91-100923MECHANICAL PERMIT
CITY OF
FEDERAL WAY BUILDING PERMIT
91- /009'1
BUILDING INSPECTION
941-1555
PERMIT NO. 91-883 M
OWNER'S NAME E O REHFELD JOB ADDRESS 31405 41ST AVE SW
CONTRACTOR WESTERN
FURANCES INC ADDRESS 2901 S TACOMA WAY P O BOX 11145 TACOMhNT. PHONE 474-8401
CONT. REG. NO. WESTEF372NO OWNER'S PHONE 838-1587 OWNER'S ADDRESS 31405 41ST AVE SW
FEDRAL 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.
IU3198-2540-05 LEGAL DESCRIPTION
ISSUED BY JOANNE JOHNSON DATE OF ISSUE DATE OF APPLICATION — —
(REC ' D 7
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. A _ 50 BOILER
RECEIVED
BATHTUBS
LAUNDRY DRAINS
COMPRESSOR TANK(S)
SF70WERS
URINALS
2 FORCED AIR FURNACE 20-00 AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS POT WATER HTR. MISc.
RETURNED
SINKS
MISC.
CONVERSION BURNER BASIC FEE
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL 43 5O
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
4350
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
43.50
Account No. 010-000-322-10-004 Total Fee $ 43.50 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 BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET:
�y
OWNER OR AGENT /�`
ti- �_ 7
Q DATE Z
v
n r• tee.
JUL 1ISM
CITY OF FEDERAL WAY 4 _
BUILDING PERMIT APPLICATION `
— Please Print —
BOX 1
OWNER E. O. Rehfeld JOB LOCATION 31405 -41st
Ave. S.W.
$
OWNER'SADDRESS 31405 -41st Ave. S.W. CITY Federal Way
PHONE 838-1587
GAS HOT WATER HEATER
DESCRIBE JOB
CONVERSION BURNER
$
THE PROPERTY IS OWNED BY: SINGLE/MARRIED XXX PARTNERSHIP
CORPORATION
BOX 2
CONTRACTOR'S NAME Western Furnaces, Inc. CONTRACTOR'S REG. # WESTEF*372ND
HEAT PUMPS, SIZE
2901 South Tacoma Way
Card MUST be presented
$
CONTRACTOR'S ADDRESS P.O. Box 11145 CITY Tacoma
PHONE 474-8401
COMMERCIAL HOOD
EXPIRATION DATE 12/31/91
OTHER
$
—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
PHONE
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5
ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6
PROPERTY TAX ACCOUNT NUMBER Parcel #873198-2540-05
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 $
GAS PIPING, FEET
$
N0. 2 FURNACE, ELEC. GAS
XXX $
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 PER-
FORM THE WORK
"44116-r-11"–)FOR WHICH PERMIT APPLICATION IS MADE.
OWNER/AGENT: rLe_lt� DATE: dune 25, 1991
0 is ANP -006 2/90
MECHANICAL PERMIT
CITY OF BUILDING PERMIT BUILDING INSPECTION
FEDERAL WAY 941-1555
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 1z DATE OF APPLICATION
BUILDING INFORMATION
ONE
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 RIOT 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 SUF
E.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
INSPECTION RECORD
CHANICAL FEE
OTAL BLDG. FEES
Water Line OK Mechanical I
PART P/C FEE
SEPA REVIEW
GAS PIPING OK Date B
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES
MECHANICAL PERMIT
AMOUNT DUE
Account No. 010-000-322-10-004 Total FPe $
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
r J
REQUIREMENTS WILL BE MET:
OWNER OR AGENT
DATE
0
•
SET BACKS AND FOOTINGS
DATE _ -_.-----BY _. ---_ _
O.K 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
FD
f G/2 S