92-101069 MECHANICAL PERMIT 1).//11 )b
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 661-4140
PERMIT NO. 92-1158M OWNER'S NAME GERALD BAKER SITE ADDRESS 34017 37TH AVE. SW
CONTRACTOR WESTERN FURNACES ADDRESS P.O. BOX 11145 TACOMA 98411 CONT.PHONE474-8401
CONT.REG.NO.WESTEF*372NDEXP. 12-31-9a/NER'S PHONE OWNER'S ADDRESS 34017 37TH AVE. SW
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. 147 330-0180-02 LEGAL DESCRIPTION
ISSUED BY ANDREA JORGENSEN DATE OF ISSUE DATE OF APPLICATION 7-27-92
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. GAS LOGS
BATHTUBS LAUNDRY DRAINS FORCED AIR FURNACE 10.00 DUCT WORK RECEIVED
SHOWERS URINALS GAS HOT WATER HTR. AIR HANDLING UNIT 6.50 NUMBER
LAVATORIES DRINKING FOUNTAINS CONVERSION BURNER MISC.
HT PUMP
Taw
SINKS MISC. BBQ BASIC FEE 20 00 RETURNED
36.
DISHWASHERS TOTAL FIXTURES DRYER 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
CHANICAL FEE 36.50
kTAL 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
36.50 Total Fee $ 36.50
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
•
mit # 1T1 \ 56,\I\
RECEIVED BY
?COMMUNITY DEVELOPMENT DEPARTMENT CITY OF FEDERAL WAY /..Ard114r(47
S `.' 'f BUILDING PERMIT APPLICATION `�`
J U L 3 0 1992 - Please Print— V/9/19/-
Boxcinvomr-:";
Mar .411 SITE LOCATION
OWNER'S ADDRE CITY PHONE
DESCRIBE JOB ` -‘0
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME -)eAg Yi1 Pt,.-xv' CS-.3 CONTRACTOR'S REG. # l C S►G 21`-k)
, Card MUST be presented
CONTRACTOR'S ADDRESS P' �' 1""�/, \`ks CITY \G -01Nk-5 PHONE LC/ 'fo I
EXPIRATION DATE ,'L� � 'ct Z .i`
— 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 PHONE
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER t Ltri O (TO — OD-
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 ()G) 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 $
BATHTUBS NO. ` FURNACE, ELEC. X GAS $ jU Lk.)
SHOWERS GAS HOT WATER HEATER $
LAVATORIES CONVERSION BURNER $
SINKS BOILER, SIZE BTU $
DISHWASHERS AIR HANDLING UNITS. $
ELECTRIC HOT WATER HEATER 1 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 THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: 6\ DATE: c Gt-)'
ANP-008 3/90