90-101510CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
CTo — ► o i s I o
BUILDING INSPECTION
941-1555
PERMIT NO. 90-1682M
OWNER'S NAME JAY JACOBS JOB ADDRESS 1927 SO SEATAC MALL
CONTRACTOR ALGENE CONSTRUCTION ADDRESS POB 1353 LYNNWOOD CONT. PHONE 774-3115
CONT. REG. NO. ALGENC306BE
11/1/90 OWNER'S PHONE 622-5400 OWNER'S ADDRESS 1530 5TH AVENUE SEATTLE
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 EXHAUST FAN/REMODEL HVAC RETURN AIR DUCT
TAX ACCOUNT NO. 762240-0010 LEGAL DESCRIPTION NA
ISSUED BY ELIZABETH
SNYDER DATE OF ISSUE A V DATE OF APPLICATION 10/30/90
BUILDING INFORMATION
WNE NA
OCCUPANCY NA TYPE OF CONSTRUCTION MECHANICAL BLDG. SO. FT. NA
BACKS: FRONT NA
SIDE NA REAR NA STORIES NA HEIGHT LIMIT NA
LUMBING NO.
NO. MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS
ELEC. HOT WATER HEATER 1 GAS PIPING FT, BOILER
RECEIVED
BATHTUBS
LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS
URINALS FORCED AIR FURNACE AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS GAS�iOT WATER HTR, MISC. EXH FAN 4.50
SINKS
MISC. CONVERSION BURNER BASIC FEE 20.00
RETURNED
DISHWASHERS
TOTAL FIXTURES 1 X $5.00 UNIT HEATER TOTAL MECHANICAL 31 _ 00
AMOUNT NONE
x
HVAC RETURN AIR DUCT
VALUATION NONE
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
,,
PERMIT FEE
PLAN CHECK FEE
FEE $ 5
INSPECTION RECORD
JEPLUMBING
CHANICAL FEE 3
00
TAIL BLDG. FEES $'36-00
Water Line OK Mechanical Inspection Notes:
I*T P/C FEE
I*
E PA REVIEW
GAS PIPING OK Date By
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES
MECHANICAL PERMIT
AMOUNT DUE $36.00
Account No. 010-000-322-10-004 Total Fee $ 36.00 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:
�� t O
OWNER OR AGENT
DATE
CITY OF
FEDERAL WAY
.. �....: :�i�^tiTAa.�-- .--.. .�..T'..�.- _.__.. .. ....�..�..__-•www,
MECHANICAL PERMIT
BUILDING PERMIT
'0--in{�Ifl
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
WINE
BUILDING INFORMATION
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 �10T 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 SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
INSPECTION RECORD
ECHAFEE
�BLDG. 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 $
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
DATE ____... BY______.-._.....
PLUMBING ROUGH IN
DATE _- __ .. BY
.-.
O.K. TO ENCLOSE FRAMING
DATE _ _ _ -- BY ... .-_..... ..... .-...__.
FINAL O.K. TO OCCUPY
DATE BY
0
OX TO POUR FOUNDATION WALLS
DATE .. _ BY ......-
WATER LINE O.K.
GAS PIPING O.K.
INSULATION
DATE _ .__.- _ BY
DCD
0
PLUMBING GROUNDWORK
DATE BY
MECHANICAL INSPECTION
DATE __ -_ _BY
WALL BOARD AND FIRE WALL
DATE _ BY ..
FD
� -le� rmit #
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
6 3 — Please Print —
BOX 1 TENANT NAME: To- ti T , ,L
OWNER A 0Cu bS *-' ITE LOCATION<5'.?�=-51`i� t'�'- 4 %92-7
OWNER'S ADDRESS J r L "r' CITY S ewr�Lc PHONE E LZ- S 00
DESCRIBE JOB D L 4 r w ,, r)z
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME r CONTRACTOR'S REG. # I'AL
Card MUST be presented
CONTRACTOR'S ADDRESS L7' x IL3 :i_3 CITY .4yhWC---`d w4 PHONE 2.2 4'3//5�
EXPIRATION DATE // /- 90
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUM
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
r
$
SUMPS, SPRINKLER VACUUM BREAKERS
OTHER "��-
$ r
DRAINS
$
OTHER
$
TOTAL FIXTURES
$
S —,
TOTAL MECHANICAL FEE
$<Oc,
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 DEF NSE OF SUCH CLAIM), WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
AND FILED AGAINST THE CITY OFfEDE LNAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLOYEES, UPON TFgACCURACY OF TI)I�INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT:
DATE: / 11 - / y- F U
ANP -008 3/90
ZONE SETBACKS:FRONT_
PLANNING DEPARTMENT APPROVAL
REMARKS:
•0
OFFICE USE ONLY (PLEASE GO 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/ � 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:
Amount
Im
PARTIAL PLAN CHECK FEE RECEIVED
Date
Receipt #
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
BUILDING DEPARTMENT APPROVAL
DATE (6- Zl'1�
Y ua I
ACCEPTED FOR FILING