92-102372CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
91, ► o J3 -7-)
BUILDING INSPECTION
661-4140
92-1120 M NOMIJAMA 32020 40TH PL SW
PERMIT NO. OWNER'S NAME SITE ADDRESS
SOUTHWEST PLUMBING 10431 16TH AVE SW SEATTLE 932-1777
CONTRACTOR ADDRESS CONT. PHONE
SOUTHP172CG 2/93 838-0580 32020 40TH PL SW FEDERAL WAY
CONT. REG. NO. EXP. OWNER'SPHONE OWNER'SADDRESS
TYPEJOB: NEWRESIDENCE ADDITION NEW INDUSTRIAL NEWCOMMERCIAL COMMERCIAL ADD. INDUSTRIALADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI -FAMILY (UNITS MULTI. ADD. SIGN GRADING OTHER
873190-2630
TAX ACCOUNT NO. LEGAL DESCRIPTION
ISSUED BY JOANNE JOHNSON DATE OF ISSUE DATE OF APPLICATION 7-21-92
BUILDING INFORMATION
ZONE SET BACKS: FRONT SIDE REAR HEIGHT LIMIT
OCCUPANCY TYPE OF CONSTRUCTION CENSUS NO. TYPE OF HEAT BLDG. SQ. FT. STORIES
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING FT. 2.00 GAS LOGS
RECEIVED
BATHTUBS LAUNDRY DRAINS FORCED AIR FURNACE DUCT WORK
SHOWERS URINALS GAS HOT WATER HTR. 6.50 AIR HANDLING UNIT
NUMBER
LAVATORIES DRINKING FOUNTAINS CONVERSION BURNER MISC.
SINKS MISC. BBQ BASIC FEE 20.00
RETURNED
DISHWASHERS TOTAL FIXTURES DRYER TOTAL MECHANICAL 28.50
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 28.50
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.
S.B.C.C. FEE
OTHER FEES
MECHANICAL PERMIT
AMOUNT DUE 28.50
Total Fee $ 28.50 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 FURNISHED BSC M TRUE D CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET:
C
OWNER OR AGENT DATE
r -
'
RECOVER
2
Permit # 71 i -o
JUL Z 1 199 CITY OF FEDERAL WAY
+ �� 13ADNG L �`�{BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME:
OWNER
OWNER'S ADDRESS 2U
DESCRIBE JOB Gor vey L -It tevh
THE PROPERTY IS OWNED BY: SINGLE/MARRIED
BOX 2 CONTRACTOR'S NAME
SITE LOCATION3 20 7_ D - `f �. �/• S• 4/,
CITY ICP fro, PHONE �2_5
PARTNERSHIP - CORPORATION
Nyo b1,01- CONTRACTOR'S REG. #_ sy aTH�
J Card MUST be presented
CONTRACTOR'S ADDRESS i911e /-/-.CITY �e ��� �� PHONE J32--/72,2 01
EXPIRATION DATE Z97– — 5
—OR—
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 Oil/ 014e -AI '" %a, -i PHONE '7 :32- —/ % % %
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.)
K.C. Plat Recording #
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
$
N0. 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 r%GnVfv� G✓U f'�y
P_w�t�$
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,q FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLOYE ON THE ACCURACY OF THE INEWMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT:
DATE:
Z �_ l
ANP -008 3/90
ZONE SETBACKS:FRONT
PLANNING DEPARTMENT APPROVAL
REMARKS:
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
SIDE REAR HEIGHT LIMIT
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL
REMARKS:
DA
v 14)
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. 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
BUILDING DEPARTMENT REMARKS:
RECEIVED
ASSIGNED ADDRESS:
PARTIAL PLAN CHECK FEE RECEIVED
Amount Date _ Receipt #
BUILDING DEPARTMENT APPROVAL
BY DATE -
0
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
0
ACCEPTED FOR FILING
MECHANICAL PERMIT
CITY OFBUILDING
BUILDING INSFEDERAL WAY PERMIT 661-4140
92-1120
M NOMJAM 32020 40V PL SW
PERMIT NO.
OWNER'S NAME SITE ADDRESS -
SOMMEST
UMBING hi
TAVESFA`_T?,F 932 -177f
2-1T7TCONT.
CONTRACTOR
E S10431
CONT. PHONE
5 $
���� 4 TH PT. SW FLFUSRAL WAY
CONT. REG. NO.
EXP. OWNER'S PHONE OWNER'S ADDRESS -12020
TYPEJOB: NEWRESIDENCE
ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW _
( N T1S g8LTI. ADD. SIGN GRADING OTHER
TAX ACCOUNT NO. NO.
]] LEGAL DESCRIPTION
;3OAM$ JOS I 7-21-92
ISSUED BY
DATE OF ISSUE DATE OF APPLICATION
BUILDING INFORMATION
ZONE
SET BACKS: FRONT SIDE REAR HEIGHT LIMIT
OCCUPANCY
TYPE OF CONSTRUCTION CENSUS NO. TYPE OF HEAT BLDG. SQ. FT. STORIES
PLUMBING NO.
NO.
MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS
ELEC. HOT WATER HEATER
GAS PIPING FT. L • 0L GAS LOGS
RECEIVED
BATHTUBS
LAUNDRY DRAINS
FORCED AIR FURNACE DUCT WORK
SHOWERS
URINALS
GAS HOT WATER HTR. 6.90 AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
CONVERSION BURNER MISC.
SINKS
MISC.
BBQ BASIC FEE 20 .00
RETURNED
DISHWASHERS
TOTAL FIXTURES
DRYER TOTAL MECHANICAL 28.50
AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
FEE
INSPECTION RECORD
16UMBING
28.50
CHANICAL FEE
TOTAL BLDG. FEES
Water Line OK Mechanical Inspection Notes:
PART PIC FEE
SEPA REVIEW
GAS PIPING OK Date- % By
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES
MECHANICAL PERMIT
AMOUNT DUE
"'
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 AY
REQUIREMENTS WILL BE MET:
OWNER OR AGENT
DATE