92-100094I
MECHANICAL PERMIT
CITY OF
FEDERAL WAY BUILDING PERMIT
BUILDING INSPECTION
941-1555
PERMIT NO. 92-0039 M OWNER'S NAME MOON'S TERIYAKI/DELI JOB ADDRESS 33501 PACIFIC HWY S
CONTRACTOR ERICKSON MFG ENT
ADDRESS 20217 CEDAR VALLEY RD LYNNWOOD CONT. PHONE 775-3597
CONT. REG. NO. ERICKI*212L7 5/92
OWNER'S PHONE 745-5206 OWNER'S ADDRESS 15724 53 PL W EDMONDS
TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTIFAMILY (UNITS ) MULTI. ADD.
SIGN GRADING OTHER SEE BELOW
TAX ACCOUNT NO. 926503-0010
LEGAL DESCRIPTION
ISSUED BY ELIZABETH SNYDER
DATE OF ISSUE DATE OF APPLICATION 1/10/92
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
BATHTUBS LAUNDRY DRAINS
GAS PIPING FT BOILER
COMPRESSOR TANK(S)
RECEIVED
SHOWERS URINALS
FORCED AIR FURNACE AIR HANDLING UNIT
NUMBER
LAVATORIES DRINKING FOUNTAINS
SINKS MISC.
GAS�IOT WATER HTR. MISQQD 6.50
CONVERSION BURNER �&ASI FUEL' 20.00
RETURNED
DISHWASHERS TOTAL FIXTURES
NONE
vvr-? PrMAKE-UP 4.50 TOTAL MECHANICAL 31 . OO
AMOUNT NONE
AIR FAN
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
UMBING FEE
INSPECTION RECORD
CHANICAL FEE $31.00
-\L BLDG. FEES
Water Line OK Mechanical Inspection Notes:
r'A iT P/C FEE
SEPA REVIEW
GAS PIPING OK Date By
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE $31.00
MECHANICAL PERMIT
Account No. 010-000-322-10-004 Total Fee $ 31.00 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:
V�1 -9 2
OWNER OR AGENT
DATE 1
RECEIVED - 0A
q,it #
JAN 10 1992 CITY OF FEDERAL WAY
a OF1%C*ftLWAY BUILDING PERMIT APPLICATION
8IIAD0,16 WT. — Please Print —
BOX 1 TENANT NAME: �IGCNS TE[;►v(+i:l DELI
OWNER SITE LOCATION
OWNER'S ADDRESS 1,5114 -i53 CITY PHONE
DESCRIBE JOB (NS«U. _T11fC L ZYLOAvyT
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME E_fkk cK 5C,3 M R; . C. �j 'T - CONTRACTOR'S REG. # CVL• tC •K1'!r L 1 Z L7
Card MUST be presented
CONTRACTOR'S ADDRESS 2-02-0 CITY 0-4-4—:") PHONE ] 7 5 -
-EXPIRATION
EXPIRATION DATE 5-1 -9 Z
—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 1 7 c
35q 7
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST'S ZLGC ` EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION t--4 z 1 WC -ST CLAMP,JS Div. `M
(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 = ) (x) 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 1 COMMERCIAL HOOD :r- Au-7ET�
$ 6•S C
SUMPS, SPRINKLER VACUUM BREAKERS OTHER LA
$
DRAINS
$
OTHER
$
TOTAL FIXTURES
$
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 ASTO 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: j.1al\t\^A� DATE:
ANP -008 3/90
ZONE SETBACKS:FRONT_
PLANNING DEPARTMENT APPROVAL
REMARKS:
0
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW I INE)
SIDE REAR HEIGHT LIMIT
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DATE
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVA
REMARKS:
TYPE OF JOB: NEW RESI CE 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:
iticovED
JAN 1 0 1992
w� pipA1I
RECEIVED
ASSIGNED ADDRESS: Ste- P_K S f
PARTIAL PLAN CHECK FEE RECEIVED
Amount Date Receipt #
BUILDING DEPARTMENT APPROVAL
BY DATE
DATE
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
s ..
ACCEPTED FOR FILING
MECHANICAL PERMIT
CITY OF BUILDINGFEDERAL WAY PERMIT
—I CtDcjj
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
ZONE 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
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�iOT WATER HTR. MISC.
SINKS
MISC.
CONVERSION BURNER BASIC FEE
RETURN
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL
AMO
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAV S CE
PERMIT FEE
PLAN CHECK FEE
UMBING FEE
INSPECTION RECORD
cCHANICAL FEE
TOTAL BLDG. FEES
Water Line OK Mechanical Inspection
PART P/C FEE
X.b\:
SEPA REVIEW
GAS PIPING OK Date By
WATER SERVICE
WATER MAIN CHG.
MECHANICAL PERMIT
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
_
Account No. 010-000-322-10-004 Total Fee
j:&
/ceipt No.
ALL PERMITS EXPIRE 180 DAYS
AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR ASATE
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