92-100271MECHANICAL PERMIT
CITY OF BUILDINGFEDERAL WAY PERMIT
BUILDING INSPECTION
941-1555
92-0214 M
FLOYD HUGHES 909 S. 321ST STREET
PERMIT NO.
OWNER'S NAME JOB ADDRESS
WESTERN
FURNACES INC P O BOX 11145 TACOMA
474-8401
CONTRACTOR
ADDRESS
CONT. PHONE
WESTEF372NO
909 S.
321ST STREET FEDERAL WAY
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
60930-0070
TAX ACCOUNT NO.
LEGAL DESCRIPTION
UED BY JOANNE
JOHNSON DATE OF ISSUE DATE OF APPLICATION 7-10-92
BUILDING INFORMATION
ZONE
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 2.00 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
20.00
RETURNED
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER 6.50 TOTAL MECHANICAL
28.50
AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR.
AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
AN CHECK FEE
LUMBING FEE
INSPECTION RECORD
MECHANICAL FEE
28.50
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
28.50
Account No. 010-000-322-10-004 Total Fee $
28.50 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:
r
OWNER OR AGENT b
��1 �?. �/► 7l N DATE
0
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
ZONE
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.
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
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
WATER LINE O.K.
GAS PIPING OX
MECHANICAL INSPECTION
DATE . .... ... BY
O.K. TO ENCLOSE FRAMING
DATE BY
INSULATION
DATE _ _...-___BY
WALL BOARD AND FIRE WALL
DATE BY
FINAL O.K. TOOCCUPY
DATE By
DCD
PSD
FD
0 0
RECEIVED BY 0 Perm#
COMMUN►TY DEVELOPMENT DEPARTMENT
CITY OF FEDERAL WAY
FEg 0 1992 BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME:
OWNER �6'
SITE LOCATION
$
OWNER'S ADDRESS
3Z) St
CITY
PHONE
DESCRIBE JOB
$
BOILER, SIZE BTU
$
THE PROPERTY IS OWNED BY: SINGLE/MARRIED
PARTNERSHIP
CORPORATION
BOX 2 CONTRACTOR'S NAME
UNIT HEATERS
CONTRACTOR'S REG. # `�) LS -y- ET`R;>%_� Z NU
AIR COOLING UNITS, SIZE
�
I `4 S
Card MUST be presented
y X40 E
CONTRACTOR'S ADDRESS
$
CITY
—PHONE1
EXPIRATION DATE
12- 3 9Z
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
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER 09 3CA C) Oo-1 O
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
.W
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
$
N0. FURNACE, ELEC. GAS
$
GAS HOT WATER HEATER
$
CONVERSION BURNER
$
BOILER, SIZE BTU
$
AIR HANDLING UNITS
$
HEAT PUMPS, SIZE
$
UNIT HEATERS
$
AIR COOLING UNITS, SIZE
$
COMMERCtIAL HOOD
S
$
_OTHER u
$
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