91-100056 MECHANICAL PERMIT
CITY OF BUILDING PERMIT BUILDING
ERMITBUILDING I
NSP
ECTIONFEDERAL WAY
941-1555
9 ) - /OD0S(o
PERMIT NO. 91-0025M OWNER'S NAME GORDON GRAHAM 29818 3 AVE SW
WASH NATURAL GAS 3130 S 38 ST TACOMA JOB ADDRESS
CONTRACTOR ADDRESS 475-6700
CONT. REG. NO. WASHING285CB 3/91 941-2037 CONT. PHONE
OWNER'S PHONE OWNER'S ADDRESS SAME
TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI-FAMILY ) MULTI. ADD. SIGN GRADING OTHER MECHANICAL
TAX ACCOUNT NO. 72532-0270 LEGAL DESCRIPTION NA
SUED BY ELIZABETH SNYDERI l )
DATE OF ISSUE ✓ `-j / 1 DATE OF APPLICATION 1791� /
BUILDING INFORMATION
ZONE NA OCCUPANCY NA
SET BACKS: FRONT NA
SIDE NA REAR NA
TYPE OF CONSTRUCTION MECHANICAL ONLY
BLDG. SQ. FT. NA
STORIES NA HEIGHT LIMIT NA
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT.
AMT. BOND
WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING 35 FT. 2.00 BOILER
BATHTUBS LAUNDRY DRAINS COMPRESSOR RECEIVED
TANKS)
SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS GAS,1OT WATER HTR. MISC. RANGE 6.50
SINKS MISC.
DISHWASHERS CONVERSION BURNER BASIC FEE 20.00 RETURNED
TOTAL FIXTURES NONE UNIT HEATER TOTAL MECHANICAL28.50 AMOUNT NONE
VALUATION NONE
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
ilIMBING FEE INSPECTION RECORD
HANICAL 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.
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 MEIS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET:
OWNER OR AGENTit, . iD , ` 4,7
1-„
ef-"
DATE / If
i/
MECHANICAL PERMIT
CITY OF BUILDING INSPECTION
FEDERAL WAY B U I L. D I N G PERMIT 941-1555
flnr)SM PPOW ( PM M
PERMIT NO. M 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
i;UED 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 frlOT 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 CHECKFEE
MBING FEE INSPECTION RECORD
;HANICAL FEE
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 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
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RECEAV7.00 . PEN # iv•
JAN 7 1991 CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
—Please Print-
BOX 1 TENANT NAME:
OWNER `z• t ' a aft SITE LOCATION , Cl%S 1 c� Ahr .`,.. c..,..;
OWNER'S ADDRESS , rn 1- CITY )-'c1 L:1 PHONE ci`-{ I -.G 37
DESCRIBE JOB gc (-3.41,),---, P - £-C:, i j-
c1`-�__r
THE PROPERTY I OWNED Y: SINGLE/MARRIED -----. 1PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME I'a \1.L t-cx1 f\_" LA-c__ GCA S CONTRACTOR'S REG. # L.t 1`1,N/N.)e,a --iz-k)
r Card MUST be presented
CONTRACTOR'S ADDRESS ' 1--))C..3 CITY J O C c---;('c. PHONE LI ) (< )(
EXPIRATION DATE 3)/ ) / 9 /
- 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 \�C cl =v T sJ € \t PHONE t-17 3-'s ??i
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER 7.Ro ;-R - C` U
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 1 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8-'(`-. ) 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) MECFJANICAL APPLIANCES - BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET ,V 3S ' $
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 ,a OTHER t-v)a� ",+%. $
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 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.
OWNER/AGENT: r--\_s2,. : <-i'- .', DATE: ‘_ _ C L,
\ ( ANP-008 3/90