93-101700 ,, , ,, ,... , ,5. -,, ,:. , ,,,
CITY OF FEDERAL WAY BUILDING PNO.: SLD93-0741
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 07/07/93
Federal Way, WA 98003 BY: FC
661-4000
SITE ADDRESS: 1109 S 348TH ST
PARCEL NO.: 2021049140
PROJECT DESCRIPTION: PLUMBING & MECHANICAL (FOR WORK NOT INCLUDED UNDER ORIGINAL PERMIT #BLD93-0338)
OWNER -- CONTRACTOR LENDER
rga COMMUNITY DIALYSIS CENTER PUGET SOUND MECHANICAL INC
S 348TH ST 1818 - 99TH ST E
FEDERAL WAY WA 98003 TACOMA WA 98445-5446
537-8900
__
ilk PUGETI*217LQ
BLD?: MEC?:X PLM?:X FLR--EXIST--PROP--- DWELLING UNITS: 0 COMP PLAN .ry FEES:
TYPE OF WORK:? USE:? 1ST.: 0: 0:sf STORIES • 0 REQUIRED PARKING..: 0 SPRINKLERS' 7 MEC PRMT ISSUANCE... $ 20.00
CENSUS CATEGORY •800 2ND.: 0: O:sf HEIGHT • 0.00 ft HAZARD CLASS •, MEC APPLIANCE FEES.* $ 6.50
OCCUPANCY GROUP 3RD.: 0: 0:sf VALUATION REQUIRED SETBACKS FIRE FLOW • 0 gpm PLM PRMT ISSUANCE.. $ 20.00
:? :? :? :? OTHR: 0: 0:sf EXIST.,$: 0 FRONT • 0.00 ft PLUMBING FIXT....93* $ 91.00
TYPE OF CONSTRUCTION BSMT: 0: 0:sf PROP...$: 0 SIDE..........: 0.00 ft WATER SERVICE..:?
:? :? :? :? DECK: 0: 0:sf REAR........... O.00:ft SEWER SERVICE..:?
OCCUPANT LOAD GAR.: 0: O:sf RECEIVED.:07/07/93
0: 0: 0: 0: TOTL: 0: 0:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
FUEL TYPES.:GAS FANS • 0 BOILERS/COMPRESSORS WATER CLOSETS • 0 URINALS • 0 TOTAL FEES $ 137.50
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 BATH TUBS • 0 DRINKING'FOUNT.: 0
FURN<100K..: 0 DUCT WORK • 0 3-15 HP.....: 0 SHOWERS • 1 SUMPS • 0
GAS HWT • 1 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 0 VAC BREAKERS...: 0
C URNER: 0 FURN>100K • 0 30-50 HP • 0 SINKS • 2 DRAINS • 1
Bb • 0 MISC • 0 5+ HP.......: 0 DISH WASHERS 0 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELEC WTR HEATERS...: 0 OTHER FIXTURES.: 9
RANGE • 0 <=10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS...: 0
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERG"OUND.: 0
•
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 `�i /d,,,.. DATE
bld_prmt 10/23/92
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City of Federal Way
v rev=.1=Ivisetwe
IV's FOR BUILDING PPRMIT
� APPLI'�ATION O
J U L 0 7 1993
CITY OF FEDEFIAL WA`: (-0
PLEASE PR/N7BUILfDJNG DEPT APPLICATION#: fit/40493 /
' SITE LOCATION 'Address //c y
Tenant (if known) Assessor's Tax#
r • 6� � &A-et-7-7,f Lot# oeto cU V-}('t
Building Owner ame AV/Ass S,
City State Zip Phone
Nature of Work
I APPLICANT 5 ,D..L.>7fi,I-k j ,uT%�6 2
Name (F,M,L)
Address
City State Zip
Contact Person Day Phone Other Phone Fax
4131JIMIlsiq CONTRACTOR
Company Na
Address
City State Zip
Contact Person Phone Fax
Contractor's # (card a presented) Expiration Date Verified ❑ Yes ❑ No
ARCHITECT
Name
Address
City State Zip
Contact Person Phone Fax
• .>
,LEGAL DESCRIPTION
Please Complete Reverse Side
CD0492(Rev 4/931
STRUCTURE I Existing Use I Proposed Use
Permit includes: *Building , Plumbing ._ Mechanical C 7 Other
'F Type of Work: ❑ Residential ❑ New ❑ Remodel ❑ Number of Units ❑ Deck
11 ❑ Commercial ❑ Addition ❑ Garage ❑ Shed ❑ Other
Enter 1st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area sq ft
Water Availability ❑ Sewer Availability ❑ On-Site Septic System Availability ❑ Project Valuation $
Zoning Lot Size Existing Bldg Valuation $
LENDER
Name Address
City / \ State Zip
MECHANICAL CONT' • TOR
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
=34 PLUMBING CONTRACTOR
Contractor Name Address
L-5 ,-',Lf /21���/ 4-1/C�-�. /3./25; y ; ����'
City /r}c_,..0/1'J..4 State 4,4,6-Z. Zip 2.eyY.S
Contact Phone Fax
u'37.4 .2 ) rl_
License # ,t�4,,i�/„ 2 .->/2Z 4 Expiration Datezz2-3J Verified ❑ Yes ❑ No
4' PLUMBING FIXTURE COUNT
Water Closets at Sinks Urinals ( :)- Lawn Sprinklers
Bathtubs Dish Washers ,').'-- Drinking Fountains , Other,cee 5,•Adc S�.-�(
Showers Eectn'c Water Heaters .710-- Sumps ? / 1
Lavatories Washing Machine 6.— Drains .'" /7 , I Total Fixture Count
Ittr,'/'c 1';rr'P / `'i,'
IIIECHANICAL UNIT COUNT
Fuel Type (electric/other) Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping Range Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUs Gas Log Unit Heater 50+ Tons
Furn >100 BTUs Fans Miscellaneous Fuel tanks
Gas Hwt / Hood Boilers Above Ground
Cony Burner Duct Work 0-3 Tons Underground
BBQ's Wood Stoves 3-15 Tons Total Unit Count
DISCLAIMER: 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. N.� `
1C Owner/Agent: - e. '� `' (�/ Date: 2- 2 - ._
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