91-101692 MECHANICAL PERMIT DI 5 a
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
PERMIT NO. 91-1632 M OWNER'S NAME MARY ROGERS JOB ADDRESS 503 SW 322ND STREET
CONTRACTOR ANOTHER PLUMBER ADDRESS 21756 123RD AVE SE KENT CONT. PHONE 639-0840
CONT. REG. NO. ANOTHP1O1KH OWNER'S PHONE 874-4068 OWNER'S ADDRESS 901 SW 127Nf STRRET PE
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. 926490-1090 LEGAL DESCRIPTION
*SUED BY JOANNE JOHNSON DATE OF ISSUE / / 4 DATE OF APPLICATION 11-22-91
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 30 FT. BOILER
RECEIVED
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS GAS1•10T WATER HTR. RI:REPLCE INS 6.50
SINKS MISC. CONVERSION BURNER BASIC FEE 20.00 RETURNED
DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL 28. 5_0 AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
IllAN CHECK FEE
I,UMBING FEE INSPECTION RECORD
MECHANICAL FEE 28.50
TOTAL 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 28.50 Account No. 010-000-322-10-004 Total Fee $ 28.50 Receipt No. CO Cl S--
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 - - CSC
l ati DATE /'" 7.9/
• Perm# l— :Z
RECEIVED CITY OF FEDERAL WAY
NOV 22 1991 BUILDING PERMIT APPLICATION
— Please Print—
( rry U FEU .q41. WAY
MALMO OM,
BOX 1 TENANT NAME:
OWNER M I y f Jt 5 SITE LOCATION 5o 3 SL'J 3
OWNER'S ADDRESS SL,J 3L,J CITY Fcx c& A•/ PHONE F74-1
DESCRIBE JOB Gk:
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME Ja oo-t MJ PLL MbL CONTRACTOR'S REG. # 1.,Joi H P 4101 k tI
Card MUST be presented
CONTRACTOR'S ADDRESS ,2 17.S /z3 A.A- S4 CITY /te-v7 PHONE : '-10
EXPIRATION DATE S- jt•9
— 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 koL Le-zoAJ PHONE 4,39 O P5/o
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST 77,2.4330"'' EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER 9(96'110 i 090
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) MECHANICAL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET 30 $
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 6'&1> /n RT rtfulA4-4- $
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: Biesua DATE: // )'SI
ANP-008 3/90
CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
BUILDING INSPECTION
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
BUILDING INFORMATION
ZONE
OCCUPANCY TYPE OF CONSTRUCTION
BLDG. SQ. 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�IOT 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.
AFie
DAVIT WIL
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
INSPVTI�t3,ly
ECHANICAL FEETOTAL
BLDG. FEES
Water Line OK Mechanical I
PART PIC FEE
/
SEPA REVIEW
GAS PIPING OK Date
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
MECHANICAL PERMIT
Account No. 010-000-322-10-004 Tota'
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
0 0
SET BACKS AND FOOTINGS
DATE_ __ . . ... ... _BY
OX TO POUR FOUNDATION WALLS
DATE .....-.......-.__.._BY
PLUMBING GROUNDWORK
DATE ____ --- - __BY
PLUMBING ROUGH IN
DATE BY
WATERLINE O.K.
GAS PIPING O.K.
MECHANICAL INSPECTION
DATE . .... ... . . .. .... .. -.....___BY
O.K. TO ENCLOSE FRAMING
BY
INSULATION
DATE
BY
WALL BOARD AND FIRE WALL
DATE --,-,..BY
FINAL O.K. TO OCCUPY
DATE ___-.BY
DCD
PSD
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BUILDING DEPARTMENT
CITY OF FEDERAL WAY
Correction
Job Located at 6)3 _tet
fwm,-�- �- 9/-ld32m
Notice
I have this day inspected this structure and these premises
and have found the following violations of City and/or State
laws governing same:
/ / o_Q t.� ra.�r, �r r S/1c.�o1 ��1//Pf� P,l'l Z jo;' Q
You are hereby notified that no more work shall be approved
upon these premises until the above violations are corrected.
When corrections have been made, call for inspection.
Date t'
nspector for Building Dept.
DO NOT REMOVE THIS TAG
AMP -007 7/05/90