91-101800CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
91-1Zi boa
BUILDING INSPECTION
941-1555
PERMIT NO. 91-1783 M OWNER'S NAME DELRAE DAKOULIS JOB ADDRESS 704 S 325 ST
CONTRACTOR WESTERN FURNACES ADDRESS POB 11145 TACOMA CONT. PHONE 474-8401
CONT. REG. NO. WESTEF*372NO (12/91) OWNER'S PHONE 941-5427 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
150241-0270
TAX ACCOUNT NO. LEGAL DESCRIPTION
SUED BY ELIZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION 12/26/91
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.GAS LOGS 6.50
SINKS MISC.
CONVERSION BURNER BASIC FEE 20. 00
RETURNED
DISHWASHERS TOTAL FIXTURES NONE
UNIT HEATER TOTAL MECHANICAL 28.50
AMOUNT
NONE
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT
SUFFICE.
PERMIT FEE
PLAN 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 INFORMATIO �RNISHED BY I TRUE ND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET:
_l __ °. = i
OWNER OR AGENT DATE �l r
J
•
Pee it#0�(-_ I'�3ln��_
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME:
OWNER I R ae- A. Ko u I )'!Sl SITE LOCATION r70,1 rl �-
OWNER'S ADDRESS 'I U S "3ZS - CITY Eez-ii-,rr tPHONEg-4 1 -S42 7
DESCRIBE JOB 1 h Te-k t (4c% -S 10 qS
THE PROPERTY IS OWNED BY: SINbLE/MARRIIfD X PARTNERSHIP CORPORATION
CONTRACTOR'S ADDRESS
EXPIRATION DATE t
CITY l?
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 4-7 Ll -
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5
ESTIMATED PROJECT COST
EXISTING BUILDING VALUATION
BOX 6
PROPERTY TAX ACCOUNT NUMBER
q
GAS HOT WATER HEATER
LEGAL DESCRIPTION
CONVERSION BURNER
$
(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
X, -OTHERS o�S
___TOTAL FIXltURES
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
$
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 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
PLAN nn�2�m2s
1 got mx►s7r1QG
Lf -&o AvDnl I-) ON)
RECEIVED
JUN 291990
cmr of FEDERAL. WAY
BUILDING DEPT.
MECHANICAL PERMIT
CITY OF BUILDINGFEDERAL WAY PERMIT
9I—Ick c�
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. 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 107 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 /j -,9L9 e/Date B
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES
MECHANICAL PERMIT
AMOUNT DUE
_
Account No. 0.10-000-322-10-004 Total Fee $ '�0 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 . ... .. .
PLUMBING GROUNDWORK
DATE BY
PLUMBING ROUGH IN
DATE - BY
WATERLINE 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 J/011/1)_ BY
DCD
PSD
FD
0 •