92-100159 MECHANICAL PERMIT 90./O O 159
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
92-0098 M SCOTT MASON 4118 SW 328TH PL
PERMIT NO. R'S NAME JOB ADDRESS
CONTRACTOR CLARK MECHANI ADDRESS 6265 S 143RD PL TUKWILA CONT. PHONE 246-8585
CONT. REG. NO. CLARKMI099CL OWNER'S PHONE 838-1267 OWNER'S ADDRESS 4118 SW 328TH PL. 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. 873204-0180 LEGAL DESCRIPTION
•SUED BY. ____JOANNE JOHNSON DATE OF ISSUE //1 �'/ 7 DATE OF APPLICATION 1-23-92
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 50 FT —2.00 BOILER
RECEIVED
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS URINALS FORCED AIR FURNACE 10.00 AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS GAS f1OT WATER HTR. 6-50 MISC.
SINKS MISC. CONVERSION BURNER BASIC FEE
20 . 00 RETURNED
DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL 38_50 AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
RMIT FEE
AN CHECK FEE
PLUMBING FEE INSPECTION RECORD
MECHANICAL FEE 38.50
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 38- 50 Account No. 010-000-322-10-004 Total Fee $ 38. 50 Receipt No. (-14 S
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 ORA- ENT C _(r ; , _1) p ) ( .L :I DATE ,, ill a . I •I
` 11
MECHANICAL PERMIT 9j, A o i5 9
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 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 ADO.
NEW MULTI-FAMILY (UNITS ) MULTI. ADD. SIGN GRADING OTHER
TAX ACCOUNT NO. LEGAL DESCRIPTION
ISSUED BY DATE OF ISSUE DATE OF APPLICATION
IIII 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 frIOT 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
:LUMBING FEE INSPECTION RECORD
CHANICAL FEE
TOTAL BLDG. FEES Water Line OK Mechanical Inspection Notes:
PART P/C FEE ,.::////)/#111/
' '
s
SEPA REVIEW GAS PIPING OK 5 O 1 Z/(/ Date 5 //f/#1$y ?
WATER SERVICE r
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
o m 0 0 0 13 0 m
• Z -1 -D1 C -1 -
m D m m K m co
O
O co 1 nD
z O 1
�
O p O Z
O m O o
C D Z O
D
CD CO K W CO z
Zi O
O u)
1
i
o o Z O O O 0
0 -1 c cn -
m r* m m 0
D
p z Z O0
Z O m C
0 O
33
7 1
O
C
z
c co
z
-o
D
C \ (n
o * C K o 10
M /-m =m i
ID W
O Zi
D n O
X D L7
o r
D z O
Z C
o -o z
-n m 0
m 0
o I m -+ O
COCO > z W 7
r
I 1
1 I
i I
JAN . Penni.3
�` WI? .3
.92
elikratr3 RA eptNAr CITY OF FEDERAL WAY ,
BUILDING PERMIT APPLICATION
—Please Print-
BOX 1 TENANT NAM ...-
E: 41 14 , t).) ?M Q
OWNER - ■ <- SITE LOCATION .a_ J
OWNER'S ADDRESS s 'd - CITY .r' mum ' PHONE .17C-2)- _ `
DESCRIBE JOB
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 `CONTRACTOR'S NAME a 7 ,?f Y 'n
. -1' If\ l Ll7 I CONTRACTOR'S REG. #CIA r,-�Y�LC'L
Card MUST be presented
j_A CONTRACTOR'S ADDRESS CPZCo' 5 , I l 1 -PI � CITY 1-06 i ku PHONE 7-1-11.o-
EXPIRATION
Co-
EXPIRATION DATE 7/ I L ?c37.
— OR—
I HAVE READ CHAPTER 18.27.010 RELATING TO411TIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON J7 PHONE Z---ka-Er--- -)
BOX
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EX BUILDING VALUATION
)0#-a PROPERTY TAX ACCOUNT NUMB Si ;� — i •i
LEGALDESCRI:PTaON°
(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 (\-r INGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) (vYEXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES(including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET �t $
BATHTUBS NO. I FURNACE, ELEC. GAS / $
SHOWERS I 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 $
D NS $
7
THER $
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.
Y OWNER/AGENT: i 1SL-�Q� ) , (_ o f DATE: Jz J CIZ_
ANP-008 3/90