91-101584CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
q I-101 5?`f
BUILDING INSPECTION
941-1555
PERMIT NO. 91-1559 M
OWNER'S NAME WASHINGTON PARK OFFICE PHASE DDRESS 33801 IST WAY S.
CONTRACTOR PACIFIC
AIR CONTROL ADDRESS 11812 N CREEK PK WAY N #104 BOTHELL CONT. PHONE 883-3348
CONT. REG. NO. PACIFAC230P8 OWNER'S PHONE 764-9663 OWNER'S ADDRESS 33801 1ST SUITE 281 FEDIML W
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. 926504-0150 LEGAL DESCRIPTION
LIED BY JOANNE
JOHNSON DATE OF ISSUE DATE OF APPLICATION 11-4-91
BUILDING INFORMATION
NE
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
BATHTUBS
ELEC. HOT WATER HEATER
LAUNDRY DRAINS
GAS PIPING FT. BOILER
RECEIVED
COMPRESSOR TANK(S)
SHOWERS
URINALS
FORCED AIR FURNACE AIR HANDLING UNIT NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS POT WATER HTR. MISC. **** 6 50
SINKS
MISC.
RETURNED
CONVERSION BURNER BASIC FEE '20 00
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL 250 AMOUNT
VALUATION
****REFRIGERATION AND CONDENSATERLINES
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
RMIT FEE
`-,P.N CHECK FEE
PLUMBING FEE
INSPECTION RECORD
MECHANICAL FEE
26.50
TAL 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
26.50
Account No. 010-000-322-10-004 Total Fee $ 26.50 Receipt No. 0
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 ,Z;
kY
MECHANICAL PERMIT
CITY OF
FEDERAL WAY BUILDING PERMIT
BUILDING INSPECTION
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 DATE OF APPLICATION
BUILDING INFORMATION
NE
OCCUPANCY TYPE OF CONSTRUCTION
BLDG. SQ. 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 OOT WATER HTR. MISC.
SINKS
MISC.
CONVERSION BURNER BASIC FEE
RETURNED
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL
AMOUNT
VALUATION
- - . .....,aL ....• ;:...-.:ti ;.. -.f.- _ fa3 :s.; ?� diltia.. a.:i a.:.. fs.-. ...
4'
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
INSPECTION RECORD
ECHANICAL FEE
TAL 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 $ ��. CA
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
J
0 0
SET BACKS AND FOOTINGS OX TO POUR FOUNDATION WALLS PLUMBING GROUNDWORK
DATE DATE _ BY DATE BY
PLUMBING ROUGH IN WATER LINE O.K. . . ... ... MECHANICAL INSPECTION
DATE BY GAS PIPING O.K.DATE --BY
O.K. TO ENCLOSE FRAMING INSULATION WALL BOARD AND FIRE WALL
DATE BY DATE BY DATE BY
FINAL O.K. TO OCCUPY
DCD PSD FD
DATE BY
9-22- 4,A. Ilk 1,n2An-_ r'04
0
erm aAECEwED
CITY OF FEDERAL WAY
Nov 1991
ov � BUILDING
PERMIT APPLICATION
�� } i.j)CHAL Al
�! 41l14MK
— Please Print —
BOX 1 TENANT NAME: WQsL,�.,gtor. Pw�l� o�4lGt
Pl�4Sa. ��
OWNER k CA \�t.,, Co.
SITE LOCATION 33 SO I1 Wq
OWNER'S ADDRESS 33 8a - 04' Su %+4
z s i CITY HONE 'wy-
96ce3
DESCRIBE JOB
THE PROPERTY IS OWNED BY: SINGLE/MARRIED
PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME Pg<L4%c_ N%r C_ov,4xn1
CONTRACTOR'S REG. # PAC_
1�kc- Z30 P$
Card MUST be pr
CONTRACTOR'S ADDRESS �\ $1-t. N C.ra.t_k
P K Wy 104 CITY PHONE-
HONEEXPIRATION
EXPIRATIONDATE 0(- j 04 / 0�-t
—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 61STRICT
WATER DISTRICT
BOX 5 ESTtMAfi€fYPROJECT COST
EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER S opt
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)
MECHANICAL APPLIANCES — BASIC FEE $
N0. WATERCLOSETS
GAS PIPING, FEET
$
BATHTUBS
N0. FURNACE, ELEC. GAS
$
SHOWERS
GAS HOT WATER HEATER
$
LAVATORIES
CONVERSION BURNER
$
SINKS
BOILER, SIZE BTU
$
DISHWASHERS
AIR HANDLING UNITS
$
ELECTRIC HOT WATER HEATER
HEAT PUMPS, SIZE
$
LAUNDRY WASHER OUTLET
UNIT HEATERS
$
URINALS
AIR COOLING UNITS, SIZE
$
DRINKING FOUNTAINS
COMMERCIAL HOOD
$
SUMPS, SPRINKLER VACUUM BREAKERS __OTHER 0-.a
$v
DRAINS
OTHER
$
TOTAL FIXTURES
$
TOTAL MECHANICAL FEE
$ '24,
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:
_Lj
DATE:
ANP -008 3/90
ZONE SETBACKS:FRONT_
PLANNING DEPARTMENT APPROVAL
REMARKS:
IL
OFFICE USE ONLY (PLEASE DO NOT WRITE SEL W THIS LINE)
SIDE REAR HEIGHT
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 SO. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION
BUILDING DEPARTMENT REMARKS:
rED
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