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91-101403 MECHANICAL PERMIT 9) '/6/ 1/13 CITY OF BUILDING INSPECTION FEDERAL WAY BUILDING PERMIT 941-1555 PERMIT NO. 91-1364 M OWNER'S NAME HAROLD LADUKE JOB ADDRESS 3925 SW 317 ST CONTRACTOR J W BROWER ADDRESS 3424 S TAC WAY TACOMA CONT. PHONE 474-3731 CONT. REG. NO. JWBOMAI59NR 8/92 OWNER'S PHONE 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 TAX ACCOUNT NO. 873198-1750 LEGAL DESCRIPTION UV --i ' ISSUED BY ELIZABETH SNYDER DATE OF ISSUE 41' DATE OF APPLICATION 10/1/91 BUILDING INFORMATION ONE 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 70 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 -10T WATER HTR. MISC. SINKS., MISC. CONVERSION BURNER BASIC FEE 20_00 RETURNED DISHWASHERS TOTAL FIXTURES NONE UNIT HEATER TOTAL MECHANICAL 39_on AMOUNT NONE VALUA:ION GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE. PERMIT FEE PLAN CHECK FEE PLUMBING FEE INSPECTION RECORD MECHANICAL FEE $32.00 OTAL 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 OTHER FEES MECHANICAL PERMITAr� () AMOUNT DUE $32.00 Account No. 010-000-322-10-004 Total Fee $ 32.00 Receipt No. e?-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 THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY G REQUIREMENTS WILL BE MET: IOWNER OR AGENT4 DATE / — — L/ U MECHANICAL PERMIT CITY OF BUILDING INSPECTION FEDERAL WAY B ILDING PERMIT 941-1555 PERMIT NO. OWNER'S NAME JOB ADDRESS I 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 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 pOT 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 PERMIT FEE Ilk PLAN CHECK FEE , ii . PLUMBING FEE INSPECTIO' rata1 MECHANICAL FEE TOTAL BLDG. FEES Water Line OK Mechanical Inspect - of PART P/C FEE SEPA REVIEW GAS PIPING OK Date By WATER SERVICE ogr WATER MAIN CHG. {► .0.000.00.J.J.;;40 .00.... '-?'43- 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 \ic//// c//`- REQUIREMENTS WILL BE MET: OWNER OR AGENT DATE )l RECEIVED • •ermit # c � VED � k0 to 4 OCT 1 1991 CITY OF FEDERAL WAY % AY BUILDING PERMIT APPLICATION �� ! `' — Please Print— BOX 1 TENANT NAME: OWNER +4 Aa_© SITE LOCATION OWNER'S ADDRESS 3 el S S • c-J 3( 1 - tE CITY - -.Jac PHONE DESCRIBE JOB ll THE PROPERTY IS OWNED BY: SINGLE/MARRIED )( PARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME . ‘Nm—Ale/4—# CONTRACTOR'S REG. # L..)6 C 144 (s9 °L. Card MUST be presented CONTRACTOR'S ADDRESS 3`( e..1, CITY Are— • PHONE q ?4/ 3 7 2 / EXPIRATION DATE � — `{ '-9 9,8'/oR — 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 ---To .AM 'cL PHONE ' l N 3 ?3/ BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER e 3 r' i g3- (-I Sc 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 = ) (X) EXISTING STRUCTURE ( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT BOX 9 PLUMBING FIXTURES (including rough-ins) MECHA,N1 /�PP�LIANCES — BASIC FEE$ NO. WATERCLOSETS GAS PIPING, FEET [©+ $ BATHTUBS NO. l FURNACE, ELEC. GAS k $ 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 THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION. OWNER/AGENTjDATE: / — /-9/ ANP-008 3/90