92-101039 MECHANICAL PERMIT 9),,A) b3 �1
CITY OF I g L D I N BUILDING INSPECTION
FEDERAL WAY u G PERMIT IT 661-4140
PERMIT NO. 92-1110 M OWNER'S NAME __ KENNETH BAKER SITE ADDRESS 28852 22ND AVE S
CONTRACTOR NORTHWEST WATER HTR ADDRESS 8201 DURANGO ST SW TACOMA CONT.PHONE 984-6404
CONT.REG.NO. NORTHWH1O3R2 EXP.12/92 OWNER'S PHONE 839-3348 OWNER'S ADDRESS 2882 2_2ND AVE S 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. 422270-0310 LEGAL DESCRIPTION
ISSUED BY _ JOANNE JOHNSON DATE OF ISSUE ` _ DATE OF APPLICATION 7-20-92
BUILDING INFORMATION
"NE 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 1 FT. 2.00 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 28.50 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 28.50
IIPTAL 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 J �,� /
AMOUNT DUE 28.50 Total Fee $ 28.50 Receipt No. elf 7
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 INF RMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE ET:
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OWNER OR AGENT t......../41DATE /2 / `
MECHANICAL PERMIT ( 1 jilt -,- 9
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 66,-4140
92-1110 M KENNETH SAILER 2RR51 22ND AVE S
PERMIT NO. N7RTIk OWNER'S NAME 8201 VU1iANG) ST SW MINA—
ADDRESS,_— 984-5404
CONTRACTOR ADDRESS CONT.PHONE
CONT.REG.NO. NORT1W0103EXP. OWNER'S PHONE 839-3348 OWNER'S ADDRESS 28852 S FEr' WAY
TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAI COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI-FAMILY (UNITS )MULTI.ADD. SIGN GRADING OTHER
/ TAX ACCOUNT NO. `" 2270"0310 LEGAL DESCRIPTION
ISSUED BY JOANNE JORHS( DATE OF ISSUE DATE OF APPLICATION 20-92
BUILDING INFORMATION
SONE _ 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. ""6 U. GAS LOGS
RECEIVED
BATHTUBS LAUNDRY DRAINS FORCED AIR FURNACE DUCT WORK
SHOWERS URINALS GAS HOT WATER HTR. b'SQ AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS CONVERSION BURNER MISC.
SINKS MISC. BBQ BASIC FEE
LO.00 RETURNED
DISHWASHERS TOTAL FIXTURES DRYER TOTAL MECHANICAL 28.50 AMOUNT
VALUATION
T GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE INSPECTION RECORD
MECHANICAL FEE
_TAL BLDG. FEES Water Line OK Mechanical Inspection Notes:
PART P/C FEE
SEPA REVIEW GAS PIPING OK Date tO,S 7.2 By /7;
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES MECHANICAL PERMIT
AMOUNT DUE 2$ 50 Total Fee $ 8 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. ( V
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 •/I
REQUIREMENTS WILL BE MET: t �i1
OWNER OR AGENT DATE
ED àermit # q - I i a �(
1992 CITY OF FEDERAL WAY
-4 UILDING PERMIT APPLICATION
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¢� - Please Print—
BOX 1 TENANT NAME:
OWNER '\ t 'A- SITE LOCATIO • • _ ��
OWNER'S ADDRE SO SSP <?''=� O v-._ "a. CITY-1•L... ! 1 _IHONE �+
DESCRIBE JOB I/1 cx.1.1
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAMI` 1s��--kti11 , .o---CONTRACTOR'S REG. #N \\-LQI61- ���i--�
`
cc Card MUST be presen d
CONTRACTOR'S ADDRESS( I (� GV S CITY4C%kCLYYIGt PHONE � `J�--(01-40 1
EXPIRATION DATE -�' a 0. 9D--
— OR —
I
D-
— 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 01SZ— PHONE c\S\—(44c4
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST C)0 EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER t_4 �- -1 V - CC31 Q
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) MECHANICAr APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET I $
BATHTUBS NO. FURNACE, ELEC. GAS $
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 EMPLOYEES, UPON THE ACCURACY OF T E INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
qOWNER/AGENT: •.• —.11% .I DATE:
ANP008 3/90