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90-101563CITY OF FEDERAL WAY MECHANICAL PERMIT BUILDING PERMIT 9o -i -6i5,63 BUILDING INSP TION 5 PERMIT NO. 90-1766M OWNER'S NAME GEORGE NEILSEN JOB ADDRESS i1114 33 AVE SW CONTRACTOR PACIFIC GAS HEATING/AIRDDRESS 2702 A 112 AVE E TACOMA CONT. PHONE 536-7997 CONT. REG, NO. PACIFGH110ME 791 OWNER'S PHONE 927-7254 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. 438801-0210 LEGAL DESCRIPTION NA ISSUED BY ELIZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION 1118190 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 3-5 _ FT. ?-no BOILER RECEIVED BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S) SHOWERS URINALS FORCED AIR FURNACE 10-0 AIR HANDLING UNIT NUMBER LAVATORIES DRINKING FOUNTAINS GAS�iOT WATER HTR. MISC. RETURNED SINKS MISC. CONVERSION BURNER BASIC FEE gn _ no DISHWASHERS TOTAL FIXTURES NONE UNIT HEATER TOTAL MECHANICAL '18-50 AMOUNT NON'F VALUATION NONE GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE. PERMIT FEE PLAN CHECK FEE UMBING FEE INSPECTION RECORD ECHANICAL FEE $38 50 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. MECHANICAL PERMIT S.B.C.C. FEE OTHER FEES AMOUNT DUE $38.50 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 THE INFORMATION FURNISH 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 t DATE 0\00 rlt�cEjVE NOV os D 1890 C! B p /NERAL wAY G ,DEPT Pen it # k 'I"�geL(2 CITY OF FEDERAL WAY BUILDING PERMIT APPLICATION — Please Print — BOX 1 TENANT NAME: (fit A.p N 2,)1 sen G -v-' ` OWNER SITE LOCATIQU l� OWNER'S ADDRESS I SI.J CITx Wd.� PHONE - DESCRIBE JOB G,!S_ FJQM (4 �'- WCUI!??2ki✓ 11-1—elc THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME 72 L Qr-AS T +- 1 CONTRACTOR'S REG. # p-ALl rC IIcmti $ Card MUST be presented CONTRACTOR'S ADDRESS CITY 7MM M Q PHONE _S3 EXPIRATION DATE UNIT HEATERS $ —OR— AIR COOLING UNITS, SIZE I HAVE READ CHAPTER 18.27.010 RELA ING TO D ITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. COMMERCIAL HOOD BOX 3 CONTACT PERSON PHONE BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST EXISTIING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER 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______J_ 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 ER TOTAL FIXTURES MECHANICAL APPLIANCES — BASIC FEE $ G -v-' ` GAS PIPING, FEET rT 3 S l� NO.- FURNACE, ELEC. GAS ✓ $ 4� 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: DATE:__ aU ANP -008 3/90 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 w )I '' / DATE OF APPLICATION DATE OF ISSUE � BUILDING INFORMATION ZONE OCCUPANCY TYPE OF CONSTRUCTION BLDG. SO. 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�10T 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 UMBING FEE INSPECTION RECORD CHANICAL 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 0 0 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 O.K.___ ., . . .... .. MECHANICAL INSPECTION DATE 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 FID I <rD )4� hftc 6 LOA 4:1 1 M ()-33 0