92-100905 MECHANICAL PERMIT 9 /oo 9 n_
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 661-4140
PERMIT NO. 92-0931 M OWNER'S NAME CLARK BELLES SA SITE ADDRESS 32811 4TH AVE SW
CONTRACTOR AMERICAN HEATING SERMDRINC 7517 PORTLAND AVE TACOMA __CONT.PHONF 847-8399
CONT.REG.NO. AMERIHS1O7M6 EXP. 7/92 OWNER'S PHONE 838-4974 OWNER'S ADDRESS 32811 4TH A7E SW FEDERAL WAY
TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEWCOMMERCIAI COMMERCIAL ADD.__ INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI-FAMILY _(UNITS )MULTI.ADD. SIGN GRADING OTHER
TAX ACCOUNT NO. 926491-1090 LEGAL DESCRIPTION —
ISSUED BY JOANNE JOHNSON DATE OF ISSUE (C) er DATE OF APPLICATION 6-17-92
BUILDING INFORMATION
SZONE 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 50 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
MECHANICAL FEE 28.50
41110 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 q
AMOUNT DUE 28.50 Total Fee $ 28.50 Receipt No.0Z- (t3 I
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 e'-ee. -''C DATE •- - ,'` -
MECHANICAL PERMIT
CITY OF BUILDINGPERMIT BUILDING INSPECTION
t. FEDERAL WAY 661-4140
PERMIT NO. 92-0931 OWNER'S NAMEp � CL RE B$LLSSSA SITE ADDRESS
CONTRACTOR AMERICAN HEATING SERWRCAbig 7517 PORTL,. 713 AVE CONT.PHONE 847-83`
CONT.REG.NO. AbtERIBSI07M6 EXP. 7/92 OWNER'S PHONE 838-4974 OWNER'S ADDRESS 32 14. 4"Ti.a ASE SW i
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. 9264- _ LEGAL DESCRIPTION
ISSUED BY y t MJNE t OJ SOtDATE OF ISSUE DATE OF APPLICATION 6-17-92
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. 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.
SINKS MISC. BBQ BASIC FEE 20.00 RETURNED
DISHWASHERS TOTAL FIXTURES DRYER TOTAL MECHANICAL 230 AMOUNT
VALUATION �"`
I, 7`'7` GAS PIPING TEST MUST- E WITNESSED BY INSPE • "{AF ILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
UMBING FEE INSPECT ' \ lit /,..) k.)
_CHANICAL FEE . 8.50 'i
TOTAL BLDG. FEES Water Line OK Mechanical1 , es:
PART P/C FEE t- ®'
SEPA REVIEW GAS PIPING OK Date ; ti
WATER SERVICE P�C
WATER MAIN CHG. µ ^.''`. n Q
S.B.C.C. FEE a,5 " Ill
OTHER FEES MECHANICAL PERMIT " ,
AMOUNT DUE 2U. •�k. •tal Fee 28+50 Receipt No.02 1g 3 51
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERTS IRE ONE YEAR AFTER DATE OF ISSUANCE.
i CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOVIO GE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET:
nWNER OR AGENT G%' -.. ._'' r. r- ��1 DATE % ' ` (1:1.--
..
S •rmit # - J� /A
RECEIVED BY
CITY OF FEDERAL WAY COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT APPLICATION JUN 1 7 1992
— Please Print—
BOX 1 TENANT NAME:
�"
OWNER (Ti1%. '. 67;_,/rt SITE LOCATION
OWNER'S ADDRESS 3o(X/i CZv Ari . CITY _.id- -4741. PHONE ,f/78'-4/(;17.y'
DESCRIBE JOB ac / '? Z•Vi
THE PROPERTY IS OWNED BYA SINGLE/MARRIED Jc. PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME l�6!'e/ Q-z 14,( CONTRACTOR'S REG. # A'Bgz-//S7e,7:ve
Q Card MUST be presented
CONTRACTOR'S ADDRES 2 /;7 CITY .2 iPHONE,--273/7-0"
' �',97
, 4 L,2
EXPIRATION DATE o - 72
— OR—
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PR iBITS 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
(302.,,( 6I)'ROPERTY 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 (}d 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) MECHANIIGAL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET -
BATHTUBS NO. FURNACE, ELEC. GAS ,2 $
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 $
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
1ADE.I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(INCLUDING COSTS,EXPENSES,AND ATTORNEYS'
.ES INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM), WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
JD FILED AGAINST THE CI Y OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
FICERS AND EMPLO , UPON THE 7Uf1FiCY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
VER/AGENT: DATE: ANP 008 3/90