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92-101052 MECHANICAL PERMIT CITY OF gu I LD I N " PERMIT BUILDING INSPECTION FEDERAL WAY 661-4140 9 - Jo /o Sa PERMIT NO. 92-1116 M OWNER'S NAME CARL LINE SITE ADDRESS 29900 4TH AVE SW PUYALLUP GAS APPLIANCAC P 0 BOX 95 PUYALLUP 848-1549 CONTRACTOR D CONT.PHONE CONT.REG.NO. PUYALGA285R1 EXP. 3/93 OWNER'S PHONE 941-1971 OWNER'S ADDRESS 29900 4TH AVE SW FEDERAL WAY TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD. NEW MULTI-FAMILY (UNITS720MULTI.ADD. SIGN GRADING OTHER TAX ACCOUNT NO. 500-0180 LEGAL DESCRIPTION ISSUED BY JOANNE JOHNSON DATE OF ISSUE -7-a3 l 3_ DATE OF APPLICATION 7-21-92 BUILDING INFORMATION •ONE SET BACKS:FRONT SIDE REAR HEIGHT LIMIT OCCUPANCY_. _ TYPE OF CONSTRUCTION CENSUS NO. TYPE OF HEAT BLDG.SQ.FT. STORIES PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING—5_ FT. 2.00 GAS LOGS RECEIVED BATHTUBS LAUNDRY DRAINS FORCED AIR FURNACE DUCT WORK SHOWERS URINALS GAS HOT WATER HTR. 6. 50 AIR HANDLING UNIT NUMBER LAVATORIES DRINKING FOUNTAINS CONVERSION BURNER MISC. RETURNED SINKS MISC. BBQ BASIC FEE 20_00 DISHWASHERS TOTAL FIXTURES DRYER TOTAL MECHANICAL 28_50 AMOUNT VALUATION GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE. PERMIT FEE PLAN CHECK FEE PLUMBING FEE INSPECTION RECORD •OTALMECHANICAL FEE 28.50 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 98.50 Total Fee $ 28. 50 Receipt No. �,.. t c`Ic 1 ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE. r , I CERTIFY THAT THE 1f,ORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL EMET: J OWNER OR AGENT '—J .4------- /--' �-v.� DATE —7 — 1 5 �/ MECHANICAL PERMIT CITY OF BUILDING PERMIT I T BUILDING INSPECTION FEDERAL WAY 661-4140 !:-. 777,,- 1 16 PERMIT NO. 9 _ 1 OWNER'S NAME ITE ADDRESS PUY .d.:. e o }lox 95 r a48-1549 CONTRACTOR y� ADDRESS NT.PHONE L e1 �1 3:'v 1.%it '1�'"r.: .:«i'�... - .. 941-1971 r_ �f'ii ii iv. : P BY ER/kY.a CONT.REG.NO. EXP. 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 ,2�j I� 8o SIGN GRADING OTHER - TAX ACCOUNT NO. l� ��j (AJJ J31. LEGAL DESCRIPTION -77`7',.77-17 JOJINF,r177 - ISSUED BY _ DATE OF ISSUE 1 ;"''� DATE OF APPLICATION 40 BUILDING INFORMATION ZONE - — _ SET BACKS:FRONT SIDE - REAR HEIGHT LIMIT OCCUPANCY TYPE OF CONSTRUCTION CENSUS NO. TYPE OF HEAT BLDG.SQ.FT. STORIES PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING -•' FT. GAS LOGS RECEIVED BATHTUBS LAUNDRY DRAINS FORCED AIR FURNACE DUCT WORK SHOWERS URINALS GAS HOT WATER HTR. 6.50 AIR HANDLING UNIT NUMBER LAVATORIES DRINKING FOUNTAINS CONVERSION BURNER MISC. RETURNED SINKS MISC. BBQ -- BASIC FEE DISHWASHERS TOTAL FIXTURES •d4 it.1 /( C DRYER TOTAL MECHANICAL AMOUNT L.-. VALUATION „_44 GAS PIPING TEST MUST --KTNESSED BY INS' ►• ' AFFIDAVIT WILL NOT SUFFICE. PERMIT FEE PLAN CHECK FEE • �r.• ,-w ilkUMBING FEE I ..'L •L L IL ' 11 CHANICAL FEE TOTAL BLDG. FEES Water Line OK Mec . \. Note',g. l PART P/C FEE \' SEPA REVIEW GAS PIPING OK i :e B WATER SERVICE ' N-''V":;-fi7k. 4, WATER MAIN CHG. f 9Q, S.B.C.C. FEE Iv OTHER FEES MECHANICAL PERMIT • AMOUNT DUE To Fee $ Receipt No. 'l'N ' i `t'-l`r) ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GR DIN RMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE. I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST R,Y KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET: OWNER OR AGENT DATE IP- = RECEIVED BY •ermit #_ ,_ I I 1 c COMMUNITY pEVSLOPMENT DEpARTM ��,,,,,,�� ;gg� CITY OF FEDERAL WAY O 'S�'P/E:�7BUILDING PERMIT APPLICATION — Please Print- J U L 21 1992 BOX 1 TSWOMIDERAL WAY OWN r "'y L SITE LOCATION Z c7 j i, OWNER'S ADDRESS z r e.04,- 1J CITY/c ', !,O y PHONE MEV DESCRIBE JOB /,v..rti GAS / 4 `r6;1Z THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION / G BOX 2 CONTRACTOR'S NAME �//UJ0/ i S/,/k/i/V e /'0 - CONTRACTOR'S REG. y1C.Z CA7 Card MUST be presentedr CONTRACTOR'S ADDRESS �`� ' �C 2 S CITY,1")/14?0 / /PHONE � y2. 7 EXPIRATION DATE 3 - - / ,S — 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 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 tOe legal description.) K.C. Plat Recording # 2 2-0 54 - 0 / 0 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$ NO. WATERCLOSETS GAS PIPING, FEET 5 $ 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. OWNER/AGENT: DATE: `/9 ANP-008 3/90