92-100415 MECHANICAL PERMIT 9 g.a 9/5
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
92-0385 M DAVE CHAMPIONgg 28615 9TH AVE S
PERMIT NO. NOR PAC HTG &WA/c NAME 3414 "A" ST SE SUITEJ�101qp RE Aan3UHNWA 931-0610
CONTRACTOR ADDRESS CONT. PHONE
CONT. REG. NO. NORPAHA123A OWNER'S PHONE 859-0928 OWNER'S ADDRESS 28615 9TH AVE S 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. 515296-0170 LEGAL DESCRIPTION
ISSUED BY JOANNE JOHNSONDATE OF ISSUE 7 �I -7 /i DATE OF APPLICATION 3-13-92
BUILDING INFORMATION
•NE 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 60 FT. 2.00 PMPLACE 6.50
BATHTUBS LAUNDRY DRAINS COMPRESSOR DRYER TANK(S) 6.50 RECEIVED
SHOWERS URINALS FORCED AIR FURNACE 10.00 AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS 2 GASjIOT WATER HTR. 13.00 MISC.
SINKS MISC. CONVERSION BURNER BASIC FEE 20.00 RETURNED
DISHWASHERS TOTAL FIXTURES UNIT HEGE 6.50 TOTAL MECHANICAL 64.50 AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE INSPECTION RECORD
ECHANICAL FEE 64.50
TAL 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 64.50 Account No. 010-000-322-10-004 Total Fee $ 64.50 Receipt No. LifuLi _
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: �j
OWNER OR AGENT ��< I�f .tiL��/
7-.14 DATE / �''
MECHANICAL PERMIT
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
.4-0385 :)r Vk; C AMPTON 28615 1'H A►V.f+ 8
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 pOT WATER HTR. _ MISC.
SINKS MISC. CONVERSION BURNER BASIC FEE 1. RETURNED
DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MEC • o.Z•a iiilk AMOUNT
s•
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY IN --N • 4 . IT WI NOT SUFFICE.
PERMIT FEE41114
PLAN CHECK FEE
diiL UMBING FEE INSPE n'v
CHANICAL FEE
TOTAL BLDG. FEES Water Line OK Mechanic- N ;
PART P/C FEE
SEPA REVIEW GAS PIPING OK s//' Date ye- .i 4/(/ ��� /Or
WATER SERVICE /5:_C �4,,, �.
WATER MAIN CHG. boli y�l��
S.B.C.C. FEE
OTHER FEES MECHANICAL PERMIT .,, �V
AMOUNT DUE Account No. 010-000-322-10-004 •' . al Fee Receipt No.
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING P RMIT " RE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEZ AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET:
OWNER OR AGENT DATE
RECEIVED
• •rmit # 9 ,23Is/t'1
MAR 3 1992 CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
CITY OF FEDERAL WAY — Please Print—
BUILDING DEPT
BOX 1 TENANT NAME:
OWNER 1<< C /✓ SITE LOCATION 2 3'L/S `i —� /i vc . S o
OWNER'S ADDRESS 2 SC IS y . hwc S CITY F-c-fe--/ 1 ' PHONE s-S 5 - `i2,5-
DESCRIBE JOB -' /J,, , Fy� ttc, / 2 //1v7, 41rcf'/4cc- I - ci � %)' / lam. . ! 4 � �,45 r:'"•,;.
THE PROPERTY IS OWNED BY: SINGLE/MARRIED 2< PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME / .' r /'., c // 75- -t 4/C CONTRACTOR'S REG. # 1.4.f f4//4 /23A
Card MUST be presented
CONTRACTOR'S ADDRESS s'/P-7' 4 Sf S. F /62 CITY I, 4,, PHONE ` 3 / e' / c'
EXPIRATION DATE —7/7/e; 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 % <,- PHONE y 3 i - 6 /c'
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER S / S 2 `i - C' / 70
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 C '
BATHTUBS NO. I FURNACE, ELEC. GAS ----
SHOWERS
SHOWERS .2 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 4 s i.),• y c $
DRAINS c1: / r.? e. s 4,
OTHER l (Se. 3 Fire/04'1c C $
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: c— ? — --< DATE: //y/ J 2
ANP-008 3/90