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92-100065 MECHANICAL PERMIT 9D-- /00 0105 CITY OF BUILDING INSPECTION FEDERAL WAY BUILDING PERMIT 941-1555 PERMIT NO. 92-0016 M OWNER'S NAME GWYNE C. ROGERS JOB ADDRESS 30156 2ND PL SW CONTRACTOR NORTHWEST WATER HEATER ADDRESS 8201 DURANGO ST SW TACOMA CONT. PHONE 984-6404 CONT. REG. NO. NORTHWHIIBR2 OWNER'S PHONE 941-2265 OWNER'S ADDRESS 30156 2ND PL SW 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. 233730-0450 LEGAL DESCRIPTION *SUED BY JOANNE JOHNSON DATE OF ISSUE /- / - 9 2-- DATE OF APPLICATION 1-7-92 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 2.00 BOILER BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S) _ RECEIVED SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT _ NUMBER LAVATORIES DRINKING FOUNTAINS GAS RIOT WATER HTR. 6_50 MISC. RETURNED SINKS MISC. CONVERSION BURNER BASIC FEE -20-00 DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL _28_50 AMOUNT VALUATION GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE. PERMIT FEE N CHECK FEE UMBING FEE INSPECTION RECORD MECHANICAL FEE 28.50 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 28.50 Account No. 010-000-322-10-004 Total Fee $ 28.50 Receipt No. 174y37) 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: �J OWNER OR AGENT �� DATE / — 9 MECHANICAL PERMIT CITY OF BUILDING INSPECTION FEDERAL WAY BUILDING PERMIT 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. SO. 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, OT 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 INSPECTION RECORD OCHANICAL FEE TOTAL BLDG. FEES Water Line OK Mechanical Inspection Notes: PART P/C FEE 16 SEPA REVIEW GAS PIPING OK ty.A' Date z. 4P• p7/ WATER SERVICE WATER MAIN CHG. S.B.C.C. FEE OTHER FEES MECHANICAL PERMIT AMOUNT DUE Account. No. 010-000-322-10-004 Total Fee $ 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 BE MET: OWNER OR AGENT DATE I i J J m z m m O 1--- 0 o �� - p w z I a 0 D 1 Z O Z CC J 0 O Q a¢ U Q Z_ I Z 0 Fri a D w U F —1.„. I- W a a 2 a s O i J 1 o -J • I 1 I a z o• m m a 0 z D O I Y Y LL O O ¢ Z W o z z O O Z a. J 2F- o w a • o o o ? o 0 1 O 1 c.5 z z m am mP. zm a OLII Z W a m I O O m w 2 w I- w Q w H I- D H ~ Z ~ � < a < O 0 m 0 il Permit # çco!/Qfr. CITY OF FEDERAL WAY BUILDING PERMIT APPLICATION -- Please Print— BOX 1 TENANT NAME: OWNER w' " �'' ! 'a SITE LOCATION �o S-> r ( I J41101 OWNER'S ADDRES 3&1 6 1( 5`�-= CITY 4- ' Glu PHONE (— ��C 5 DESCRIBE JOB � 1.( A 1.2k-�kr /, - 7 THE PROPERTY IS OWNED BY: (NGLE/MARRIED ✓ PARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME /14-{4-k,--c-.51-5'I` Li- i CONTRACTOR'S REG. # /00l-77.114/r 3 k 2- Card MUST be presented Yd CONTRACTOR'S ADDRESS Dd D( Dac ' 54- J CU CITY ciw '-- PHONE 98`1" err 7 EXPIRATION DATE /.7 �— — 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 iti PHONE (Yf 6 /O BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST-frgnC, EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER a. 3 3 7 30 Q 1,. c) 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 ('V1'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 $ 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 $ SUMP:, SPRINKLER VACUUM BREAKERS OTHER $ D' INS _ $ ITHER $ 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/1 PON TH, ACCURACY OF T INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION. i OWNER/AGENT: `� — DATE: , / -7/9i ANP-008 3/90