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92-100857 MECHANICAL PERMIT 9 ,- )01) $57 CITY OF BUILDING INSPECTION FEDERAL WAY BUILDING PERMIT 661-4140 PERMIT NO. 92-895 M OWNER'S NAME NANCY SMITH SITE ADDRESS 2023 S 282 PL CONTRACTOR NW WATER HEATER ADDRESS 8201 DURANGO ST SW TACOMA CONT.PHONE 984-6404 CONT.REG.NO. NORTHWH1O3R2 EXP. 12/92 OWNER'S PHONE 946-1145 OWNER'S ADDRESS TYPE JOB: NEW RESIDENCE ADDITION NEWINDUSTRIAI NEWCOMMERCIAI COMMERCIAL ADD. _INDUSTRIAL ADD. NEW PUBLIC __ PUBLIC ADD. NEW MULTI-FAMILY (UNITS )MULTI.ADD. SIGN GRADING OTHER __. TAX ACCOUNT NO. 422231-0120 LEGAL DESCRIPTION ISSUED BY EBS DATE OF ISSUE - / DATE OF APPLICATION 6/10/g2 BUILDING INFORMATION ZONE SET BACKS:FRONT SIDE REAR HEIGHT LIMIT II 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 RECEIVED BATHTUBS LAUNDRY DRAINS FORCED AIR FURNACE 10.00 DUCT WORK 4SHOWERS URINALS GAS HOT WATER HTR. 6.50 AIR HANDLING UNIT NUMBER LAVATORIES DRINKING FOUNTAINS CONVERSION BURNER MISC. 20.00 RETURNED SINKS MISC. BBQ BASIC FEE DISHWASHERS TOTAL FIXTURES DRYER TOTAL MECHANICAL 36.50 AMOUNT VALUATION GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE. PERMIT FEE PLAN CHECK FEE UMBING FEE INSPECTION RECORD liptCHANICAL FEE $36.50 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 $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: ( d QI 1 OWNER OR AGENT '4� 12 DATE Cc 5 Penn E EIV D CITY OF FEDERAL WAY an 101992 BUILDING PERMIT APPLICATION �,w� `'�FEDERAL — Please Print— NG BOX 1 TENANT NAME: ��r7 OWNER"inCc ct\C SITE LOCATI N OWNER'S ADDRESS �l CITY- J- L 3 PHONE ")4, DESCRIBE JOB 1 v. v A cc- THE t THE PROPERTY IS OWNED BY: SINGLE/MARRIED — PARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME`-00\14a'I' l CLY R a CONTRACTOR'S REG. # 1�10>Z-C"14G�`�i ID3 Card MUST be presented CONTRACTOR'S ADDRESS TX\ U-4(6-v\ E. CITY Ck C cw e-- PHONE °M--(LibtI EXPIRATION DATE 1.)- 3,E — 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 Q cU `' PHONE 'S'--t- 6 Li CA BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COSTAL S 2•--I EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER Li 'c)-:3 ( — C3 IXD 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 ( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT BOX 9 PLUMBING FIXTURES (including rough-ins) MECHAN CAL APPLIANCES— BASIC FEE$ NO. WATERCLOSETS GAS PIPING, FEET . ■ $ 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 $ I OTH RS IJJ 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:I v DATE: ANP-008 3/90