92-100818 MECHANICAL PERMIT 5 2_ JotsI g
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 661-4140
1 PERMIT NO. 92-0857 M OWNER'S NAME HELMER PACIFIC INC SITE ADDRESS 3613 SW 311TH LANE
CONTRACTOR B & B HEATING & A/C ADDRESS 5309 84TH ST E TACOMA CONT.PHONE 536-6681
CONT.REG.NO. BBHEAAO94RC EXP. 10/92 OWNER'S PHONE 432-5055 OWNER'S ADDRESS 22035 SE WAX RD STE 14 MAPLE VALLEY
TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEWCOMMERCIAI COMMERCIAL ADD. _ INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI-FAMILY (UNITS )MULTI.ADD. SIGN GRADING OTHER
TAX ACCOUNT NO. 058755-0130-08 LEGAL DESCRIPTION
A7 .
IIPSUED BY JOANNE JOHNSON DATE OF ISSUE IF
DATE OF APPLICATION 6-2-9 7
BUILDING INF•AMA ION
ZONE _ SET BACKS:FRONTSIDE _ 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 100* 3.50 GAS LOGS
0 O
BATHTUBS LAUNDRY DRAINS FORCED AIR FURNACE 10. DUCT WORK RECEIVED
SHOWERS URINALS GAS HOT WATER HTR. 6.50 AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS CONVERSION BURNER MISC.
SINKS MISC. BBQ BASIC FEE 20.00 RETURNED
DISHWASHERS TOTAL FIXTURES DRYER TOTAL MECHANICAL 40_00 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 40.00
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 / i
OTHEROTHER FEES MECHANICAL PERMIT
0 .
AMOUNT DUE 40.00 Total Fee $ 40.00 Rece' t No.
) 3
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:
77
OWNER OR AGENT /�g,:-C--/ DATE L-%
MECHANICAL PERMIT
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 661-4140
92-0857 M ;3-' `.`ER PACIFIC INC 3613 SW 311TH L A/1E
PERMIT NO. OWNER'S NAME SITE ADDRESS
CONTRACTOR P & B HERTZ-.'+... '- ADDRESS 5309 84TH ST E TACO. CONT.PHONE 53 -'6681
CONT.REG.NO. "Olt EAA094RC EXP. __ /92 OWNER'S PHONE 432-51 5OWNER'S ADDRESS 22035 SE V7 .7' " 14 MAPLE VALLEY
TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD.__ INDUSTRIAL ADD. NEW PUBLIC_ PUBLIC ADD.
NEW MULTI-FAMILY $(UU7NITS 7 MULTI. D. SIGN GRADING OTHER
TAX ACCOUNT NO._ S` �aj ``"ADLEGAL DESCRIPTION '
'�
ISSUED BY JOANNE JOHNSON DATE OF ISSUE /?.
(74,.....).........„
DATE OF APPLICATION 5-2-92
IPBUILDING INFORMATION
ZONE SET BACKS:FRONT SIDEREAR 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 f OM.. 3.!")i.: GAS LOGS
BATHTUBS LAUNDRY DRAINS FORCED AIR FURNACE 10.00DUCT WORK RECEIVED
SHOWERS URINALS GAS HOT WATER HTR. 6'S® AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS CONVERSION BURNER MISC.
SINKS MISC. BBQ BASIC FEE 20.00 RETURNED
DISHWASHERS TOTAL FIXTURES DRYER TOTAL MECHANICAL 40.00 AMOUNT
VALUATION
r
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVI ' • FIl' '
PERMIT FEE
i
::
PLAN CHECK FEE ."
a .
UMBING FEE INSPECTIe 'a �I:, $: 1
•CHANICAL FEE 40.00
,k a v
TOTAL BLDG. FEES Water Line OK Mechanical Inspect of / 1.0
PART P/C FEE ��
SEPA REVIEW GAS PIPING OK /o-i-'7 - 414 A) Date By NI
t-------'
n
WATER SERVICE O
WATER MAIN CHG.
S.B.C.C. FEE �/ \ i
OTHER FEES MECHANICAL PERMIT B ` ,' ( ) V. .T
AMOUNT DUE 40•00 Total Fee $ "''-'�^ Rece. t No. 1 .
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
RECEIVED BY
Per. # �2_ - ,� 57 ./1
COMMUNITY DEVELOPMENT DEPARTMENT
CITY OF FEDERAL WAY
JUN 2 1992 BUILDING PERMIT APPLICATION
— Please Print
BOX 1 TENANT NAME:
OWNER L) RJl l (t SITE LOCATION . ) •. - t 1. L�
OWNER'S ADDRESS,;`,1- 0,;{) � U.tc-�( GI ,5 /L( CITY I 4 0 - PHONE -) -SL%',C.4
DESCRIBE JOB
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME j5+6 ` aiPJAI?( ai-AIT-, CONTRACTOR'S REG. #66/464S)4t3 'Ye-
Card MUST be presented
CONTRACTOR'S ADDRESS (.--)--W1 gLe' E CITY 30.COVI,C-( PHONE_ bID T
EXPIRATION DATE 4`t
— 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. ,1
BOX 3 CONTACT PERSON `CA'.aA.1 PHONE,Z - /
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER O .Y 7s3-- O` - L-) - 6 5
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 J
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 PIPIrp, FEET d, ,S,e,A_ / ) - $
BATHTUBS NO. / FURNACE, ELEC. GAS $
SHOWERS I 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 EMPLOYE S, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: z__Z--..-
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