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91-101443 9J - folyY. MECHANICAL PERMIT CITY OF BUILDING INSPECTION FEDERAL WAY BUILDING PERMIT 941-1555 PERMIT NO. 91-1398 M OWNER'S NAME MICHAEL BALL JOB ADDRESS 843 SW 317 PL CONTRACTOR NORTHWEST USI ADDRESS 1908 S 341 PL #9 FEDERAL WAY CONT. PHONE 661-2852 CONT. REG. NO. NORTHUS101JJ 4/92 OWNER'S PHONE 941-3938 OWNER'S ADDRESS SAME 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 ONLY TAX ACCOUNT NO. 555731-0380 LEGAL DESCRIPTION k,Cir Viii ilkSUED BY ELIZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION 10/4/91 BUILDING INFORMATION ZONE 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 RECEIVED BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S) SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER LAVATORIES DRINKING FOUNTAINS GAS rIOT WATER HTR. MISC. SINKS MISC. CONVERSION BURNER BASIC FEE 20.00 RETURNED • DISHWASHERS TOTAL FIXTURES NONE -timrmelfrriTAIR COND. 6.50 TOTAL MECHANICAL 26_.50 AMOUNT NONE VALUATION GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE. PERMIT FEE •LAN CHECK FEE PLUMBING FEE INSPECTION RECORD MECHANICAL FEE $26.50 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 $26.50 Account No. 010-000-322-10-004 Total Fee $ 26.50 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 B)MET: //�� / OWNER OR AGEN i/ i AI .�A DATE /0/e/.,/ MECHANICAL PERMIT CITY OF BUILDING INSPECTION FEDERAL WAY B I L D I N G 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 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;/OT 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 AUMBING FEE INSPECTION RECORD CHANICAL FEE , i % TOTAL BLDG. FEES Water Line OK Mechanical Inspect PART P/C FEE I ` , SEPA REVIEW GAS PIPING OK Date By WATER SERVICE ► WATER MAIN CHG. S.B.C.C. FEE DA� OTHER FEES MECHANICAL PERMIT PI AMOUNT DUE Account No. 010-000-322-10-004 Totaleijy e $ ceiptn No. ......00"1"j1 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 1o m o 0 o v o cn m D m 4 r H m K m --10 W > �\ O m Z 0 Z 1 ui O r I O n O C 0 O T__ p C) C m Z O < < K_ < -< Z Z o 0 D Z D o O I .M c m i D-T) O Z r O Z O m C m O O , m 7 I 0 C 1 0 D CO CO --i < O Z m D o 1 r- o 0 K 0 W m r m n m K r = O Z Co Z D nO m y O I o r W > Z 0 Z C C I 0 Z -n m 0 mm 0 co * W zz xiW r I 1 I I • PerIlift I I 13`l RECEIVED - , OCT - 4 4( CITY OF FEDERAL WAY CITY OFFEDERAL W BUILDING PERMIT APPLICATION RAIDING DEFT - Please Print— BOX 1 TENANT NAME: OWNER U c2 1 ei . SITE LOCATION ' 5 w, 63/ ,l► . OWNER'S ADDRESS � 3. ' . • - / . CITY 4.'.' x Itt-U- PHONE �7 " 3'132? DESCRIBE JOB C. at:/k t CY � (5t j THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERS'HIP CORPORATION BOX 2 CONTRACTOR'S NAME 110 juf51' t C- 5 CONTRACTOR'S REG. # A/or/L15iUt3J Card MUST be presented CONTRACTOR'S ADDRESS 908 5 ?qi-Dipi,--Lxrc CITY t.e{/ PHONE 64e/"c2952- EXPIRATION DATE `� -?2 — 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 Vein, 5 ran'? PHONE &6/ -2.5 2 BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER 555 731 - ,165 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$ 2 t- 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 $ 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 ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION. /L24/7/ OWNER/AGENT: DATE: l ANP-008 3/90