90-100389 MECHANICAL PERMIT
CITY OF BUILDING INSPECTION
gI L D I N
FEDERAL WAY u g PERMIT 941-1555
70-I'D i 3-g
90-538 M HOFFMAN 1112 S.W. 322ND ST
PERMIT NO. OWNER'S NAME JOB ADDRESS
CONTRACTOR NW WATERHEATER ADDRESS 8201 DURANGO ST SW TACOMA CONT. PHONE 984-6404
CONT. REG. NO. NORTHWH137KJ OWNER'S PHONE 874-6313 OWNER'S ADDRESS 1112 SW 322 ST 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. LEGAL DESCRIPTION
ISSUED BY JOANNE JOHNSON DATE OF ISSUE DATE OF APPLICATION 5-7-90
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. 2.00 BOILER
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S) RECEIVED
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 UNIT HEATER TOTAL MECHANICAL 28.5 0 AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE INSPECTION RECORD
ECHANICAL FEE 28.50
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
AMOUNT DUE 28.50 Account No. 010-000-322-10-004 Total Fee $ 28.50 Receipt No.C1 " 7Y)
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 T:
OWNER OR AGENT 1,A*\ti L tn.w`-C."L 1 DATE
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
0 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 Wki t H N Og
BLDG. FEES Water Line OK Mechanical Inspection Notes: W rC� .
P/C FEE Gf a
SEPA REVIEW GAS PIPING OK /� `� Date 7' l-- lOBy
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES MECHANICAL PERMIT
AMOUNT DUE Account No. 0.10-000-322-10-004 Total Fee $ 28. 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
MAY 0 7 1990
/� CITY OF FELDEI AL WAY
1 a CITY OF FEDERAL WAY BUILDING DEPT.
"t,� BUILDING PERMIT APPLICATION
— Please Print—
'BOX 1 OWNER --IO-U 1'l'\a (\ JOB LOCATIO
OWNER'S ADDRESS I 1 I a Stti) f d ,(:-‘7,4- CITY- c�Prr• ( UI }% PHONE gj!G-1 - COe/
DESCRIBE JOB /AIS4-C.t (( Cc:i (vGtA-.r 1C'o. 1--er---
J )Y THE PROPERTY IS OWNED BY: SINGLE/MARRIEDX PARTNERSHIP CORPORATION
'BOX 2 CONTRACTOR'S NAME GJ Lir-4f f- /._C G-If (- CONTRACTOR'S REG. #/1 Of-MA./4//374'1
Card MUST be presented
CONTRACTOR'S ADDRESS UCCl1ur&..r C ,c4:-.--Ci CITY �cCGn4A- PHONE c/gy-CPL/G"�/
EXPIRATION DATE ,:z/ga c?o 4C?
— OR —
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PRO BINS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
I BOX 3 CONTACT PERSON - I\0 -?r PHONE
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.)
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
I BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) (A) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ F�T/�
/BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$ 1�CYv
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 • a FURTHE' HAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PER-
FORM THE WORK FOR WHICH, 'ERMIT • •PLICATION IS MADE. r
OWNER/AGE morr, DATE: c.....51:71 .6
ANP-006 2/90
• •
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE SETBACKS: FRONT SIZE 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. ROOF 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
EBUILDING PERMIT NO. PLAN CHECK FEE REC'D RECEIPT NO.
PERMIT FEE PLAN CHECK FEE PLUMBING FEE MECH. FEE
TOTAL FEES SBCC SURCHARGE ENERGY SURCHARGE AMOUNT DUE
BUILDING DEPARTMENT APPROVAL DATE
REMARKS:
ASSIGNED ADDRESS:
00
16'0 (VG
.� e ,y0/20
4/ ) 4:fy �O
RECEIVED ACCEPTED FOR FILING