91-101293CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
BUILDING INS4ECTION
941-1555
PERMIT NO. 91-1268 M
OWNER'S NAME ROBERT WALKER JOB ADDRESS 32865 40 CT SW
CONTRACTOR NORTHWEST
WATER HTR ADDRESS 8201 DURANGO ST SW TACOMA CONT. PHONE 984-6404
CONT. REG. NO. NORTHWH103R2 1291 OWNER'S PHONE 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 SEE BELOW
TAX ACCOUNT NO. 873204-0690 LEGAL DESCRIPTION NA
ISSUED BY ELIZABETH
SNYDER DATE OF ISSUE I- !9�1 7 —�i / DATE OF APPLICATION 911 0/91
BUILDING INFORMATION
NE
F-.z,c,,:T
OCCUPANCY TYPE OF CONSTRUCTION BLDG. SQ. FT.
BACKS: FRONT
SIDE REAR STORIES HEIGHT LIMIT
NO.
NO.
MECHANICAL APPLIANCES AMT. AMT.
BOND
50 2.00
WATA CLOSETS
ELEC. HOT WATER HEATER
GAS PIPING FT. BOILER
RECEIVED
BATHTUBS
LAUNDRY DRAINS
COMPRESSOR TANK(S)
SHOWERS
URINALS
FORCED AIR FURNACE GAS' 0.00 AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS riOT WATER HTR. 6.50 MISC.
20.00
RETURNED
SINKS
MISC.
CONVERSION BURNER BASIC FEE
DISHWASHERS
TOTAL FIXTURES NONE
UNIT HEATER TOTAL MECHANICAL7+-8750
AMOUNT NONE
38.50
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
INSPECTION RECORD
$38.50
MECHANICAL FEE
TOTAL BLDG. FEES
Water Line OK Mechanical Inspection Notes:
T PIC FEE
A REVIEW
GAS PIPING OK Date By
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES
MECHANICAL PERMIT
S
AMOUNT DUE
Account No. 010-000-322-10-004 Total Fee $ 38.50 Receipt No. 5—
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 INFOPMATtON
FURNISHED BY ME IS RUE AND COR - T -TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL B ET:
OWNER OR AGENT '
- DATE '�
Permit # q I - (2-6
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME:
OWNER KQ •4 i %Ua SITE LOCATION `c " SUJ
OWNER'S ADDRESS C S CITY s/ PHONE
DESCRIBE JOB - e-4
THE PROPERTY IS OWNED BY: SINGLE/MARRIED L�_ PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME o-f� 'f CONTRACTOR'S REG. # A-KkAt lC.;
/ Card MUST be presented
CONTRACTOR'S ADDRESS �a0
OW S CITY � mss'` PHONE 9Sf V V
EXPIRATION DATE
—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 nuc e—t_ PHONE t(– &
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST -7 0 0 6, 00 EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER r 7 C C% c
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
1 •
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
MECHANIQAL APPLIANCES —
BASIC FEE $
GAS PIPING, FEET -5 c " 1 "
$
N0. FURNACE, ELEC. GAS
i� $
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 OFTHE CITY, INCLUDING ITS
OFFICERS AND EMPLOYE, UPgN TfiE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT:
lylAft & DATEs/,d
:
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 DATE
REMARKS:
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
SEP 12 1991
`yWFE DePTWAY
DW
RECEIVED
ASSIGNED ADDRESS:
Amount
PARTIAL PLAN CHECK FEE RECEIVED
Date
Receipt #
BUILDING DEPARTMENT APPROVAL
BY DAT
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
ACCEPTED FOR FILING
CITY Cir''
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT BUILDI94 1555ECTION
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
qw
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 rIOT 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
LUMBING 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
SET BACKS AND FOOTINGS
DACE __.... BY
O.K TO POUR FOUNDATION WALLS
DATE __ __._. BY
PLUMBING GROUNDWORK
DATE BY _
PLUMBING ROUGH IN
DATE -_..._ BY
WATERLINE O.K. ___._
GAS PIPING O.K._. /l"l<�_1'i1�"l_--
MECHANICAL INSPECTION
DATE ll_/v _ !�___BY
O.K. TO ENCLOSE FRAMING
DATE _.- __.....BY _._-
INSULATION
DATE ...- _- _.BY _
WALL BOARD AND FIRE WALL
DATE BY
FINAL O.K. TO OCCUPY
�(
DATE /L. hL-t _BY ......
DCD
PSD
FD