92-100146 MECHANICAL PERMIT 9)' /fib IVO
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
92-0088MLARRY SIMMS 29613 21ST PL S
PERMIT NO. OWNER'S NAME JOB ADDRESS
CONTRACTOR NORTHWEST WATER HEATER ADDRESS 8201 DURANGO ST SW TACOMA CONT. PHONE 984-6404
CONT. REG. NO. NORTHWH1O3R2 OWNER'S PHONE839-70455474-776 NER'S ADDRESS 29613 21ST PL S FEDERAL WAY
vvvTYPE 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. 751180-0060 LEGAL DESCRIPTION
----99"'.----'
ISSUED BY JAONNE JOHNSON DATE OF ISSUE DATE OF APPLICATION 1-21-92
• 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 GASI-10T 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
PLUMBING FEE _ INSPECTION RECORD
.ECHANICAL 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.
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 ETT:
/ ? ) .
.
OWNER OR AGENT\4 . DATE ' '
MECHANICAL PERMIT
CITY OF BUILDING INSPECTION
FEDERAL WAY u ' L D ' 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
ill
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;-10T 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
UMBING FEE INSPECTION RECORD
WLCHANICAL FEE
•
TOTAL BLDG. FEES Water Line OK Mechanical Inspectio Notes:
PART P/C FEE /?j
SEPA REVIEW GAS PIPING OK Date y
WATER SERVICE v
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES MECHANICAL PERMIT
AMOUNT DUE Account No. 010-000-322-10-004 Total Fee $ 3ni 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
.
• 0
SET BACKS AND FOOTINGS O.K TO POUR FOUNDATION WALLS PLUMBING GROUNDWORK
DATE BY DATE BY DATE BY
PLUMBING ROUGH IN WATER LINE O.K. MECHANICAL INSPECTION
DATE BY GAS PIPING O.K. DATE BY
O.K. TO ENCLOSE FRAMING INSULATION WALL BOARD AND FIRE WALL
DATE BY DATE BY DATE BY
y
FINAL O.K. TO 0/
CUPY
DATE
DCD PSD FD
„2/1--- 2"f3Y/2....
• •
P�„it # 9 L pow
JAN 2 1 1992 CITY OF FEDERAL WAY 1/)'
any tFFEDERAL WAY BUILDING PERMIT APPLICATION
9UIWDING DEPT — Please Print—
BOX 1 TENANT NAME:
OWNER ‘,--5SITE LOCATION /3 s i S4 �� . F4
OWNER'S ADDRESS r 3 � ►(s CITY . PHONE `3 - t"f '71'.'71'..-1461.'- /
DESCRIBE JOB •r- -s
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION__
BOX 2 CONTRACTOR'S NAMECONTRACTOR'S REG. # ,10/L%k/1'10 De7--
M��Y'�(���'f A.61- Card MUST be presented
CONTRACTOR'S ADDRESS 6? ( pv-c-rc J i• S CITY ' /NC c�` PHONE l‘sc `"e`�e'`I
EXPIRATION DATE /1-- �-'?- -c
— 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 K PHONE y �6 c{6 c../
BOX 4 SEWER DISTRICT WATER DISTRICT f
BOX 5 ESTIMATED PROJECT COST -',5'..-0• 60 EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER 7S// Fe 6 6G
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 1.71SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ') EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANI APPLIANCES — BASIC FEE $
NO. WATERCLOSETS GAS PIPING, FEET $
BATHTUBS NO. r FURNACE, LEC. GAS V $
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 FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLOYEE UP N T ACCURACY 0 THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: -- DATE:
ANP-008 3,90