92-100874 MECHANICAL PERMIT
CITY OF DU I LDI N PERMIT BUILDING INSPECTION661 4140
FEDERAL WAY G
PERMIT NO. 92-0907 M OWNER'S NAME WESTLEY TAYLOR _ SITE ADDRESS 30149 10TH AVE SW _ _
CONTRACTOR FUTURE II NATURAL GASDDREss 9505 120TH ST E PUYALLUP CONT.PHONE 770-2785
CONT.REG.NO. FUTURINO99OM EXP. 11/92 OWNER'S PHONE 839-0989 OWNER'S ADDRESS 30149 10TH AVE SW 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. 515320-0427 LEGAL DESCRIPTION
✓
, SUED BY JOANNE JOHNSON DATE OF ISSUE
I C. _ DATE OF APPLICATION 6-11-92
4111 BUILDING INFORMATION
ZONE SET BACKS:FRONT SIDE __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 29 FT. 2_00 GAS LOGS RECEIVED
BATHTUBS LAUNDRY DRAINS FORCED AIR FURNACE DUCT WORK
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 28.50 AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
UMBING FEE INSPECTION RECORD
ECHANICAL 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 . C 7
AMOUNT DUE 28.50 Total Fee $ 28.50 Receipt NoQ� (C1 `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 Eif MET:
4116 k
is OWNER OR AGENT a..-/ \ • w - S DATE \i Ht= LA Z-
MECHANICAL PERMIT
CITY OF BUILDING PERMIT I T BUILDING INSPECTION
FEDERAL WAY
661-4140
PERMIT NO. 92-0907 M OWNER'S NAME _ FTPSTfe ' TAY =`• SITE ADDRESS 30149 1OTFT Avr SW
CONTRACTOR PUTURE II Ni- _ _ ADDRESS 9505 120TH ST E ._jAJp CONT.PHONE 7 70 2785
CONT.REG.NO. FUTURINC}o _ EXP. 11/92 OWNER'S PHONE 839-0989 OWNER'S ADDRESS 30149 10TH AVE SW 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. ►15320--04 LEGAL DESCRIPTION
ISSUED BY JOARTIF JOHNSON DATE OF ISSUE 9 DATE OF APPLICATION
• BUILDING INFORMATION
ZONE _ SET BACKS:FRONT SIDE 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 HEATERGAS PIPING 29 FT. 2.e GAS LOGS
RECEIVED
BATHTUBS LAUNDRY DRAINS FORCED AIR FURNACE DUCT WORK
SHOWERS URINALS GAS HOT WATER HTR. 6.50 AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS CONVERSION BURNER MISC. _.0__�0
RETURNED
SINKS MISC. BBQ BASIC FEE
DISHWASHERS TOTAL FIXTURES DRYER _. TOTAL MECHANICAL •50 AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
.
LUMBING FEE INSPECTION RECORD
ECHANICAL FEE
TOTAL BLDG. FEES Water Line OK Mechanical Inspection Notes:
PART P/C FEE
SEPA REVIEW GAS PIPING OK 7 r//c7 Date7//6/ 0By ,
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES MECHANICAL PERMIT /
AMOUNT DUE Total Fee $ Receipt No a)2 ` t
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 _ _ _
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REC.SWED%wawa . POt i t # 1 �" C
COMMUNITY
JUN 1 1 1992 CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print-
BOX 1 TENANT NAME:
OWNER ',V BEST E-1 T744,1Z SITE LOCATION -30 I Lief ' S - w • C�
OWNER'S ADDRESS 301 iO A ) S_ 1,U . CITY PES jAA-ki PHONE PP
DESCRIBE JOB . MHT1 cLL.. &i45 10 ATE-12- HCA-Tc-a-,
THE
' A-Tc- _-
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME Ir�TV -E T P\J A41 V vis CONTRACTOR'S REG. # .-u njLI N099QM
CI
_ {� Card MUST be presented
CONTRACTOR'S ADDRESS "t Sus i ZU� L • CITY f�I)(1AV--O PHONE 11 U -Z�2r5
EXPIRATION DATE f t I l 3 i c-!. Z *
�
� '' — OR —
I HAVE READ CHAPTER 18.27.010 RELATING TO EF ITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON v.-Fr H )(V� L4�S PHONE ' J �O-L
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER .51 S S ZU - Q 2"7
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 ,pt $
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 ANI PLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: � eA c‘Nr- 1Y1 TDATE:
U
f, ANP-008 3/90
I