92-100121 MECHANICAL PERMIT 9 -baa,ia/
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
92-0052 M LARRY MEIER 2452 SW 307TH STREET
PERMIT NO. OWNER'S NAME JOB ADDRESS
CONTRACTOR NORTHWEST USI ADDRESS 1908 341ST PL S #9 FEDERAL WAY CONT. PHONE 952-5433
CONT. REG. NO. NORTHUS1O1JJ OWNER'S PHONE OWNER'S ADDRESS 2452 SW 307TH STREET FEDERAL WAY
TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI-FAMILY )1 MULTI.GADD. SIGN GRADING OTHER
TAX ACCOUNT NO. 1 LEGAL DESCRIPTION
IIISUED BY JOANNE JOHNSON DATE OF ISSUE DATE OF APPLICATION 1-16-92
L'
BUILDING INFO•MATION
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 90 FT. 2.00 BOILER
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S) RECEIVED
SHOWERS URINALS FORCED AIR FURNACE 10.00 AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS GAS pOT WATER HTR. 6. 50 MISC.
SINKS MISC. CONVERSION BURNER BASIC FEE 20.00 RETURNED
DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL 38.50 AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
AIIIRMIT FEE
AN CHECK FEE
PLUMBING FEE INSPECTION RECORD
MECHANICAL FEE 38.50
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 / n
AMOUNT DUE 38.50 Account No. 010-000-322-10-004 Total Fee $ 38.50 Receipt No. 44
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 E M f7
OWNER OR AGENT Z A, !�'� DATE /
MECHANICAL PERMIT
CITY OF Bu I I_ ® ' N G P E RM BUILDING INSPECTION
FEDERAL WAY 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 par WATER HTR. MISC.
SINKS MISC. CONVERSION BURNER BASIC FEE RETURNED
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 OK CX-)63G Date \ k' By ��`� i2.
WATER SERVICE r, I ((o,(,i� � ti\L
WATER MAIN CHG. crton.
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 THF BEST )F MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET:
OWNER OR AGENT DATE
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Perm. q)--(D<)-Yli
JAN 1 6 1992 CITY OF FEDERAL WAY
O17YOFFEDERALWAY BUILDING PERMIT APPLICATION
BUILDING DEPT. - Please Print—
BOX 1 TENANT NAME:
OWNER me.l'L / 5. (J ' �f
. 3O .
OWNER'S ADDRESS a� ( 9Sa?o� J:�J• 30 Sk-, CITY Fe _eea iy` PHONE
DESCRIBE JOB Eict , -1-c) S ae.03. �>rneut On ..c Q. 3 L()c e.,P 1:i
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME I(C)e -�wc,&A- L.5...L. CONTRACTOR'S REG. #A10 E-114 LA_?-, lUl JS
Card MUST be presented
CONTRACTOR'S ADDRESS 1�.C% -3,,1p-).1.4,�. 1t9 CITY Fe(QeeoQ.( PHONE c-iSg"5 /33
EXPIRATION DATE LI 'S-`7a
— OR —
I HAVE READ CHAPTER 18.27.010 RELATI EFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON x- 2c_e__ PHONE.. --x`133
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EX TING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBS H l C- O 1 C--
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 I 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 90 cm. $
BATHTUBS NO. I 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 $
DRAINSo $
I HE' •_:tom::_-�`i:�w►�..3'• . $
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 EMPLOY,EES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: �� I� /6/{.9X)-
DATE: /- /�- p
ANP0083/90