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91-100069CITY OF FEDERAL WAY MECHANICAL PERMIT BUILDING PERMIT 01 BUILDI G INSPECTION 941-1555 PERMIT NO. 91-0047M OWNER'S NAME CHUCK LUDINGTON JOB ADDRESS 30439 1 PL S CONTRACTOR PACIFIC GAS HTNG/AIR ADDRESS 2702A 112 AVE E TACOMA CONT, PHONE 536-7997 CONT. REG. NO. PACIFGH110ME 7/91 OWNER'S PHONE 941-8819 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 MECH ONLY TAX ACCOUNT NO. 339190-0350 LEGAL DESCRIPTION NA ISSUED BY ELIZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION 1/11/91 BUILDING INFORMATION ONE NA OCCUPANCY NA TYPE OF CONSTRUCTION MECH ONLY BLDG. SO. FT. NA ET BACKS: FRONT NA SIDE NA REAR NA STORIES NA HEIGHT LIMIT NA 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 100 AIR HANDLING UNIT NUMBER LAVATORIES DRINKING FOUNTAINS GAS RIOT WATER HTR. MISC. RETURNED SINKS MISC. CONVERSION BURNER BASIC FEE 20-0 DISHWASHERS TOTAL FIXTURES NONE UNIT HEATER TOTAL MECHANICAL '10 nn AMOUNT NONE. 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 $3000 OTAL 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 $30-00 Account No. 0.10-000-322-10-004 Total Fee $ 30.00 Receipt No. I I '7 t %� ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE. I ,ftRTIFY 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 MECHANICAL PERMIT CITY OF BUILDING PERMIT BUILDING INSPECTION FEDERAL WAY 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, 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. 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. 'RMIT FEE LAI i CHECK FEE PLUMBING FEE INSPECTION RECORD ECHANICAL FEE ,OTAL BLDG. FEES Water Line OK Mechanical Inspection Notes: g2& PART P/C FEE SEPA REVIEW GAS PIPING OK Date" P- By 21 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 $ �C+-lYf� Receipt No. ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL. -.ND 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 0 0 0 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 __,13Y WALL BOARD AND FIRE WALL DATE BY . ... .... . . . .... . FINAL O.K. TO OCCUPY _% DATE ,;? BY- 1w- DCD PSD FD ;2 • *ermit # - CITY OF FEDERAL WAY BUILDING PERMIT APPLICATION — Please Print — BOX 1 TENANT NAME Chuc V. \_66 t A6W �n — BASIC FEE $ OWNER SITE LOCATION GAS PIPING, FEET $ OWNER'S ADDRESS OLA 261j Q1 S CITY -1 -al WCi a PHONE - L NO.- FURNACE, ELEC. GAS DESCRIBE JOB QrC SHOWERS THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG. #� pF&,ll,4 0 rml CONVERSION BURNER $ Card MUST be presented SINKS CONTRACTOR'S ADDRESS ba- A \ �� CITY TAACsrn la PHONE S (o EXPIRATION DATE `7 ) AIR HANDLING UNITS $ —OR— OR ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE I HAVE READ CHAPTER 18.27.010 RELATING TO INITIONS OF CONTRACTORS AND SPECIALTY CONTRACTORS AND CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. UNIT HEATERS BOX 3 CONTACT PERSON PHONE BOX 4 SEWER DISTRICT WATER DISTRICT $ BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION COMMERCIAL HOOD BOX 6 PROPERTY TAX ACCOUNT NUMBER 3 3 C1 SUMPS, SPRINKLER VACUUM BREAKERS OTHER LEGAL DESCRIPTION DRAINS (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 NO.- FURNACE, ELEC. GAS l-- $ 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 $ 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 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: DATE: ANP -008 3/90