90-100653 MECHANICAL PERMIT
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
PERMIT NO. 90-921 M OWNER'S NAME NORMAN MINARSICH JOB ADDRESS 33732 32 AVE SW
CONTRACTOR NW WATER HEATER ADDRESS 8201 DURANGO ST SW TACOMA CONT. PHONE 9R4-6404
CONT. REG. NO. NORTHWH137KJ OK OWNER'S PHONE 927-5528 .. _ OWNER'S ADDRESS SAME AS SITE
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 MECHANICAL ONLY
TAX ACCOUNT NO. NA LEGAL DESCRIPTION EXISTING HOUSE
ISSUED BY ELIZABETH SNYDER DATE OF ISSUE to I - ? (..) DATE OF APPLICATION 6/18/9n
BUILDING INFORMATION
ONE NA OCCUPANCY NA TYPE OF CONSTRUCTION MECHANTCAT. ONT.Y BLDG. SQ. FT. NA
T BACKS: FRONT NA SIDE NA REAR NA STORIES NA HEIGHT LIMIT N
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING 10 FT. 2-00 BOILER
RECEIVED
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS URINALS FORCED AIR FURNACE 10 00 AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS GAS HOT WATER HTR. 6_50 MISC,
RETURNED
SINKS MISC. CONVERSION BURNER BASIC FEE 20_00
DISHWASHERS TOTAL FIXTURES NONE UNIT HEATER TOTAL MECHANICAL 38.50 AMOUNT NONE
VALUATION NONE
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE INSPECTION RECORD
MECHANICAL FEE $38 50
TAL BLDG. FEES Water Line OK Mechanical Inspection Notes:
iiT 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 $38.50 Account No. 010-000-322-10-004 Total Fee $ :3 _ •)--"L.) Receipt No. //,-{c)/7c../7-
ALL
/T-
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 BEMET:
OWNER OR AGENT 4 . z)d DATE C---1 �//��� / !/
MECHANICAL PERMIT
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
,,_ HD (, ;
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
OCCUPANCY TYPE OF CONSTRUCTION BLDG. SO. FT.
S 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 HOT 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 r;���
BLDG. FEES Water Line OK Mechanical Inspection Notes: 4"(
PA T PIC FEE n
SEPA REVIEW GAS PIPING OK Date iS y
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
• •ermit # � - Z-2/ '
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print— 1'4
— c.J-0,..-A
BOX 1 TENANT NAME:mi),/,9 (--,..c / c kl/'I')6t
OWNER (36./4'U- T LOCATION �/ 5 h't
OWNER'S ADDRESS _ _� i C t/ CIT &OW HONE c
DESCRIBE JOB 1 • , &...0 Ar << L'14 .r ?HONE
THE PROPERTY IS OWNED BY: SINGLE/MARRIED) PARTNERSHIP CORPORATION f
BOX 2 CONTRACTOR'S NAME�Gt/ �i✓� <'/4 4 (.�' CONTRACTOR'S REG. #/ /i -0K
CC rrd M ST be presented
CONTRACTOR'S ADDRESS 8:970 / %0/C4/21O S7/''ITY 7 (d7r14 PHONE 57 z/U ev
EXPIRATION DATE
— 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 72 i77 PHON TC " ' 4.-/0 C/
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
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 = ) 4.-YtXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL --TOTAL AREA OF PROP ! SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS P P G, FEET � $
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 C ,OF F DERAL WAY :UT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLOY S, IJP1 I THE ACCU• £CY OF THE INFORMATION SUPPLIED TO THE C TY AS PART OF THIS APPLICATION.
OWNER/AG : .� 4%f 1 A A DATE:
ANP-008 3/90