91-100811 MECHANICAL PERMIT 9 1- /008"/J
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
PERMIT NO. 91-773 M OWNER'S NAME GEGGE A GILMORE JOB ADDRESS 32318 6TH AVENUE SW
CONTRACTOR NORTHWEST WATER HEATER ADDRESS 8201 DURANGO ST SW TACOMA CONT. PHONE 984-6404
CONT. REG. NO. NORTHWH 103R2 OWNER'S PHONE 838-2381 OWNER'S ADDRESS 32318 6TH AVENUE SW 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. 926490-0760 LEGAL DESCRIPTION � J
ISSUED BY JOANNE JOHNSON DATE OF ISSUE �ll DATE OF APPLICATION 6-10-91
BUILDING INFORMATION
likNE 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 5_FT. 2.00 BOILER
RECEIVED
BATHTUBS LAUNDRY DRAINS COMPRESSOR _ __ TANK(S)
SHcWERS URINALS _ FORCED AIR FURNACE 10.00 AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS GAS friOT WATER HTR. MISC.
RETURNED
SINKS MISC. CONVERSION BURNER BASIC FEE 70_O0
DISHWASHERS TOTAL FIXTURES _ UNIT HEATER _ TOTAL MECHANICAL 17_00 AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE INSPECTION RECORD
jAL
HANICAL FEE
32.00
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 32.00 Account No. 010-000-322-10-004 Total Fee $ 32.00 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 - INFOR' . ON FURNISHED BY ,% -UE AtcORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENT. WILL :E MET: '
OWNER OR AGENT f /,L -.AL.--e ---.- r�' DATE
-- / ' 'T- F
Recei�/ •mit #
�u '�iD •
H i 1 1 •
Ci CITY OF FEDERAL WAY
6ULDINGERgi-WAY BUILDING PERMIT APPLICATION
Dept — Please Print-
BOX 1 TENANT NAME:
OWNER 6e,-e r^ 'e_ SITE LOCATION ) 3 i ��` t4 . `J --t 611
OWNER'S ADDRES ).( 4". 5 i^^ CITY rid c+'a-I W4 PHONE g-3Y/
DESCRIBE JOB '1 i.�' 1 6a—f) t,tf o-CF' i` Gcs Fu'rt c /c Cc �-
I -7/"‘THE PROPERTY IS OWNED BY: SINGLE/MARRIED` t PARTNERSHIP CORPORATION�
BOX 2 CONTRACTOR'S NAME /6'`64"tla. 'sf 1.A-L4-k-7 1 � ��✓ CONTRACTOR'S REG. # /"o1 ! (4k /6 3�7-
Card MUST be presented
CONTRACTOR'S ADDRESS g56( 17w'c-t o S1-° 5C CITY r o-rtLC PHONE �' Y -- 6 O tlf
EXPIRATION DATE / - 7_ (#0
— 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 {Nli K PHONE 4'Y-- (a yd
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST / 5 O. to EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER 9.• y? - 6 7 r
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 ('+--fi 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) MECHA I AL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET ` $
BATHTUBS N0._ i FURNACE, ELEC. GAS L/ $
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 FEDERA WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLOYEES, PON TIDE CURACY OF T INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: DATE:
r
ANP-008 3/90