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91-100526 MECHANICAL PERMIT 9)-)005,* CITY OF BUILDING INSPECTION FEDERAL WAY BUILDING PERMIT 941-1555 PERMIT NO. 91-493 M OWNER'S NAME WAYNE RODGERS JOB ADDRESS 29829 2ND PL SW CONTRACTOR NORTHWEST USI ADDRESS 1908 S 341ST PL #9 FEDERAL WAY CONT.PHONE 661-2852 CONT. REG. NO. NORTHUSIOLJJ 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. 720532-0210 LEGAL DESCRIPTION k3c'Ja , ISSUED BY JOANNE JOHNSON DATE OF ISSUE DATE OF APPLICATION 4-23-91 BUILDING INFORMATION S. 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 2 FT. 2.00 BOILER RECEIVED BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S) SHOWERS URINALS FORCED AIR FURNACE 10-00 AIR HANDLING UNIT NUMBER LAVATORIES DRINKING FOUNTAINS GAS .IOT WATER HTR. MISC. SINKS MISC. CONVERSION BURNER BASIC FEE ao_ao RETURNED DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL .3, ..00 AMOUNT VALUATbO_N GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE. PERMIT FEE PLAN CHECK FEE PLUMBING FEE INSPECTION RECORD WCHANICAL FEE 32_00 AL 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 4 AMOUNT DUE 32.00 Account No. 010-000-322-10-004 Total Fee $ 32.00 Receipt No. (:4 1--- ALL PERMITS EXP - 180 ' AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE. I CERTIFY THAT THE •FORMATI• FURNISHE B , : E AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL B 4 T: o, OWNER OR AGENT A_ �� DATE (-7 - 3e, ^ // MECHANICAL PERMIT CITY OF B U I L D I VG P � ITBUILDING 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 MULTI-FAMILY (UNITS ) MULTI. ADD. SIGN GRADING OTHER TAX ACCOUNT NO. LEGAL DESCRIPTION ISSUED BY DATE OF ISSUE DATE OF APPLICATION 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 RECEIVED BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S) SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER LAVATORIES DRINKING FOUNTAINS GAS11OT 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 N• PERMIT FEE PLAN CHECK FEE lotPLUMBING FEE INSPECTION f' ' CHANICAL FEE IAL BLDG. FEES Water Line OK Mechanical In- io. , •' PART P/C FEE /� SEPA REVIEW GAS PIPING OK Date By WATER SERVICE WATER MAIN CHG. Wei S.B.0 C. FEE tiosolookigifilogo. OTHER FEES MECHANICAL PERMIT AMOUNT DUE Account No. 010-000-322-10-004 Total llg 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 • ,rmit # ' 1 - 13 A APR 2 3 1991 CITY OF FEDERAL WAY CITY OFFEDERAL WAY BUILDING PERMIT APPLICATION BUILDING DEPT. -Please Print— BOX 1 TENANT NAME: OWNER Way/2 lkoop-et 5 SITE LOCATION., - - % • -L, cS OWNER'S ADDRESS - " . ' .. '1 . _ CITY P• •rn Way PHONE 9'i1/-0?85Y DESCRIBE JOB ?QS I-0 945 1 )P/?&Ce 'lilac t in` THE PROPERTY I OWNED BY: SI GLE/MARRIED PARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG.#,JD,e7/4J6$0/)t - Card MUST be presented CONTRACTOR'S ADDRESS /9i 6' SD• 377RL• 9 CITY/ % t/h-ky PHONE `Q4�pZ7c o�Z. EXPIRATION DATE S 9oZ / — OR— I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. BOX 3 CONTACT PERSON 27 )'/.7i S Z4t-/2 PHONE 4041 eagvro2 BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER `7&c 53a- oo?/D LEGAL DESCRIPTION (If necessary, please submit a separate page with the legal description.) K.C. Plat Recording# BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR / 3RD FLOOR / BASEMENT / DECK / GARAGE____/ BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION ( ) MULTIFAMILY(NO. OF UNITS = ) ( ) EXISTING STRUCTURE ( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT BOX 9 PLUMBING FIXTURES(including rough-ins) MECHANI9AL APPLIANCES— BASIC FEE$ NO. WATERCLOSETS GAS PIPING, FEET c2 $ 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/-023 AS A PART OF THIS APPLICATION. OWNER/AGENT: ._/AV ;/__il� `� „ ./ •ATE: �i �3 / eANP-008 3/90