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90-100091CITY OF FEDERAL WAY MECHANICAL PERMIT BUILDING PERMIT q 0- 1000011 BUILDING INSPECTION 941-1555 PERMIT NO. 90-1343M OWNER'S NAME BOB POLUS JOB ADDRESS 30229 1 PL S CONTRACTOR PACIFIC GAS HTNG/AIR ADDRESS 2702A 112 ST E TACOMA CONT. PHONE 536-7997 CONT. REG, NO. PACIFGH110ME 7/91 OWNER'S PHONE 922-6603 OWNER'S ADDRESS SAME 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 MECHANICAL ONLY TAX ACCOUNT NO. 339180-0082 LEGAL DESCRIPTION NA ISSUED BY ELIZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION 8110/90 BUILDING INFORMATION fETNE NA OCCUPANCY NA TYPE OF CONSTRUCTION MECHANICAL BLDG. SO, FT. NA BACKS: FRONT NA SIDE NA REAR NA STORIES NA HEIGHT LIMIT NA PLUP91NG NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND WATER CLOSETS _ ELEC. HOT WATER HEATER GAS PIPING 6 FT. 9-00 BOILER RECEIVED BATF' UBS LAUNDRY DRAINS COMPRESSOR TANK(S) SHOWERS URINALS FORCED AIR FURNACE _IU. 0 AIR HANDLING UNIT NUMBER LAVATORIES DRINKING FOUNTAINS GAS�iOT WATER HTR. 6_..50 MISC. SINKS MISC. CONVERSION BURNER BASIC FEE 2Il_00 RETURNED DISHWASHERS TOTAL FIXTURES NONE UNIT HEATER TOTAL MECHANICAL3R _50_ AMOUNT NONF. VALUATION NONE. 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 TAIL 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 Account No. 010-000-322-10-004 Total Fee $ 38.50 Receipt No. 1 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 ��>�1G,� n �. Jam, DATE--':2-/T��1 MECHANICAL PERMIT CITY OF BUILDINGFEDERAL WAY 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 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 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. 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 MECHANICAL FEE 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 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 __._._........ _......_.-_ OX TO POUR FOUNDATION WALLS DATE _.... .... BY -_ - PLUMBING GROUNDWORK DATE _ -- - -.... BY .... - PLUMBING ROUGH IN DATE ---.BY _ - WATERLINE O.K. GAS PIPING O.K. _ /� _ MECHANICAL INSPECTION DATE_`' `fid _BY O.K. TO ENCLOSE FRAMING DATE _-... BY -.. INSULATION DATE ..- ....----BY WALL BOARD AND FIRE WALL DATE --_.. _ BY FINAL O.K. TO OCCUPY DATEf BY __...*7�Z - DCD PSD FD r -- ok Ccvt fel l�cQ f c'�2 • 4ermit q a0 - 13 43 n."— CITY OF FEDERAL WAY BUILDING PERMIT APPLICATION — Please Print — BOX 1 TENANT NAME: I OWNER SITE LOCATION y — I Pl OWNER'S ADDRESS CITY S PHONE O,1).— 44D DESCRIBE JOB 'Vithdl X ir b.�oCr'*►� THE PROPERTY IS OWNED BY: SI GLE/MARRIED PARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME CONTRACTOR'S ADDRESS Z lo. EXPIRATION DATE CONTRACTOR'S REG. #iCIFC�ttu DQE Card MUST be presented CITY7_0_Cb� PHONE 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 cc C, rip �U,qi PHONE BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION PROPERTY TAX ACCOUNT NUMBE 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 ( ) NONSTRUCTION ( ) MULTIFAMILY (NO. OF UNITS= ) ( XISTING STRUCTURE ( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT :1 • 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 4M Lre#ssr (o $ NO._FURNACE, ELEC. GAS _ $ 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 OFTHE 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,, JPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION. OWNER/AGENT: DATE: u �S— 0 ANP -008 3/90