90-100725 MECHANICAL PERMIT
CITY OF BUILDING PERMIT BUILDING INSPECTION
FEDERAL WAY 941-1555
90,)o'a )aS
PERMIT NO. 90-1053M OWNER'S NAME UROUHART JOB ADDRESS 3809 SW 121 ST
CONTRACTOR NW WATER HTR ADDRESS 8201 DURANGO ST SW TACOMA CONT. PHONE 984-6404
CONT. REG. NO. NOBTHWH1 37KJ 1 2/90 OK OWNER'S PHONE 959-3331 OWNER'S ADDRESS SAME AS SITE
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 14ECHANTOAT. ONLY (HOT WATER HEATER ONLY)
TAX ACCOUNT NO. NA LEGAL DESCRIPTION EXISTING HOUSE
---4/(0/
ISSUED BY ELIZABETH SNYDER DATE OF ISSUE 5 l_.' (7 r DATE OF APPLICATION 7/5/90
• BUILDING INFORMATION
ZONE NA OCCUPANCY NA TYPE OF CONSTRUCTION MECHANICAL ONLY BLDG. SO. FT. NA
SET 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 _12 FT 2_00 BOILER RECEIVED
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS URINALS FORCED AIR FURNACE 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 NONE UNIT HEATER TOTAL MECHANICAL 28_50 AMOUNT NONE
VALUATION NONE
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
UMBING FEE INSPECTION RECORD
CHANICAL 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 � _ r';
AMOUNT DUE $28.50 Account No. 010-000-322-10-004 Total Fee $ 2.) Receipt No. 0
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
-�-,./ THAT THE A*FORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
-_ 4 , 1 /1
'ATC
MECHANICAL PERMIT
CITY OF BUILDING PERMITBUILDING INSPECTION
FEDERAL WAY
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 MULTIFAMILY (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.
ACKS: 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 HOT WATER HTR. MISC.
SINKS MISC. CONVERSION BURNER BASIC FEE RETURNED
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 �c��
T L BLDG. FEES Water Line OK Mechanical Inspection Notes:
wrP/C FEE /(1
SEPA REVIEW GAS PIPING OK Date / &(0 y
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
RECEIVED
it # 9C) --- «5 r,�
'UL 1990CITY OF FEDERAL WAY
CITY OF FEDERAL WAY BUILDING PERMIT APPLICATION
BUILDING DEPT. — Please Print—
BOX 1 TENANT NAME:
OWNER lYrdt/j (//7"/
, � SITE LOCATION
OWNER'S ADDRESSF7 Ytu , ? '/ S¢ CIT � t IJ' 'HONE 95,9 3j/
DESCRIBE JOB..:- /1f7 , J. /V/' i' /€G
THE PROPERTY IS OWNED BY: SINGLE/MA'RIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME A/ l .err1 AW CONTRACTOR'S REG. # .i -
rrd�MUST se presenteI
CONTRACTOR'S ADDRESSjPrc�1/ �4'3L7 7TS!✓ CITY C PHONE �i 7" 0GJ
EXPIRATION DATE 17—/go �
— 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 PERSOr(-TJ.. PHONE �P tfo<<
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
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
(I
( ) 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--C. (O
NO. WATERCLOSETS GAS PIPING, FEET / $ - - ( 'O
BATHTUBS NO. FURNACE, ELEC. GAS /..� $
SHOWERS x GAS HOT WATER HEATER $ IZ7.—
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 $ a “.--)
TOTAL MECHANICAL FEE $ ag
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 D FENSE OF SUCH CLAIM), WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
AND FILED AGAINST THE CITY OF -1ER WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLOY ,71"THE CURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A P T OF THIS APPLICATION. A
OWNER/ NT: a C DATE: -7/- r e
ANP-008 3/90
•
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE SETBACKS: FRONT SIDE. REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL
REMARKS:
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DATE
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL DATE
REMARKS:
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ADD/ALT NEW MULTIFAMILY (UNITS
MULTIFAMILY ADD/ALT TENANT IMP. OTHER
OCCUPANCY TYPE OF CONSTRUCTION STORES
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION
BUILDING DEPARTMENT REMARKS: PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
ASSIGNED ADDRESS:
�6, `� •-•/1/0> PARTIAL PARTIAL PLAN CHECK FEE RECEIVED
Q �' yy00a mount Date Receipt#
V/1./N 1,9r BUILDING DEPARTMENT APPROVAL
RECEIV L , BY DATE ACCEPTED FOR FILING