90-100176CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
BUILDING INSPECTION
941-1555
qo- /00/�(
90-0235M REN SMITH 31301 33 AVE SW
PERMIT NO.
OWNER'S NAME JOB ADDRESS
CONTRACTOR CITY
SHEET METAL ADDRESS 4202 AUBURN WAY N #8 AUBURN CONT. PHONE 852-2174
CONT. REG. NO. C'_TTYSM1
7 TA 1-191 OWNER'S PHONE NA 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
TAX ACCOUNT NO.
NA LEGAL DESCRIPTION NA
ISSUED BY ELIZABETH
SNYDER DATE OF ISSUE DATE OF APPLICATION 3/79/90
BUILDING INFORMATION
NA NE
OCCUPANCY NA TYPE OF CONSTRUCTION NA BLDG. SO. 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 311— FT. 2-00 BOILER
RECEIVED
BATHTUBS
LAUNDRY DRAINS
COMPRESSOR TANK(S)
SHOWERS
URINALS
FORCED AIR FURNACE 10 _ __0 n AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS HOT WATER HTR. 6 5n MISC.
RETURNED
SINKS
MISC.
CONVERSION BURNER BASIC FEE 7n nn
DISHWASHERS
TOTAL FIXTURES NONE
UNIT HEATER TOTAL MECHANICAL __j8__1j_0
AMOUNT NONE
NONE
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
INSPECTION RECORD
38.50
ECHANICAL FEE
-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
Account No. 010-000-322-10-004 Total 9410�
AMOUNT DUE
$38 _ 5D
Fee $ Receipt No.jLW
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 jNFARM,�TION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS W L BE
MET:)
OWNER OR AGENT /
�� it- / L `-� DATE
r
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 OWNER KZ'y\ S0^6," JOB LOCATION 31 '2, 01 -S _2,A ) 1A -c-- S12
OWNER'S ADDRESSCITY r-eA__C W w 1 PHONE
DESCRIBE JOB C
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION IJ
BOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG. # C (T- Sv�'� 1`l3 - t3 k
Card MUST be presente
CONTRACTOR'S ADDRESS AZL` L ZM 4N.A�VAA_i W!tj KI CfTY fisc )UVB PHONE 21'_3 Z— �}
EXPIRATION DATE
werla e
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 PERSONCC.tiz�- C- v�-c��� 's-, t PHONE
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 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)
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 $
Z5 ,o®
GAS PIPING, FEET 3_z�
$
NO. I FURNACE, ELEC. GAS
"L $
c" •C c'
I GAS HOT WATER HEATER
$
SG
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 KNO E AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PER-
FORM THE WOK FOR HICH PERMIT APPLI ATION IS MADE.
OWNER/AGEN 11 �.0 t2_ DATE:f� D
ANP -006 2/90
0
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
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVA
REMARKS:
DA'
DATE
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
3
TOTAL FEES
SBCC SURCHARGE
ENERGY SURCHARGE
AMOUNT
DUE
BUILDING DEPARTMENT APPROVAL -----------------------------
DATE
3 3 c� Yc
L
REMARKS:
ASSIGNED ADDRESS:
RECEIVED
ACCEPTED FOR FILING
CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING INSPECTION
BUILDING PERMIT
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
OCCUPANCY TYPE OF CONSTRUCTION
BLDG. SQ. FT.
ACKS: 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
FEES
Water Line OK Mechanical Inspection
Notes:
OBLDG.
P/C FEE
SEPA REVIEW
GAS PIPING OK Date y By
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
MECHANICAL PERMIT
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_ ....... __._..
WATER LINE O.K.
GAS PIPING Q.K.
MECHANICAL INSPECTION
DATE _-
O.K. TO ENCLOSE FRAMING
DATE ____ _ _____BY -
INSULATION
DATE _ BY
WALL BOARD AND FIRE WALL
DATE _ _ _BY
FINAL O.K. TO OCCUPY
DATE (0'22 BY'"--
DCD
PSD
FD