92-101022CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
BUILDING INSPECTION
661-4140
92-1081 M THIBADEAU 31423 42ND PL SW
PERMIT NO. OWNER'S NAME SITE ADDRESS
RENNIE SHEET METAL IA&ESS 4820 S. WASHINGTON TACOMA CONT. PHONE472-4099
CONTRACTOR
RENNISM110QN 11/92OWNER'S 838-4430 31423 42ND EL SW FEDERAL WAY
CONT. REG. NO. EXP PHONE OWNER'S ADDRESS
TYPEJOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI -FAMILY (UNITS ) MULTI. ADD. SIGN GRADING OTHER
873199-0350
TAX ACCOUNT NO. LEGAL DESCRIPTION
ISSUED BY JOANNE JOHNSON DATE OF ISSUE ! DATE OF APPLICATION 7-15-92
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 0 GAS LOGS
.
BATHTUBS LAUNDRY DRAINS FORCED AIR FURNACE 10.00 DUCT WORK
RECEIVED
SHOWERS URINALS GAS HOT WATER HTR. 6.50 AIR HANDLING UNIT
NUMBER
LAVATORIES DRINKING FOUNTAINS CONVERSION BURNER MISC.
SINKS MISC. BBQ BASIC FEE _2k_0
RETURNED
DISHWASHERS TOTAL FIXTURES DRYER TOTAL MECHANICAL 38.5
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 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.
S.B.C.C. FEE
OTHER FEES
MECHANICAL PERMIT
AMOUNT DUE 38.50
GG
Total Fee $ 38.50 Receipt No.
AL6 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 B� MET:
OWNER OR AGENT��t�'�' DATE
RECEIVED BY 1
MUNITY DEVELOPMENT DEPARTMENT • lI'mjt # �` I
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
Please Print —
,j
BOX 1
TEaA"II h
ttaEVt,
GASPIP NG, FEET
$
NO. FURNACE, ELEC. GAS
OWNER -7 X 1,P
SITE LOCATION
$
CONVERSION BURNER
OWNER'S ADDR S x'1423 41- A.
CITY .^t7L
PHONE 8:39-44-1-b
AIR HANDLING UNITS
DESCRIBE JOB,xu ;, kx
HEAT PUMPS, SIZE
$
UNIT HEATERS
THE PROPERTY IS OWNED Y: S#NGLE/MARRIED
PARTNERSHIP
CORPORATION
BOX 2
CONTRACTOR'S NAME Ak&A-L-
lic— - CONTRACTOR'S REG. # &VAti I10 1�
$
Card MUST be presented
1
CONTRACTOR'S ADDRESS ���v Wlku � 0 x
���
"� �CITY 145—
PHONE 412-4099
$
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 I4
PHONE
BOX 4 SEWER DISTRICT
WATER DISTRICT
BOX 5
ESTIMATED PROJECT COST
EXISTING BUILDING VALUATION
BOX 6
PROPERTY TAX ACCOUNT NUMBER '77 al ci�� — U
3 ,5_0
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
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 $
GASPIP NG, FEET
$
NO. FURNACE, ELEC. GAS
li
$
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 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:
ANP -008 3/90
0 •
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE SETBACKS:FRONT_
PLANNING DEPARTMENT APPROVAL
REMARKS:
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAI
REMARKS:
SIDE REAR HEIGHT LIMIT
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:
RECEIVMD
ASSIGNED ADDRESS:
Amount
PARTIAL PLAN CHECK FEE RECEIVED
Date
Receipt #
BUILDING DEPARTMENT APPROVAL
BY DA
DA
DA
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 OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING INSPECTION
BUILDING PERMIT 661-4140
92-1081 M
THIBADFAU 314- PL SN
PERMIT NO.
WNEF'4JINppE SITF LqW
'(��
CONTRACTOR
11 1A11L� ADJvic TAI
OIWHO
`�
CONT. REG. NO.
WJVY
EXP. OWNER'S PHONE OWNER'S ADDRESS
TYPEJOB: NEWRESIDENCE
ADDITION NEW INDUSTRIAL NEWCOMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI-FAMILY�.jIjNLTJyIULTI. ADD. SIGN GRADING OTHER
''�
// S� AA
TAX ACCOUNT NO.
UU LEGAL DESCRIPTION
ISSUED BY edL
e
"DATE OF ISSUE DATE OF APPLICATION 7-15-92
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
0
RECEIVED
BATHTUBS
LAUNDRY DRAINS
,FORCED AIR FURNACE �j . DUCT WORK
SHOWERS
URINALS
i'GAS HOT WATER HTR. V ..70 AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
t CONVERSION BURNER MISC.
—�—
0.00�
RETURNED
SINKS
MISC.
BBQ BASIC FEE
9-.5C
DISHWASHERS
TOTAL FIXTURES
DRYER TOTAL MECHANICAL
AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNgS�105i5k 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�
GAS PIPING OK� -`� �)� Date --�� 5-2 �7•�
SEPA REVIEW
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 WAY
REQUIREMENTS WILL BE MET:
OWNER OR AGENT
DATE