90-100111 MECHANICAL PERMIT
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDINCa PERMIT 941-1555
- /ao ///
PERMIT NO. 90-0153M OWNER'S NAME DOUG SHAVER JOB ADDRESS 12628 6 AVE SW
CONTRACTOR NOBTHWEST WT$ HTR ADDRESS 8201 DTTRAN(,O ST SW TACOMA CONT. PHONE 627-4048
CONT. REG. NO. NORTHWHT 37KJ 17/90 OWNER'S PHONE 874-6959 OWNER'S ADDRESS SAME AS ST TE 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 MECHANTCAT.
TAX ACCOUNT NO. NA LEGAL DESCRIPTION NA
ISSUED BY ELIZABETH SNYDER DATE OF ISSUE .__ _ DATE OF APPLICATION 3/22/90
BUILDING INFORMATION
IPNE NA OCCUPANCY NA TYPE OF CONSTRUCTION NA BLDG. SO. FT. NA
SET 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 53 FT. 2.00 BOILER
RECEIVED
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS _ GAS HOT WATER HTR. 6.50 MISC. RETURNED
SINKS _ MISC. CONVERSION BURNER BASIC FEE 20'00
DISHWASHERS TOTAL FIXTURES NONE UNIT HEATER TOTAL MECHANICAL 28.50 AMOUNT NONE
VALUATION NONE
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE FEECHANICAL FEE
PLUMBINGINSPECTION RECORD
E 28.50
TAL 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 12 r0
OTHER FEES MECHANICAL, PERMIT j
AMOUNT DUE $28 50 Account No. 010-000-322-10-004 Total Fee $ 2. Receipt No. 1
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 MET:
/ /4 �/ -7f
OWNER OR AGENT � � � DATE 3 oC / `7
MECHANICAL PERMIT
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
ISSUED BY DATE OF ISSUE DATE OF APPLICATION
BUILDING INFORMATION
OCCUPANCY TYPE OF CONSTRUCTION BLDG. SQ. FT.
SETBACKS: 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
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE INSPECTION RECORD
MECHANICAL FEE
1 /BLDG.C FEE FEES Water Line OK Mechanical Inspection Notes:
P P/C FEE
SEPA REVIEW GAS PIPING OK Date -1- `10By ' i'.
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
o m o o o m o cn
D z D . > r > m
H -i T H C H -1
m D m H m K m co
O O co D
m Z 0
H 0 ! cn
Z O
O rO D
O 0 o
O m = m
O m 0
C m 1 Z O
Co < CO > CO CO —I
-< � _K -< -< Z
Z O
O cn
•
O 0 •-• 0 •
O D Z D > > O
cn
o m C cn m -i
D 37
m O
rm
O Z
Z O m O
• Ox
0 m
0
••
c
1 I z
0
W D
HO
z
2) ! >
Cnr-
o r
Ln
:
C7 * 0 K 0 m
r
rn D m n m C
M r m = m0
CO
O !� Z ' 0
n
o r O
?J
Dz 0
Z I C
•
0 ,-' (n Z
m -n `^� O •
CO
v
o CO W O IW DJ
-< D { -C
r
•
I
i 1 •
. i
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 OWNER (3t)LilirY ° ‘,;'_.5 /3eJOB LOCATION 1 /t 4,✓
OWNER'S ADDRE +,tt
e/- • P,dve Lt/ CITY - hi PHONE 77',55 <
DESCRIBE JOB I4 4 �S U(/1G1CF ` 4 111-1-, /3 7kr
THE PROPERTY IS OWNED BY:'StNGLEC_IED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME A i '5 / w cii or/ CONTRACTOR'S REG. # w
�" Card MUS be presented
CONTRACTOR'S ADDRESS Y. �i 0 D CON n S'-SSV CITY TGieLl c PHONE G 7 Vei ZI/'
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 _ PHONE/ 7 ' d__ _
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.)
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 SO FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANI.AL 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 KNOW EDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PER-
FORM THE WORK WHICH RE IT PPLIC TION IS MADE.
OWNER/AGENT: CM/ DATE: ?....-��
5- ANP-006 2/90
\