90-100297 MECHANICAL PERMIT -JD 60197
CITY OF BUILDING INSPECTION
BUILDING PERMIT
941-1555
PERMIT NO. 90-405M pME JOHN JENSEN JOB ADDRESS 33205 32 PL SW
CONTRACTOR PACIFIC GAS A��i ADDRESS 2702A 112 ST F. TACOMA CONT. PHONE 916-7(497*
CONT. REG. NO. PACIFGH110ME 7/90 OWNER'S PHONE 838-4682 OWNER'S ADDRESS SAME. AS ST TE
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 MECHANTCAT• ONLY
TAX ACCOUNT NO. NA LEGAL DESCRIPTION NA
ISSUED BY ELIZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION 4/23/90
BUILDING INFORMATION
•NE NA OCCUPANCY NA TYPE OF CONSTRUCTION NA BLDG. SO. FT. NA
SET BACKS: FRONT NA SIDE NA REAR NA STORIES NA HEIGHT LIMIT NA
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. 1 BOND
WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING 50 FT. 2.00 BOILER
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S) RECEIVED
SHOWERS URINALS FORCED AIR FURNACE lO.00 AIR HANDLING UNIT NUMBER
LAVATORIES : DRINKING FOUNTAINS GAS HOT WATER HTR. 6.50 MISC.
SINKS MISC. CONVERSION BURNER BASIC FEE
20.00 RETURNED
DISHWASHERS TOTAL FIXTURES ATS UNIT HEATER TOTAL MECHANICAL 38.50 AMOUNT NONE
VALUATION NONE
I
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
,ii
PLUMBING FEE INSPECTION RECORD
ECHANICAL FEE $38.50
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 5-0
AMOUNT DUE $38.50 Account No. 010-000-322-10-004 Total Fee $ jg Receipt' No.3 4 51
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 °(:"n#
DATE 4110)// 5 797
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
BUILDING INFORMATION
OCCUPANCY TYPE OF CONSTRUCTION BLDG. SO. FT.
IPA C K S: FRONT SIDE REAR STORIES HEIGHT LIMIT
PLUMBING NO. NO. I 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 HOT 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
PLUMBING FEE INSPECTION RECORD
MECHANICAL FEE
BLDG. FEES Water Line OK Mechanical Inspection Notes: c we-02-
P/C FEE
SEPA REVIEW GAS PIPING OK �'L;. Date 4/ O/ O By �(✓ T2- (1•t-i'rG (�{) (5_- 14--
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
I I I 1 1
V1
>- >- J >-
a: z C°, °°
¢ O
Ow
0 - o
o Lu z a a
a CO ��
O Z—"+ G
CC J Oa
() Q Q
o O <
�
Z Z 0
0 m Q
D W U H J H
W Q
a a 2 O 3 a
0
cn
Q , a
Z l
O m m Cl 0
M
a
o Y Y N
° o
aLu
Z
o Z z a ° °
O
a a
O. Iho z
jI, I Z LI
0
O i Z
Z } r N
m m Q m a m
o j w 0
o u) o
Q O 0 O
CC 0 H t
Y Z w
Z_ 0 ,
4 m 0 ^\V
C17) w2 w I- w J LU
Z7.1-,.
C./)o ao 0 o a o
•
mit # ]D if-D511A-
CITY OF FEDERAL WAY
BUILDING PERMIT-APPLICATION . p ' >
— Please Print— 6)/Pecs .- �X\
F
BOX 1 TENANT NAME: (,„` �Qyj(y"
<0f+�,��r /a
O SC
OWNER AeykSel� SITE LOCATION 5'4,042-- -Aj 6L
OWNER'S ADDRESS 7 3 2-o 5 3 2 .51-ti 1 .51- CITY �2 PHONE 3.3 =1l h 3 Z
DESCRIBE JOB Eke- 4.c, 94 S ,A( � i Wa et -v-
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME P4c. . .. 66� let-4\ ( .Ari -1‘,..c. _ CONTRACTOR'S REG. #. P464_911 if t'''4
9 if 6 Card MUST be presented
CONTRACTOR'S ADDRESS Z 7 oz—A I f -41, S#—E CITY , c.-"t PHONE 5 3 d 7'i 7
EXPIRATION DATE 1 q D &-S.—
{'
J — 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 .5-411 PHO3 G 7 f f 7
BOX 4 SEWER DISTRICT --- _ WATER DISTRICT r-
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
(If necessary, please sumites 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$ Za•OD
NO. WATERCLOSETS GAS PIPING, FEET f° $
BATHTUBS NO. I FURNACE, ELEC. GAS $ I _
SHOWERS ( GAS HOT WATER HEATER $ -• 1
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 AND EMPLOYEES, UPON"THE ACCU CY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: �����/y DATE: G/ 2.3—?O
ANP-008 3/90