92-100149 MECHANICAL PERMIT 9 - / 6 a /Y F
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
PERMIT NO. 92-0095 M OWNER'S NAME CHARLIE ANDERSON JOB ADDRESS 561 SW 334TH CT
CONTRACTOR ANOTHER PLUMBER ADDRESS 21756 123RD AVE SE KENT CONT. PHONE 639-0840
CONT. REG. NO. ANOTHP1O1KH OWNER'S PHONE 874-5654 OWNER'S ADDRESS 651 SW 334TH CT
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. 729801-0360 LEGAL DESCRIPTION 1 4,4_,
ISSUED BY JOANNE JOHNSON DATE OF ISSUE Lt ' DATE OF APPLICATION 1-22-92
0 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 60 FT. 2.00 BOILER
RECEIVED
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS URINALS FORCED AIR FURNACE AIRHANDLINGUNIT NUMBER
LAVATORIES DRINKING FOUNTAINS GAS IOT WATER HTR. MISFTAS LOGS 6.50
SINKS MISC. CONVERSION BURNER BASIC FEE
20.00 RETURNED
DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL 28.50 AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
UMBING FEE INSPECTION RECORD
IIIIPE CHANICAL 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. .-4-54-(/
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 '( c.-- :.3.--1-,-, DATE j-- l ::-7-).--
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MECHANICAL PERMIT ' - / o c) /(/ S
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
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.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
iliLUMBING FEE INSPECTION RECORD
:CHANICAL FEE
TOTAL BLDG. FEES Water Line OK Mechanical Inspection Notes: C) tneeLLCtY5
PART P/C FEE
SEPA REVIEW GAS PIPING OK 1 lalX1gZDate A `1By ; F i Oc c f 'A S►9('-e
WATER SERVICE OMAN
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
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RECEIVED NO it # I( - I'
AN 2 2 1992 CITY OF FEDERAL WAY
OrrY OFINDEPwAY
BUILDING DEPT: BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 TENANT NAME: ¶( I )Lt__J 2* C-t-
OWNER �,''AP P;Z cl, ANC4e QSo'J SITE LOCATION
OWNER'S ADDRESS 56 I ',w 13•t./ CT CITY FPr7 !ter PHONE 7 U/ St,5/
DESCRIBE JOB A-41,i ; /M;
J
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME Tk RYSTkeR H .i)2g- CONTRACTOR'S REG. # t p�r k F X Ivi PI
Card MUST be presented
c .
CONTRACTOR'S ADDRESS 0S4- /a3 C,.t,,o S E CITY /C:z A-T_ PHONE 631 V g 2/0
EXPIRATION DATE S `i 1
— OR —
I HAVE READ CHAPTER 18.27.010 RELATIN(�T DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON 64,6 I ezopi PHONE LS r4 0 `/U
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST 71440c.) E TING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER 7••Z9 SQ.I - 03
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
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET 1-00 r. $
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 a OTHER b063 4,17 $
BRAINS $
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: / -a ' C3
ANP-008 3/90