90-100378 MECHANICAL PERMIT qt) 'Io6v2 >8
CITY OF BUILDING INSPECTION
FEDERAL WAY B U I L D I N G PERMIT 941-1555
PERMIT NO. 90-1267 M OWNER'S NAME MICHAEL TIPPER JOB ADDRESS 31116 6TH AVE S
CONTRACTOR NORTHWEST USI ADDRESS 1908 S 341 PL SUITE 9 FF.DERAT. WAY CONT. PHONE 952-5433
CONT. REG. NO. NORTHUSIO1JJ OWNER'S PHONE 941-5419 OWNER'S ADDRESS 31116 6TH AVE. S.
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. NA LEGAL DESCRIPTION NA
7 , d
ISSUED BY JOANNE JOHNSON DATE OF ISSUEM741) DATE OF APPLICATION 7-31-90
BUILDING INFORMATION
IINE OCCUPANCY TYPE OF CONSTRUCTION BLDG. SQ. FT.
ET BACKS: FRONT SIDE REAR STORIES HEIGHT LIMIT
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING 35 FT. 2.00 BOILER
RECEIVED
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS GAS HOT WATER HTR. MISC. BBQ 0
RETURNED
SINKS MISC. CONVERSION BURNER BASIC FEE 20.00 A
DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL 28.5.0 AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE INSPECTION RECORD
MECHANICAL FEE 28.50
•TAL BLDG. FEES Water Line OK Mechanical Inspection Notes:
FART P/C FEE
SEPA REVIEW GAS PIPING OK Date By
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE q �
OTHER FEES MECHANICAL PERMIT
28.50I
AMOUNT DUE Account No. 010-000-322-10-004 Total Fee $ 28.50
Receipt No. `
ALL PERMITS EXPIRE 180 '/AYS • ER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFO- ATION F -NISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE ME .
rG
OWNER OR AGENT �� 4-AMIMIILA--%..._ DATE _cD
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 HOT 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
MECHANICAL 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.
i
S.B.C.C. FEE 1
I
OTHER FEES MECHANICAL PERMIT /^ 3 I
AMOUNT DUE Account No. 010-000-322-10-004 Total Fee $ Receipt No. A "
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
C m 0 0 C m C CD
A Z A A r-" A m
-i n -1 C H -i
m D mH m m co
�(\ O 1 Z n
ill m
Z cn
Vp rn Q A
\\ ,O O O C
If m -I O
1
CO - CO CO> z CO 0
Z
Z 0
0 CD
C C z 0 0 0
0
> cn > > >
C m D v m H
37 0
v rv
_
O z Z 0
Z 0 m C
O m
O
m
T 0
C
I C
co
COW -i
- j 5
Z
m D
C r-
(n
0 S C K C '0
r
A m COC
m
m r m m m r-
CO A CO
0 Z I Z
5 0
37 1 A O
C r ( 3:]
A
Z CD CC
C m Z
m
m n
C CD
W 73 -i 70.1
-< A { -G
r
1
1 1 t I
Permit # Qv "727 ./(-4
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 TENANT NAME:
OWNER /2 Gore- Ti'Ape 62 SITE LOCATION
OWNER'S ADDRESS -S I 1 co /4v, S CITY ,A41-. t)�
4( i PHONE q'0,_s---(0 7
DESCRIBE JOB it; 6A-s LN.Q , B q /
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME h 0k11.4-6-)'S T (J S CONTRACTOR'S REG. #1.)04T# uS f a i 313
—
Card(�` // � Card MUST be presented
CONTRACTOR'S ADDRESS 190 V S 3y I Pi, S.7.4, ( CITY W/ PHONE ?S a - s"-/3 3
EXPIRATION DATE Li- S--- 7/ I
— OR —
I HAVE READ CHAPTER 18.27.010 RELA�i 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 �e.ON i-N 74A&.) PHONE 9S�----S—`13 3
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION ( /�( S TI bu ( p 4 n J S--
(If
(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
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET .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 HO $
//SUMPS, SPRINKLER VACUUM BREAKERS / OTHER $
DRAINS $
e_OTHER $
TOTAL FIXTURES $
TOTAL MECHANICAL FEE $
I CERTIFY UAJDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
AND FURTHIER 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 AGAI , THEDITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND E IPLOYEE , UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
'- c' i
� /• DATE: - ) r - '2T)
v
ANP-008 3/90