91-100590CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
91 - I t3o s coo
BUILDING INSPECTION
941-1555
PERMIT NO. 91-563 M OWNER'S NAME DANIEL ORLANDO JOB ADDRESS 29307 IST AVE S
CONTRACTOR PACIIFC GAS HEATING
& A&AESS 2702-A 112TH ST E TACOMA CONT. PHONE 536-7997
CONT. REG. NO. PACIFGH110ME
OWNER'S PHONE 839-5270 OWNER'S ADDRESS 29307 FIRST AVE S FEDERAL 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. 119600-1145
LEGAL DESCRIPTION
ISSUED BY JOANNE JOHNSON
DATE OF ISSUE DATE OF APPLICATION 5-1-91
BUILDING INFORMATION
ZONE 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 -8Q_ FT. 2.0 BOILER
BATHTUBS LAUNDRY DRAINS
COMPRESSOR TANK(S)
RECEIVED
SHOWERS URINALS
FORCED AIR FURNACE 10-0 AIR HANDLING UNIT
NUMBER
LAVATORIES DRINKING FOUNTAINS
GAS riOT WATER HTR. 6-9 MISC, GAS LOGS -6-50
SINKS MISC.
CONVERSION BURNER BASIC FEE 20 _00
RETURNED
DISHWASHERS TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL 4 S _ ()0
AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
LUMBING FEE
INSPECTION RECORD
6_CHANICAL FEE 45 _ nn
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 FEES45
MECHANICAL PERMIT
AMOUNT DUE -
Account No. 010-000-322-10-004 Total Fee $ 45.00 Receipt No.c
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
CITY OF
FEDERAL WAY
MECHANICAI, PERMIT
BUILDING PERMIT BUILDING
941!N 55ECTION
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
UED BY
DATE OF ISSUE DATE OF APPLICATION
;UMBING
BUILDING INFORMATION
NE
OCCUPANCY TYPE OF CONSTRUCTION
BLDG. SQ. FT.
T BACKS: FRONT
SIDE REAR STORIES
HEIGHT LIMIT
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
SINKS
DRINKING FOUNTAINS
MISC.
GAS POT WATER HTR. MISC.
CONVERSION BURNER BASIC FEE
RETURNED
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL
AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR.
AFFIDAVIT WILL NOT SUFFICE.
ERMIT FEE
LAN CHECK FEE
PLUMBING FEE
INSPECTION RECORD
MECHANICAL FEE
TAL BLDG, FEES
Water Line OK Mechanical Inspection
Notes:
PART P/C FEE
EPA REVIEW
GAS PIPING OK �-.� �-5 j �j 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
0 00 0 00
SET BACKS AND FOOTINGS
DATE -,..---BY
OX 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 _00 _ BY
DCD
PSD
FD
0
p40nit #
RECEIVED CITY OF FEDERAL WAY
MAY 0 2 1991 BUILDING
PERMIT APPLICATION
CITY OF FEDERAL WAY
— Please Print —
BI�SVLTT
BOX 1 TENANT NAME:
CONVERSION BURNER
OWNER __'5 �
SITE LOCATION
OWNER'S ADDRESS A G 301 1 }� 14
4 s CITY -E' Ujr, -I PHONE 76
DESCRIBE JOB
A. ellin
THE PROPERTY IS OWNED BY: SINGft/MARRIED
PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME 1--�k-e.L4u, &2 %
cc-/zn., O L -I CONTRACTOR'S REG. # h ��
$
Card MUST be presented
CONTRACTOR'S ADDRESS D DA 1`� CITY _TCOOyw- PHONE 5'_3 t, 1 S Cl,
EXPIRATION DATE 1 -_ 9
$
—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 ( 1 1L\ %,14-
PHONE 5_2 V 7 g 4 7
BOX 4 SEWER DISTRICT
WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST
EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER \ `�
Le 1.L \ \
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)
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
$
NO. FURNACE, ELEC. GAS /
$
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 i '- ' •
$
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: _i -.,_' t La/ F OAC' -:.- DATE: 'J— I --q
ANP -008 3/90
ZONE SETBACKS:FRONT
PLANNING DEPARTMENT APPROVAL
REMARKS:
OFFRE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
M
SIDE REAR HEIGHT LIMIT
BUILDING DEPARTMENT REMARKS:
RECOVE
MAY 0 2 1991
IN OF FEoEi RAL VV i`
BUILDING UE?T
RECEIVED
ASSIGNED ADDRESS:
PARTIAL PLAN CHECK FEE RECEIVED
Amount Date Receipt #
BUILDING DEPARTMENT APPROVAL
BY 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
ACCEPTED FOR FILING
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 SQ. FT.
@ _
BUILDING SQ. FT.
@ _
BUILDING SQ. FT.
@ _
TOTAL SQ. FT.
TOTAL VALUATION
BUILDING DEPARTMENT REMARKS:
RECOVE
MAY 0 2 1991
IN OF FEoEi RAL VV i`
BUILDING UE?T
RECEIVED
ASSIGNED ADDRESS:
PARTIAL PLAN CHECK FEE RECEIVED
Amount Date Receipt #
BUILDING DEPARTMENT APPROVAL
BY 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
ACCEPTED FOR FILING