92-100866 MECHANICAL PERMIT 9 D- !b b W96
CITY OF I g L D I N BUILDING INSPECTION
FEDERAL WAY u G PERMIT 1T 661-4140
PERMITNO. 92-893 M OWNER'S NAME DALE PAC SITE ADDRESS 3909 SW 336 PL
CONTRACTOR NW WTR HTR ADDRESS 8201 DURANGO ST SW TACOMA CONT.PHONE 984-6404
CONT.REG.NO. NORTHWH103R2 EXP.12/92 OWNER'S PHONE 838-2790 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. 921151-0530 LEGAL DESCRIPTION
I ISSUED BY EBS _DATE OF ISSUE ( c� > DATE OF APPLICATION 6/10/92
BUILDING INFORMATION
ZONE SET BACKS:FRONT SIDE REAR HEIGHT LIMIT
OCCUPANCY _ TYPE OF CONSTRUCTION CENSUS NO. TYPE OF HEAT BLDG.SQ.FT. STORIES
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING _ FT. GAS LOGS
RECEIVED
'BATHTUBS LAUNDRY DRAINS _ FORCED AIR FURNACE DUCT WORK
SHOWERS URINALS GAS HOT WATER HTR. 6.50 AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS CONVERSION BURNER MISC.
'SINKS MISC. BBQ BASIC FEE 20.00 RETURNED
DISHWASHERS TOTAL FIXTURES DRYER TOTAL MECHANICAL 26.50 AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
UMBING FEE INSPECTION RECORD
,ECHANICAL FEE $26.50
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 $26.50 Total Fee $ 26.50 Receipt No. G 2 - /S R-s c
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 ET:
r _ ,
OWNER OR AGENT DATE 1
MECHANICAL PERMIT
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 661-4140
92-893 MDALE PAC 3909 SW 336 PL
PERMIT NO. OWNER'S NAME SITE ADDRESS
CONTRACTOR NW
i11TR BTR 8201 ST "' CONT.PHONE984-6404
CONT.REG.NO. N0�I03 EXP.1 RESS OWNER'S PHONE 838_Z790 OWNER'S ADDRESS
TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. _INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.__
NEW ``��jj MULTI-FAMILY-97.14 TSS-053` MULTI.ADD. _ SIGN GRADING OTHER -
TAX ACCOUNT NO.MULTI-FAMILY-9-7-1411-0534 LEGAL DESCRIPTION
- - - - - ---
, -
ISSUED BY __ DATE OF ISSUE DATE OF APPLICATION 6/I0/92
• BUILDING INFORMATION
ZONE SET BACKS:FRONT SIDE_ - REAR _ HEIGHT LIMIT
OCCUPANCY TYPE OF CONSTRUCTION CENSUS NO.. -_ TYPE OF HEAT _ _ BLDG.SQ.FT. _ -STORIES
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING FT. _ GAS LOGS RECEIVED
BATHTUBS LAUNDRY DRAINS FORCED AIR FURNACE DUCT WORK
SHOWERS URINALS GAS HOT WATER HTR. AIR HANDLING UNIT - _ NUMBER
LAVATORIES DRINKING FOUNTAINS CONVERSION BURNER MISC.
SINKS MISC. BBQ BASIC FEE
20_0(0 RETURNED _
DISHWASHERS TOTAL FIXTURES DRYER TOTAL MECHANICAL 26.50 AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED ,.BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
•LUMBING FEE INSPECTION RECORD
ECHANICAL FEE $26.50
TOTAL BLDG. FEES Water Line OK Mechanical Inspection Notes:
PART P/C FEE /I
SEPA REVIEW GAS PIPING OK (0// /e/ 2- Date�qA&/‘? By C,1,1,,/
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES MECHANICAL PERMIT
AMOUNT DUE Total Fee $ 26.50 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 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 O o -o o cn
r
Z -1 7 -D-I c -1
m D m m K m co
I� O 0 p0
7 1 z o X
O p 2O Z
0 cn C I O
n TI 1 = I
Om
C3 z O
>
co K co-< m Z
N, z 1 o
O cn
0 o z 0 o O •
0 D cn D D D 'x
m c m H
D v M O
r I v
p z O
z m c
DJ
o
O
O
, c
I o
D
m W —I
-< , -< O
Z
-0
cn D
o r
I r
I cn
I
CJ O K 0 '0
m r —1 =m C
D Co
Co Z z
> 5 1 5)
O
o r (70
Z u) o
1 0 -o Z
m „ o
o W CO o m
r
I
1 I
i
1
- - _ oni
;t # 9-7,- f(ir t
'IV D
JUN I 0 1992 CITY OF FEDERAL WAY
WvoFFEogg BUILDING PERMIT APPLICATION
nmiJ.wRy — Please Print—
INNUaral
BOX 1#TENANT NAME:
OWNER r SITE LOCATION ...3_9__Q9_3_4. -' R{ L.
OWNER'S ADDRESS 3`;\ $ 1 < `.-�3(.. "PL CITY .--: . " 'Y 'HONE g3 - ,D-79 b
DESCRIBE JOB 1 Y\S}-tA\\ L bc-' cif 4
THE PROPERTY IS OWNED BY: SINGLE/MARRIED }C.) PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME"�(\( 5Y"�1/1kA 1dZLA-, tea. CONTRACTOR'S REG. #KluK�-1-1 %H 10M)--
Card MUST be presented
CONTRACTOR'S ADDRESS ` S , ''CITY I C-CY�'1�- _ PHONE ci -'I` 40L-1EXPIRATION DATE 1.2- 2<31 9 n -
— OR —
I HAVE READ CHAPTER 18.27.010 RELATING T1 A1 FINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON b-i'v\ PHONE "( -I�- Co L, COY
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST '- 51-4 I EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER "1 D-l1 S —Q 30
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 $
BATHTUBS NO. 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 _ $
ruIE_NpSrT4efzfper_je,zczzzdr,e,___,_ $
1 $
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 ON WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLOYEES, UPON THE ACCURACY OF T 7 INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
C--)
OWNER/AGENT: it-A . L `ii. Alk Iv DATE:
ANP-008 3/90