91-100974CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT BUILDING
941 �N 55ECTION
q)-1Dag7y
91-930 M
THOMAS C RIES 2741 SW 330TH STREET
PERMIT NO.
OWNER'S NAME JOB ADDRESS
CONTRACTOR NORTHWEST
WATER HEATER ADDRESS 8201 DURANGO STREET SW TACOMA CONT. PHONE 984-6404
CONT. REG, NO. NORTHWH103R2 OWNER'S PHONE 874-4680 OWNER'S ADDRESS 1741 SW 330TH ST FEDERAL WAY
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.
894520-0890 LEGAL DESCRIPTION
ISSUED BY JOANNE
JOHNSON DATE OF ISSUE _7I/ -1it/i DATE OF APPLICATION 7-11-91
BUILDING INFORMATION
NE
OCCUPANCY TYPE OF CONSTRUCTION BLDG. SQ. FT.
BACKS: FRONT
SIDE REAR STORIES HEIGHT LIMIT
PLUMBING NO.
NO. MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS
ELEC, HOT WATER HEATER GAS PIPING -3-0— FT. 2-0 0 BOILER
RECEIVED
BATHTUBS
LAUNDRY DRAINS COMPRESSOR TANK(S)
SHC)WERS
URINALS FORCED AIR FURNACE 10-0 n AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS GAS riOT WATER HTR. 6 _ S MISC.
RETURNED
SINKS
MISC. CONVERSION BURNER BASIC FEE 0
DISHWASHERS
TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL A
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
3$ 50
BLDG. FEES
Water Line OK Mechanical Inspection Notes:
ISAL
T 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
3R _ sn
Account No. 010-000-322-10-004 Total Fee $ 38.50 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 TH FORM
IO=FURNISHED E TRUE AND"'CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTSLL BF_ MET:
OWNER OR AGENT
�� DATE 7-4:7-
-</
RECEIVED ermit #
JUL 11 i%i CITY OF FEDERAL WAY
CITY OFFEDEFIALWAY BUILDING PERMIT APPLICATION
WLDM DM — Please Print —
BOX 1 TENANT NAME:
OWNER «_ SITE LOCATION, �f I 33C S Fc c�Jc= (C
OWNER'S ADDRESS L47 5 (V � `� CITY Me c= PHONE
DESCRIBE JOB r�_,crW-Ct
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME IVC( -4M►= 0A t4:v.&, _ s_ CONTRACTOR'S REG. # ACO K 7_1Y k-)ff It, S (/-
and MUST be presented
CONTRACTOR'S ADDRESS 132,6 c t' �� %�' �� � C'' CITY 10-6-C if �,ci PHONE
EXPIRATION DATE
—OR—
I HAVE READ CHAPTER 18.27.010 RELATING 0 DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON / �, V t.-- PHONE -q _ �
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST "6C , C, C EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER ` 5_9-C C 5
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 (, ,T'�INGLE 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 $
N0. WATERCLOSETS
GAS PIPING, FEET ='r
$
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
$
S MPS, SPRINKLER VACUUM BREAKERS
OTHER
$
RAINS
$
OTHER
$
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 EMPLOYEEV UPON TW ACCURACY OF TA INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
L
OWNER/AGENT: DATE: �� f
ANP -008 3/90
MECHANICAL PERMIT
CITY OF
FEDERAL WAY BUILDING PERMIT BUILDING 941!N555ECTION
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. S0. 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�40T 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
OX TO POUR FOUNDATION WALLS
DATE BY
PLUMBING GROUNDWORK
DATE ____ -- ____BY
PLUMBING ROUGH IN
DATE BY . . .......
WATERLINE O.K.MECHANICAL
GAS PIPING O.K.
INSPECTION
DATE - 71-1101- --BY
O.K. TO ENCLOSE FRAMING
DATE BY
INSULATION
DATE
BY
WALL BOARD AND FIRE WALL
DATE BY
FINAL O.K. TO OCCUPY
DATE BY
DCD
PSD
I'D