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90-101303 MECHANICAL PERMIT CITY OF BUILDING INSPECTION FEDERAL WAY BUILDING PERMIT 941-1555 96 46f3-03 PERMIT NO. 90-1491 M OWNER'S NAME DEAN R PAULSEN JOB ADDRESS 31416 11 PL SW CONTRACTOR NORTHWEST USI ADDRESS 1908 S 341 PL FEDERAL WAY CONT. PHONE 661-2852 CONT. REG. NO. NORTHUS1O1JJ OWNER'S PHONE 946-1229 OWNER'S ADDRESS 31416 11TH PL S.W. 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. 5556050-0180 LEGAL DESCRIPTION /? p/ 44"://g ISSUED BY JOANNE JOHNSON DATE OF ISSUE// DATE OF APPLICATION 9-17-90 BUILDING INFORMATION ONE 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 BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S) RECEIVED SHOWERS ', URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER LAVATORIES ', DRINKING FOUNTAINS GAS r1OT WATER HTR. 6_50 MISC. RETURNED SINKS MISC. CONVERSION BURNER BASIC FEE 70_00 DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL EAMOUNT VALUATION ZA` '5 GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE. PERMIT FEE PLAN CHECK FEE PLUMBING FEE INSPECTION RECORD ECHANICAL FEE r~�12 1TAL 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 P OTHER FEES MECHANICAL PERMIT y AMOUNT DUE 1 it I. - Account No. 010-000-322-10-004 Total Fee $ 30.00 Receipt No. ' 2-4)0 i ALL PERMITS EXPIRE 180 DAY-S AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE. I CERTIFY THAT THE INFOR •TION FURNISHED BY1$ TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET. OWNER OR AGENT Lt X.� ID DATE 7,_ �� MECHANICAL PERMIT CITY OF BUILDING INSPECTION FEDERAL WAY BUILDING PERMIT 941-1555 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 4111 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 RECEIVED BATHTUBS LAUNDRY DRAINS COMPRESSOR _ TANK(S) SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER LAVATORIES DRINKING FOUNTAINS GAS 110T WATER HTR. MISC. RETURNED SINKS MISC. CONVERSION BURNER BASIC FEE DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL AMOUNT VALUATION 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 5---- / By 613 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 ill k \ a J Y CO O ml m! ti ` W 0 Z I �4� cc cc 1 J I o O Q Z• I Zm a /` w1 w aJ w oWo oPIPP- a 2 1 `\ I a • m m vv a z I Ce� O Y Y Y L o o 1 w z h Z O ...s....)O z a J a � ¢ Er. a w - lil • • < < <,b. . 0 _, . . . D ) v N Q, of O . . • m m m mF= a O ? a0 j OLL 0W U \; O O CC o i 0_ �q 1\ ..._. O rl I� h hhL • emit # l 0-19i0/1 CITY OF FEDERAL WAY BUILDING PERMIT APPLICATION — Please Print— BOX 1 TENANT NAME: OWNER -DE Ai ) 1'Z- 4-)A v LSSA) SITE LOCATIO OWNER'S ADDRES 1 Ili 1p I PI. S.W CITY G d , Jr4--7 PHONE `7 '/to -` 1Z 147 DESCRIBE JOB i0 l ac-c' C 4S /-f 00 h6C C, l THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME NG IR tL1 i i S7' US I CONTRACTOR'S REG. #!UORT1" US /0/jr (� Card MUST be presented c� CONTRACTOR'S ADDRESS ' 1 Dg S 3y1 pi- CITY J t C✓/ PHONE (9 (CV—R 8-5--AEXPIRATION DATE �! S' / / 11 — OR — I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND CHAPTER 18.27.110 HICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. BOX 3 CONTACT PERSON ANT> 24,91A IL) PHONE G is r-off-k-s BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST s EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER S-5 to Q c- 0/ a 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 © $ 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 $ AINS $ OTHER $ TOTAL FIXTURES $ TOTAL MECHANICAL FEE $ I CERTIFY UN ER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHE 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 I VFSTIGATION AND DEFENSE OF SUCH CLAIM), WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED, AND FILED AGAIN• THE Y OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS OFFICERS AND EM•LOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION. ------ 9 OWNER/AGENT: &l • v - • DATE: L `/? ! G? ANP-008 3/90