91-101304 MECHANICAL PERMIT 9/-/o/ 3a Y
CITY OF BUILDING PERMITBUILDING INSPECTION
FEDERAL WAY
941-1555
PERMIT NO. 91-1270 M OWNER'S NAME MARGARET BRAVO JOB ADDRESS 30033 5 AVE SW
CONTRACTOR NORTHWEST WATER HTR ADDRESS 8201 DURANGO ST SW TACOMA CONT. PHONE -4±$-4$1 $-
CONT. REG. NO. NORTHWH1O3R2 12/91 OWNER'S PHONE 946-4878 OWNER'S ADDRESS SAME 984-6404
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 SEE BELOW
TAX ACCOUNT NO. 039590-0110 LEGAL DESCRIPTION NA
ISSUED BY ELIZABETH SNDYER DATE OF ISSUE CJ" / / .. C% 1 DATE OF APPLICATION 9/12/91
BUILDING INFORMATION
ZONE OCCUPANCY TYPE OF CONSTRUCTION BLDG. SQ. FT.
ET BACKS: FRONT SIDE REAR STORIES HEIGHT LIMIT
UMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
.WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING 50 FT. 2.00 BOILER
'3ATHTUBS` LAUNDRY DRAINS COMPRESSOR TANK(S) RECEIVED
SH')WEAS URINALS FORCED AIR FURNACEGAS1O.00 AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS GAS.00T WATER HTR. 6.50 MISC.
SINKS MISC. CONVERSION BURNER BASIC FEE 20.00 RETURNED
DISHWASHERS TOTAL FIXTURES _NONE UNIT HEATER TOTAL MECHANICAL 38.50 AMOUNT NONE
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE INSPECTION RECORD
MECHANICAL FEE $38.50
TOTAL BLDG. FEES Water Line OK Mechanical Inspection Notes:
RT P/C FEE
A REVIEW GAS PIPING OK Date By
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES MECHANICAL PERMIT
AMOUNT DUE $38.50 Account No. 010-000-322-10-004 Total Fee $ 38.50 Receipt No. 35,3 j
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 : MET:
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OWNER OR AGENT !� _ _ _ ` tw DATE 7--/ 7—(/
'
MECHANICAL PERMIT
CITY OF Bu I I_ D IPI G PERMIT BUILDING 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
ZONE 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 GAS;-10T WATER HTR. MISC.
RETURNED
SINKS MISC. CONVERSION BURNER BASIC FEE
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 INSPECTI. ' e- 9 111OECHANICAL FEE 111
OTAL BLDG. FEES Water Line OK Mechanical Inspe. on N.
1
PART P/C FEE
SEPA REVIEW GAS PIPING OK Date By i , F.
WATER SERVICE
WATER MAIN CHG. ....2"Csa4/
S.B.C.C. FEE
vl
OTHER FEES MECHANICAL PERMIT RR
AMOUNT DUE Account No. 010-000-322-10-004 Total FES" 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. r
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 "Nk..,,,V/
REQUIREMENTS WILL BE MET:
OWNER OR AGENT DATE
Permit # 91 -
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 TENANT NAME: ,4 f
OWNER (\ ct-± 'QJo SITE LOCATION, 3c033 �'t J4c S LL FYc�Y��rnl Gc�
OWNER'S ADDRESS 3-60'2.3 3 ` 140, Vii) CITY Fe- _ PHONE ?Lf(o" `faze
DESCRIBE JOB L s 0 (o&S Lye-. -. ' ti '
THE PROPERTY IS OWNED BY: SINGLE/MARRIED_ PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME Alaf &-toe-�`�- iJk -e/ / ' c_{ CONTRACTOR'S REG. # /Lie• 1-6--1.01k /oJ
'it?-(1
Card MUST be presented
CONTRACTOR'S ADDRESS 1-96( (.���1 0 3 r 5c0 CITY l cr ti PHONE b (IC
EXPIRATION DATE 1 f
— 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 AkI i -- PHONE
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST /, 3 00 . 00 EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER 0 3 •1 C L / /(
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 (V(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"-C-)
$
BATHTUBS NO. I FURNACE, ELEC. GAS $
SHOWERS I 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 WVRE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLOYE , UPON T ACCURACY OF HE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: DATE:
ANP-008 3/90