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP
BOX 2 CONTRACTOR'S NAME _IX 'Z `5 C„t1 t L' '
CORPORATION
CONTRACTOR'S REG. #
CONTRACTOR'S ADDRESS CITY i1W✓41fi PHONE
EXPIRATION DATE
�k�
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 _ LI), RC —C- _k PHONE % SI L/
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBE
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legdi 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)
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. 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
OTHER
S
S
TOTAL MECHANICAL FEE $
I CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE
BEST OF MY KNOWEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PER-
FORM THE WORK FOR WHICH 'P(ERMIT APPLICATION IS MADE.
OWNER/AGENT: �- 'Vq YS at DATE: 1-
ANP -006 2/90
CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT BUILDING
941!N 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
VSBACKS:
OCCUPANCY TYPE OF CONSTRUCTION
BLDG. SO. FT.
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
ME HANICAL FEE
BLDG. FEES
Water Line OK Mechanical Inspection
/
Notes: / l Jaz
PA T P ICC FEE
SEPA REVIEW
GAS PIPING OK % -yp "j S_ Date?/f 9C By % .S_
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