92-100490 MECHANICAL PERMIT C.a- /O0Y 9
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
PERMIT NO. 92-0471 M OWNER'S NAME BISH JOB ADDRESS 113 SW 307TH PL
CONTRACTOR USI ADDRESS 1908 341ST PL S #9 FEDERAL WAY CONT. PHONE 952-5433
CONT. REG. NO. NORTHUS1O1JJ OWNER'S PHONE 946-3392 OWNER'S ADDRESS 113 SW 307TH PL 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. 556000-1140 LEGAL DESCRIPTION
SUED BY JOANN E JOHNSON DATE OF ISSUE .3 ._ _) / - / 'L DATE OF APPLICATION 3-26-92
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 10.00 AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS GAS 1-i OT WATER HTR. MISC.
SINKS MISC. CONVERSION BURNER BASIC FEE 20. 00 RETURNED
DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL 30.00 AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
DUMBING FEE INSPECTION RECORD
CHANICAL FEE 30_00
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 30.00 Account No. 010-000-322-10-004 Total Fee $ 30. 00 Receipt No. 0.2 - i 1 763
ALL PERMITS EXPIRE 1:: • •• • TER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE IN 'RMATION . RNISHED BY ME IS - D_CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE :
OWNER OR AGENT ,‘I DATE
MECHANICAL PERMIT
CITY OF BUILDING INSPECTION
FEDERAL WAY DU I LDI NG 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. 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 SHOT 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
TOTAL BLDG. FEES Water Line OK Mechanical Inspection Notes:
PART P/C FEE
SEPA REVIEW GAS PIPING OKizi.,L
4 Date1/j ' By 7/16
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
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RECEIVEnPeon # ( RJ 11
MAR 2 6 1992CITY OF FEDERAL WAY
MTV OF
SWAY BUILDING PEReMIPTtAPPLICATION
BOX 1 TENANT NAME:
OWNER SITE LOCATION __-` 3O ' .
OWNER'S ADDRESS G • CITY Fe 3Q+4_ _ �a: PHONE# - _
DESCRIBE JOB 11 �Qre (-)nc�. �c...Q__I;.mc .
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME NcIRAL\,t,:. `,k CA- '2, t , CONTRACTOR'S REG. #ivice-i-i, Lt_:_. t CA JT
St Card MUST be presented
CONTRACTOR'S ADDRESS /c/C) 3Yl PL.en
CONTRACTOR'S #? CITY re..SleeelLOatPHONE/_`o-S `R2
EXPIRATION DATE `/--S- `3ca./
— 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 i .(1Y\t J 2.c:_.Q.L. PHONE r?So)-5Y33
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST ETING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMB 5SLCOC) - I N-II( )
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 I. 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) (X) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 Pb4.MBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. \ WATERCLOSETS GAS PIPING, FEET d $
BATHTUBS NO. I FURNACE, ELEC. GAS / $
\ SHOWERS GAS HOT WATER HEATER $
LAVATORIES CONVERSION BURNER $
KS BOILER, SIZE BTU $
DIS•. ,SHERS AIR HANDLING UNITS $
C 'IC HOT WATER HEATER HEAT PUMPS, SIZE _ $
LAUNDR WASHER OUTLET UNIT HEATERS $
/ URINALS AIR COOLING UNITS, SIZE $
DRINKING FO►NTAINS COMMERCIAL HOOD $
SUMPS, SPRIN' ER 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 AGAI i _ 14 .LITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND ' PLOYEE UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: tf- ` \c'`'`'am DATE: 5— 3 to - / �..
ANP-008 3/90