91-101337MECHANICAL PERMIT
CITY OF BUILDINGFEDERAL WAY PERMIT
BUILDING INSPECTION
941-1555
PERMIT NO. 91-1285 M OWNER'S NAME AL GUIZZETTI JOB ADDRESS 31728 7TH PL S
CONTRACTOR ABC GAS
INSTALLATIONS ADDRESS 9923 64TH CT E PUYALLUP CONT. PHONE 845-7482
CONT. REG. NO. ABCGAI113N3 OWNER'S PHONE 845-7482 OWNER'S ADDRESS 31728 7TH PL 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. 794150-0220
LEGAL DESCRIPTION
SUED BY JOANNE
JOHNSON DATE OF ISSUE DATE OF APPLICATION 9-17-91
BUILDING IN ORMATION
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 _5 FT. -nnn BOILER
RECEIVED
BATHTUBS
LAUNDRY DRAINS
COMPRESSOR TANK(S)
SHOWERS
URINALS
FORCED AIR FURNACE AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS POT WATER HTR. 6 50 MISC.
RETURNED
SINKS
MISC.
CONVERSION BURNER BASIC FEE
DISHWASHERS
r
TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL 28.50
AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
UMBING FEE
INSPECTION RECORD
ECHANICAL 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 ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET:
— j cr
OWNER OR AGENT
DATE
CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDINGPERMIT BUILDI94Y � 555ECTION
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
NE
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.�iOT 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
CHANICAL FEE
OTAL BLDG. FEES
Water Line OK Mechanical Inspection
Notes:
PART P/C FEE
SEPA REVIEW
GAS PIPING OK Date 9 -?1i..41 By rim_
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.
1 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
SET BACKS AND FOOTINGS
DATE - -..-BY
PLUMBING ROUGH IN
DATE _ -__-_BY
O.K. TO ENCLOSE FRAMING
DATE __._...-. -_ BY _
FINAL O.K. TO OCCUPY
DATE _ yBY
0
O.K TO POUR FOUNDATION WALLS
DATE ...._ ...._....BY ..............-
WATER LINE O.K. ____ -- ...... .__
GAS PIPING O.K.
INSULATION
DATE BY __-
DCD I PSD
9-1_2 - 9i — I- 17s
•
PLUMBING GROUNDWORK
DATE BY
MECHANICAL INSPECTION
DATE / - y ___-BY
WALL BOARD AND FIRE WALL
DATE -_ -....- - ---,,BY
FD
RECEIVED i - Wit # aFl��
SEP 17 1991 CITY OF FEDERAL WAY
011VOF- FEAERAL.WAY BUILDING PERMIT APPLICATION
— Please Print —
OWNER SITE LOCATION
OWNER'S ADDRESS, �04 � CITY e PHONE rt C - Z'ZC
DESCRIBE JOB
THE PROPERTY IS OWNED BY: SINGI P19ARRIED PARTNERSHIP ` CORPORATION
BOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG. # !"4PA,(6Al3
Card UST be presented
CONTRACTOR'S ADDRESS ��f�-y �� CITY V- PHONE
EXPIRATION DATE �2
,1)f
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 PHONE S `tS',
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER rj 4 'q
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 ( ) 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)
N0. WATERCLOSETS
BATHTUBS
SHOWERS
LAVATORIES
SINKS
DISHWASHERS
ELECTRIC HOT WATER HEATER
LAUNDRY WASHER OUTLET
URINALS
DRINKING FOUNTAINS
SUMPS, SPRINKLER VACUUM BREAKERS
DRAINS
OTHER
TOTAL FIXTURES
MECHANICAL LIANCES —
BASIC FEE $
GAS PIPING, FEET
$
N0. FURNACE, ELEC. GAS
$
_GAS HOT WATER HEATER
$
CONVERSION BURNER
$
BOILER, SIZE BTU
$
AIR HANDLING UNITS
$
HEAT PUMPS, SIZE
$
UNIT HEATERS
$
AIR COOLING UNITS, SIZE
$
COMMERCIAL HOOD
$
OTHER
$
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, IPPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT:�c --•.1-���-�-- DATE:
ANP -008 3/90