92-100758 MECHANICAL PERMIT 9 , /00-75?
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
92-0806 M FEDERAL WAY CHIROPRACTIC 1105 S 348TH STREET BLDG B
PERMIT NO. OWNER'S NAME JOB ADDRESS
CONTRACTOR NORTH MECHANICAL sERvIcgA ESS 3040 "B" ST NW #11 AUBURN CONT. PHONE 735-1007
CONT. REG. NO. NORTHS133RZ OWNER'S PHONE 874-9507 OWNER'S ADDRESS 402 S 333RD ST #103 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. 042104-9140 LEGAL DESCRIPTION
ISSUED BY JOANNE JOHNSON DATE OF ISSUE 5 - i 2 DATE OF APPLICATION 5-21-92
BUILDING INFORMATION
ZONE OCCUPANCY TYPE OF CONSTRUCTION BLDG. SQ. FT.
SET BACKS: FRONT SIDE REAR STORIES HEIGHT LIMIT
PLUMBING NO. NO. i MECHANICAL APPLIANCES AMT. AMT. BOND
WATER Cl SETS 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 pOT WATER HTR. MISC.DUCTS 6-50
SINKS MISC. CONVERSION BURNER BASIC FEE 20-00 RETURNED
DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL 26_S0 AMOUNT
VALUATION
s._i GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
UMBING FEE INSPECTION RECORD
mieCHANICAL FEE 26. 50
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
AMOUNT DUE 26.50 Account No. 010-000-322-10-004 Total Fee $ 26.50 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 : T:
OWNER OR AGENTS / :.I....-1,----' _ DATE
• Pnit # alt- Yc C ri
1
1 \ " CITY OF'FEDERAL WAY
1BUILDING PERMIT APPLICATION
';‘":(-$',41001,0"
" - Please Print-
BOX 1 TENANT NAME: fErOL2„4 L 14//1-`t-- /yzao4-4-
OWNER
c4OWNER e- SITE LOCATION //OS S. 398 Sr Bc.o6-. 8
OWNER'S ADDRESS 1fOZ S, 333 ST. -x`/0 3 CITY fr,O. Pc/4 r PHONE .0/7 /06-3
DESCRIBE JOB ?EWA-K/7 /H9/'/La' 'n c Av7 87'/- 7S07
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME iV ti-i /9/6:CN,4.v/64-c Scm-v/Ce5 CONTRACTOR'S REG. # WA777'S/33 RZ.
Card MUST be presented
CONTRACTOR'S ADDRESS 3O90 ,g Sr, 4/w ' /� CITY AU(gv/e-N PHONE 7 3 S-/S)U 7
EXPIRATION DATE /-ZU-613
- OR -
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON 11 ,4 Ca,q /A/ PHONE 7 3 S-/O 01
B@X 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST L(_OO • 00 EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
L N 017121047/ - 4/0
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
(?C) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES - BASIC FEE$
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 QUA'?S -,IJV-4C $
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.
WNER/AGENT: ,,a041'41170te.;- DATE:
5=-2-/- 92—
ANP-008 3/90