90-101190 MECHANICAL PERMIT 604°// 9D
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
PERMIT NO. 90-1400M _ OWNER'S NAME GAGNON HOMEL JOB ADDRESS 33607 7 PL SW
CONTRACTOR CORBY, INC ADDRESS 1471 127 PL NE BELLEVUE CONT. PHONE 646-3471
CONT. REG. NO. CORBY**2620S 5/91 OWNER'S PHONE 251-0732 OWNER'S ADDRESS 19011 WEST VALLEY HWY KENT
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. 729804-0110 LEGAL DESCRIPTION NA
l ff
ISSUED BY ELIZABETH SNYDER DATE OF ISSUE VI
t
( �1 DATE OF APPLICATION 8/23/90
BUILDING INFOR AVON
NE NA OCCUPANCY NA TYPE OF CONSTRUCTION Mal d ► 4. BLDG. SQ. FT. NA
T BACKS: FRONT NA SIDE NA REAR NA STORIES NA HEIGHT LIMIT NA
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING FT. 3.50 3--aOILEF-LOG LTRS 19.5 0
RECEIVED
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS URINALS FORCED AIR FURNACE 4.00 AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS GAS friOT WATER HTR. 2 13,(10 MISC. COOK TOP 6.50
SINKS MISC. CONVERSION BURNER BASIC FEE ao_oo RETURNED
JSHWASHERS TOTAL FIXTURES NONE UNIT HEATER TOTAL MECHANICAL 72.50 AMOUNT NONE
VALUATION NONE
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE INSPECTION RECORD
CHANICAL FEE414
$72.50
L BLDG. FEESli
Water Line OK Mechanical Inspection Notes:
HRT P/C FEE
SEPA REVIEW GAS PIPING OK Date By
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES MECHANICAL PERMIT 9
a--- ,
AMOUNT DUE $72.50
Account No. 010-000-322-10-004 Total Fee $ 72.50 Receipt No. e_'._:-21:4
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:1
LaOWNER OR AGENT a-L L"L`, i// r (iZti'l--72-<--------, DATE / .)""// C)
I
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT' 941-1555
,L) IA
PERMIT NO. OWNER'S NAME 1/ 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
10
M ISSUED BY DATE OF ISSUE 11 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
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S) RECEIVED
I 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 S L-1-________5
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
LUMBING FEE INSPECTION RECORD
CHANICAL FEE
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 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
REQUIREMENTS WILL BE MET:
OWNER OR AGENT DATE
1
is
IIIi
iol1
M 4611
zo COI CO
CC o '' WSJ
w
o w C:) MIN \.....
zz kl
m Q m - 411100 1 w O 1w- 0�
L),
Q
a o 2 o o •`
...7
Cl)
J CO
4., 6
Z
Q
111.z
Q
N
O cr-
u_
O Otr i
0 zZzO ,
cca
-01
o Q 111I- L11 w/- .O o 7 Z 0 ,
. .1
N,
0 z �� .11
8• m m < m } m im i \geto....
O z Q a '
OLL = w 1 Cd
Za i 0 o ,....
(n 1 U41 11
0 WY ......., , �a
z O
lia
Q i m O
m w 2 w /- w Q w `S
I-. H 0 F Y F 7 1--
it # l U ` 7C-16fr
•erm
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 TENANT NAME:
OWNER G/9—/vow o t' SITE LOCATION 3 3,0.07 7&A S IA)
OWNER'S ADDRESS /re)!/ uJ. `Z1e—€E- M CITY / PHONE c2 5/ & 7.3..E
DESCRIBE JOB _ 9
THE PROPERTY IS OWNED BY: INGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME G)4' CONTRACTOR'S REG. #a
Card MUST be presented
CONTRACTOR'S ADDRESS /'/'l 1c9 Mg P/ / ' _ CITY PHONE 51‘ 3 /7/
EXPIRATION DATE _ 13 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 ` o-/�I- `,1�-� ,et,�*�i�✓ PHONE 96—3547/
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER 7'c2 l 8'e, o
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 ().4 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$ O. °r�
NO. - _WATERCLOSETS GAS PIPING, FEET $ .57.9
BATHTUBS NO. / FURNACE, ELEC. GAS V- $ /6,6d
SHOWERS GAS HOT WATER HEATER $ /313e)
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 OT ER
DRAINS / �,o4' • 7' $ e.iv
OTHER Le9- L/ /f i;75 $
TOTAL FIXTURES $
TOTAL MECHANICAL FEE $ S`7)
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,iUPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: C/EEDATE:
ANP-008 3/90