92-100489 MECHANICAL PERMIT 7 ),fjD6YPs?
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
PERMIT NO. 92-0476 M OWNER'S NAME KATHY ANN SALSCHEIDER JOB ADDRESS 33724 37TH PL SW
CONTRACTOR ENVIRONMENTAL DESIGN INNRESS 25328 SE 200TH STREET MAPLE VALLEY CONT. PHONE 1-206-432-4247
CONT. REG. NO. ENVIROND 1098KL OWNER'S PHONE 874-2051 OWNER'S ADDRESS 33724 37TH PL SW 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. 921151-0030 LEGAL DESCRIPTION
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ISSUED BY JOANNE JOHNSON DATE OF ISSUE � DATE OF APPLICATION 3-26-92
BUILDING INFORMATION
NE OCCUPANCY TYPE OF CONSTRUCTION BLDG. SQ. FT.
ET BACKS: FRONT SIDE REAR _ , STORIES HEIGHT LIMIT
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING FT. 2.00 BOILER
RECEIVED
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS GAS;-10T WATER HTR. 6_50 MISC.
SINKS MISC. CONVERSION BURNER BASIC FEE 90_00 RETURNED
DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL 78_ 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
TAL BLDG. FEES Water Line OK Mechanical Inspection Notes:
ART P/C FEE
SEPA REVIEW GAS PIPING OK Date By
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE 0)- (g/ �J/ ,.,
OTHER FEES MECHANICAL PERMIT V �
AMOUNT DUE 28.50 Account No. 010-000-322-10-004 Total Fee $ 28.50 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.
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
MECHANICAL PERMIT
CITY OF BUILDING INSPECTION
FEDERAL WAY B I LD I N G 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
411 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 frIOT 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 INSPE •'- . AFc DA WILL NOT SUFFICE.
PERMIT FEE A
PLAN CHECK FEE
OLE
UMBING FEE INSPECTI• *,.y ' I ,.' Cil
i
CHANICAL FEE ..1
TOTAL BLDG. FEES Water Line OK Mechanical Ins• i• ' • es:
r
PART P/C FEE ._:-.104.,•
SEPA REVIEW GAS PIPING OK Date irt
WATER SERVICE J
WATER MAIN CHG. N. '4t 4Pb
S.B.C.C. FEE x i ,,,,
OTHER FEES MECHANICAL PERMIT
r-,
'
AMOUNT DUE Account No. 010-000-322-10-00$, . • ." Fee ;\\1\
Receipt No.
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRA I' 't .1 .MITS EXP - ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEQGOND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET: ��
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OWNER OR AGENT DATE
• •ermit #
7 NT
CITY OF FEDERAL WAY
MAR 2 6 19 ';' BUILDING PERMIT APPLICATION
—Please Print—
BOX 1 TENANT NAME:
OWNER I INN / IA ) - .r _fir.ITE LOCATION ''' A
OWNER'S ADDR SS A CITY fl -4 PHONE yw-4•C& /
DESCRIBE JOB %/t L‘. IL t.
THE PROPERTY IS OWNED BY: SINGLE/MARRIED ✓ PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME L'=11 //J/4G/1/22t"/L L- _DFcSJ/'t'/'L -CONTRACTOR'S REG. # tA,vi/i2; /
Card MUST be presented
CONTRACTOR'S ADDRES� -72 `` CITY4Q/ %`fl/tPHONE 4,(37-4/3"/7
EXPIRATION DATE .1 ) /2- /
— OR—
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON &_t_1.g b//� PHONE 44297
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER qc-L/ - 1,57 o 36
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( V NGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES(including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET $
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 INV TIGATION AND DEFENSE OF SUCH CLAIM), WHICH MAY BE MADE BY ANY PERSON„JNCLUDING THE UNDERSIGNED,
AND FILED AGAIN HE ►ITY OF FEDERAL WA ,BU ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OFTHE CITY,INCLUDING ITS
.'
OFFICERS AND . PLO ' S, UPON THE CC C OF THE INFORMATION SUPPLIED TO THE C TY AS PART OF THIS APPLICATION.
OWNER/AGEN • I�_ / DATE: J �—
ANP-008 3/90