91-101089 CITY OF FEDERAL WAY BUILDING PERMIT PERMIT NO.: 91-1045
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 11/02/92
Federal Way, WA 98003 BY: FLF
661-4000
SITE ADDRESS: 1436 S 312 ST
PARCEL NO.: 082104-9060
PROJECT DESCRIPTION: RENEWAL/REVISIONS
OWNER - CONTRACTOR — LENDER
'S BANK I
:36 S 312TH ST
"DERAL WAY WA 98003
227-4780
BLD?: MEC?: PLM?: FLR--EXIST--PROP--- DWELLING UNITS: 0 COMP PLAN FEES:
TYPE OF WORK:CA USE: 1ST.: 0: 0:sf STORIES • 0 REQUIRED PARKING..: 0 SPRINKLERS? OTHER MISC REVENUE.. $ 45.00
CENSUS CATEGORY •437 2ND.: 0: O:sf HEIGHT • 0.00 ft HAZARD CLASS...: FINAL PLAN CHECK...* $ 30.00
OCCUPANCY GROUP 3RD.: 0: 0:sf VALUATION REQUIRED SETBACKS FIRE FLOW • 0 gpm
.•
OTHR: 0: 0:sf EXIST..$: 0 FRONT • 0.00 ft
TYPE OF CONSTRUCTION BSMT: 0: 0:sf PROP...$: 500 SIDE • 0.00 ft WATER SERVICE..:
. DECK: 0: 0:sf REAR • 0.00:ft SEWER SERVICE..:
OCCUPANT LOAD GAR.: 0: 0:sf RECEIVED.:08/07/91
0: 0: 0: 0: TOIL: 0: O:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:
FUEL TYPES.: FANS • 0 BOILERS/COMPRESSORS WATER CLOSETS • 0 URINALS • 0 TOTAL FEES $ 75.00
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 BATH TUBS • 0 DRINKING FOUNT.: 0
FURN<100K..: 0 DUCT WORK • 0 3-15 HP • 0 SHOWERS • 0 SUMPS • 0
GAS HWT • 0 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 0 VAC BREAKERS...: 0
V BURNER: 0 FURN>100K • 0 30-50 HP • 0 SINKS • 0 DRAINS • 0
• 0 MISC • 0 5+ HP • 0 DISH WASHERS • 0 LAWN SPRINKLERS: 0
S DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELEC WTR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE • 0 <=10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR QUILTS...: 0
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
ALL PERMITS EXPIRE 160 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.
/
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OWNER OR AGENT - / L ' r 'A __ DATE 2 92
bld_prmt 10/23/92; -/
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
PERMIT NO. 91-1045 CA OWNER'S NAME U S BANK JOB ADDRESS 1436 S 312TH
CONTRACTOR BRIDGEWAY CONSTRUCTION .Tdgtss 3826 WOODLAND AVE N SEATTLE WA 9810.ONT. PHONE 632-0800
CONT. REG. NO. BRIDGCC186R3 7/92 OWNER'S PHONE 344-4662 OWNER'S ADDRESS 1414 4TH AVE SEATTLE
TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI-FAMILY ) MULTI. ADD. SIGN GRADING OTHER
TAX ACCOUNT NO. 0 10 9060-01 LEGAL DESCRIPTION (SEE PLANS FOR LEGAL)
ISSUED BY__ JOANNE JOHNSON DATE OF ISSUE /� - C. c' � DATE OF APPLICATION 8-7-91
BUILDING INFORMATION
1111 NE BC OCCUPANCY B2 TYPE OF CONSTRUCTION VN BLDG. SO. FT.
SET BAr1KS' 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 HOT WATER HTR. MISC.
RETURNED
SINKS MISC. CONVERSION BURNER BASIC FEE
DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL AMOUNT
VALUATION 7,000 _ PLANNING DEPT APPROVAL: CS 8-9-91
PERMIT FEE 90.00_ FIRE/BUILDNG DEPT APPROVAL: CR 8-12-91 KC 8-13-91
PLAN CHECK FEE 59.00
PLUMBING FEE
CHANICAL FEE
TAL BLDG. FEES
PART P/C FEE
SEPA REVIEW _ DATE: : L / 2
WATER SERVICE
WATER MAIN CHG. AMOUNT: $158.00
S.B.C.C. FEE 4.50
OTHER FEESF-D- 4.50 RECEIPT: - II 7 3 C,_
AMOUNT DUE 158.00
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 W ET:
1kP
OWNER OR AGENT - ('` DATE 1 Co 'l'L.
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 ADD.
NEW MULTI-FAMILY (UNITS ) MULTI.ADD. SIGN GRADING OTHER
TAX ACCOUNT NO. LEGAL DESCRIPTION
'SUED 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 HOT WATER HTR. MISC. _
RETURNED
SINKS MISC. CONVERSION BURNER BASIC FEE
DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL AMOUNT
VALUATION '- tNG DEPT APPROVAL: CS R-'9-9 .
PERMIT FEE t kJ:if EtWILDIA.3 DLPI APPROVAL: CR 8-12--91 KC 8-I3-91
PLAN CHECK FEE
UMBING FEE
ECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW DATE --
WATER SERVICE
WATER MAIN CHG. AlViri x' $158.00 S.B.C.C. FEE
OTHER FEES ,f'k:i «---
AMOUNT DUE
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
CITY OF FEDERAL WAY BUILDING PERMIT PERMIT NO.: 91-1045
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 11/02/92
Federal Way, WA 98003 BY: FLF
661-4000
SITE ADDRESS: 1436 S 312 ST
PARCEL NO.: 082104-9060
PROJECT DESCRIPTION: RENEWAL/REVISIONS
OWNER CONTRACTOR LENDER
US BANK
tm
1436 S 312TH ST
FEDERAL WAY WA 98003
14780
I
BLD?: MEC?: PLM?: FLR--EXIST--PROP--- DWELLING UNITS: 0 COMP PLAN • FEES:
TYPE OF WORK:CA USE: 1ST.: 0: 0:sf STORIES • 0 REQUIRED PARKING..: 0 SPRINKLERS? • OTHER MISC REVENUE.. $ 45.00
CENSUS CATEGORY •437 2ND.: 0: O:sf HEIGHT • 0.00 ft HAZARD CLASS...: FINAL PLAN CHECK...* $ 30.00
OCCUPANCY GROUP 3RD.: 0: O:sf VALUATION REQUIRED SETBACKS FIRE FLOW • 0 gpm
.•
OTHR: 0: 0:sf EXIST..$: 0 FRONT - 0.00 ft
TYPE OF CONSTRUCTION BSMT: 0: 0:sf PROP...$: 500 SIDE • 0.00 ft WATER SERVICE..:
. DECK: 0: 0:sf REAR • 0.00:ft SEWER SERVICE..:
OCCUPANT LOAD GAR.: 0: 0:sf RECEIVED.:08/07/91
0: 0: 0: 0: TOTL: 0: 0:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:
FUEL TYPES.: FANS • 0 BOILERS/COMPRESSORS WATER CLOSETS • 0 URINALS • 0 TOTAL FEES $ 75,00
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 BATH TUBS • 0 DRINKING FOUNT.: 0
FURN<100K..: 0 DUCT WORK • 0 3-15 HP • 0 SHOWERS • 0 SUMPS • 0
GAS HWT • 0 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 0 VAC BREAKERS...: 0
CONV BURNER: 0 FURN>100K • 0 30-50 HP • 0 SINKS • 0 DRAINS • 0
BBQ • 0 MISC • 0 5+ HP • 0 DISH WASHERS • 0 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELEC WTR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE • 0 <=10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS...: 0
CLOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
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.
OWNEF.'OR AGENT - �,-t-.- .-�J� � /% .7.-�/1 . (/; > DATE ///� )c J
bld_prmt 10/23/92 // �/ ll(
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CITY OF FEDERAL WAY B U I L D I N G PERMIT PERMIT NO.: 91-1045
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 10/16/92
Federal Way, WA 98003 BY: FLF
661-4006
SITL ADDRESS: 1436 S 312 ST
PARCEL NO.: 082104®9060
PROJECT DESCRIPTION: K .L WIa-L-.
— OWNER .- CONTRACTOR LENDER
US BANK
1111
BLD?: NEC?: PLM?: FLR--EXIST--PROP--- DWELLING UNITS: 0 COMP PLAN • FEES:
TYPE OF WORK:CA USE: 1ST.: 0: O:sf STORIES • 0 I REQUIRED PARKING..: 0 SPRINKLERS' • OTHER MISC REVENUE.. $ 45.00
CENSUS CATEGORY -437 2ND.: 0: O:sf HEIGHT • 0.00 ft 1 HAZARD CLASS...:
OCCUPANCY GROUP 3RD.: 0: 0:sf VALUATION REQUIRED SETBACKS FIRE FLOW • 0 gpm
.•
OTHR: 0: 0:sf EXIST..$: 0 FRONT • 0.00 ft
TYPE OF CONSTRUCTION BSMT: 0: 0:sf PROP...$: 7000 SIDE • 0.00 ft WATER SERVICE..:
. DECK: 0: 0:sf REAR • 0.00:ft SEWER SERVICE..:
OCCUPANT LOAD GAR.: 0: 0:sf RECEIVED.:08/07/91
0: 0: 0: 0: TOTL: 0: 0:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:
FUEL TYPES.: FANS • 0 BOILERS/COMPRESSORS WATER CLOSETS • 0 URINALS • 0 TOTAL FEES $ 45.00
GAS PIPING.: 0 ft HOOD • 0 0-3 HP......: 0 BATH TUBS • 0 DRINKING FOUNT.: 0
FURN<100K..: 0 DUCT WORK • 0 3-15 HP • 0 SHOWERS • 0 SUMPS • 0
GAS HWT • 0 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 0 VAC BREAKERS...: 0
CONV BURNER: 0 FURN>100K • 0 30-50 HP • 0 SINKS • 0 DRAINS • 0
BBQ • 0 MISC • 0 5+ HP • 0 ? DISH WASHERS • 0 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS I ELEC WTR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE • 0 <=10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS...: 0
—*LOGS— 0 > 10,000 CFM: 0 UNDERGROUND.: 0
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.
OWf'=P•OR AGENT -- .2 �.,`z 1's� v 63-c-(-1 - 6,1'3 8G,r' , DATE 'A_ A 4.
bld_prm: 07/31/92, R
Airit
,,,.,
BY ..,. DATE -1
•mit # 9,," - /6 A
RECEIVED CITY OF FEDERAL WAY
NM 7 iggi BUILDING PERMIT APPLICATION
— Please Print—
Mr,' fraieRAiref
BOX 1AI0fE: 14-3&' S
OWNER LS IsANIK SITE LOCATION 3-12 [-U4i lq S
OWNER'S ADDRESS 1414 4-"NCITY S E T'I'LE PHONE 32- "4 6v6,2_
DESCRIBE JOB [1.TOt.lo1Z 1Zct O2EL OF1;5CI5TIJ — PAN t4. 13•1A 16.4
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION X-1
BOX 2 CONTRACTOR'S NAME DLI T FZ 117 CONTRACTOR'S REG. #
Card MUST be presented
CONTRACTOR'S ADDRESS CITY PHONE
EXPIRATION DATE
— OR —
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 JAh1 I rZ__/L.4vlizr^NGe- YUAN ,AssccS,PHONE 343 _7 S7 3
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST t{3 5) 00'0 EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER O8 Z-1o4 -010‘%/9 ' O'
LEGAL DESCRIPTION SEE 54-1T A I , d
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR 412-'7b/ 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
JK)-COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET $
BATHTUBS NO. FURNACE, ELEC. GAS $
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: 7 �
ANP-008 3/90
.411
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THI LINE)
ZONE 8e SETBACKS: FRONT N/'' SI E N//-/ REAR 11///4 HEIGHT LIMIT AP/ 'I '�"'
PLANNING DEPARTMENT APPROVAL .�m�: � ,f'- 9 - 7/
REMARKS,: t/-.s;sau,<. vow u _
-.� ,r
v ,„
164344.164344. '.:. ...
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL �% • . DATE ei. /4�V
REMARKS: f -C.,..-C.,.. ?) /3 ` c7/j
PUBLIC WORKS DEPARTMENT APPROVAL }�j DATE
7(/
REMARKS:
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ADD/ALT ' NEW MULTIFAMILY (UNITS )
MULTIFAMILY ADD/ALT TENANT IMP. OTHER
OCCUPANCY 6 .- TYPE OF CONSTRUCTION - STORES
(1)"(-- ( c ( BUILDING SQ. FT. @ = j-c)0 e'
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ =
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ /tA.Qd ( -(t�l_ = 0,2,0
TOTAL SQ. FT. TOTAL VALUATION -700 C
BUILDING DEPARTMENT REMARKS: PERMIT FEE 1 O
PLAN CHECK FEE fi--c(
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE (4, S C
OTHER FEES=
0 Permits 9/ -- /o 4/5-
'`g V/5/0/✓/xe,v,.l c "
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 TENANT NAME: U• S. ty`�
OWNER U ' -S k K SITE LOCATION ----- Sf �
OWNER'S ADDRESS lC X.p - S 3i 2' S; CITY Fe4,ed k/2 , ya'Ga3PHONE Z27 _L{7Pv
DESCRIBE JOB Aerv2wa.Q I /-4_4.-‘,A...4...6.,4
�/
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG. #
Card MUST be presented
CONTRACTOR'S ADDRESS CITY PHONE
EXPIRATION DATE
— OR —
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 �€-- ,'Lw-z v&z.,/ PHONE 3'/4V-1,es2 #7
BOX 4 SEWER DISTRICT WATER DISTRICT -
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
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 1 - -
3RD - FLOOR J 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$---- .
NO. - - WATERCLOSETS - GAS PIPING, FEET $..._ .
BATHTUBS NO. FURNACE, ELEC. GAS $
SHOWERS
GAS HOT WATER HEATER $-
LAVATORIES - - -- - - - CONVERSION BURNER - -- -. --__ $__ . .
SINKS BOILER, SIZE BTU $
DISHWASHERS . . ---AIR HANDLING UNITS S----- --
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 $
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
.ADE.I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(INCLUDING COSTS,EXPENSES,AND ATTORNEYS'
EES INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM), WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
{ND 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.
)A'NER/AGENT: DATE:
AHP-00.11 3,PO