91-100218 MECHANICAL PERMIT
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
91-lo od)g
PERMIT NO. 91-185m OWNER'S NAME PEGGY BOLF JOB ADDRESS 31415 8 AVE S
CONTRACTOR N.W. WATER HEATER ADDRESS 8201 DURANGO ST SW TACOMA CONT. PHONE 984-6404
CONT. REG. NO. NORTHWH1O3R2 10/91 OWNER'S PHONE 946-8547 OWNER'S ADDRESS SAME
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 FURNACE/PIPING
TAX ACCOUNT NO. 858800-0050 LEGAL DESCRIPTION NA
SUED BY ELIZABETH SNYDER
fill DATE OF ISSUE ; -- " i
DATE OF APPLICATION 2/20/91
BUILDING INFORMATIONIII
•NE_ NA OCCUPANCY NA TYPE OF CONSTRUCTION MECHANICAL BLDG. SO. FT. NA
SET BACKS: FRONT NA SIDE NA REAR NA STORIES_ NA HEIGHT LIMIT NA
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING_ FT. 2.00 BOILER
RECEIVED
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS URINALS FORCED AIR FURNACE 10.00 AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS GAS pOT WATER HTR. MISC.
SINKS MISC. CONVERSION BURNER BASIC FEE 20_00 RETURNED
DISHWASHERS TOTAL FIXTURES NONE UNIT HEATER TOTAL MECHANICAL 37_00 AMOUNT NONE.
VALUATION NONE
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
N CHECK FEE
MBING FEE INSPECTION RECORD
CHANICAL FEE $32.00
OTAL 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 $32.00 Account No. 010-000-322-10-004 Total Fee $ 32.00 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 TR.U.E-AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WIL t
OWNER OR AGENT e-e-f - 2,___..�1 DATE --A17"----,97.-
MECHANICAL PERMIT
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
/-IoUM
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 GAS1IOT 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 652e
//$/Date
_74 7 By j2
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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RECEIVED • • lorro# 61, H
FEB 2 1991 g5y)(----
CITY OF FEDERAL WAY
CITY QFF DEAALWAY BUILDING PERMIT APPLICATION
BUILDING DEPT. — Please Print—
BOX 1 TENANT NAME:
OWNER e- ' SITELOCATION S- r" i . • e ea Wiz.
OWNER'S ADDRE S 3P-If-S- 8'f 'v S. CITY `, tea- - / PHONE ?iq - as y 7
DESCRIBE JOB 6c,-.-S -wiia- 0e_ .`,t S-/c.//p f, i
THE PROPERTY IS OWNED BY: SINGLE/MARRIED L----- PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME Nor fkr.,)t•,"f li.-)a- /
Ale.a.�'at/ CONTRACTOR'S REG. # /14,eih/lx!/f /e3A ,2.
Card MUST be presented
CONTRACTOR'S ADDRESS 0/ A.,,-re-vi. o STf• 3 i CITY 4-co /tea- PHONE V 8)(" C `-(t' 'I
EXPIRATION DATE /J - a' - I/ '
rr — 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 h1, Kt-- PHONE 9f`f'" 4 `/o 5
BOX 4 SEWER DISTRICT WATER DISTRICT ---
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER '.5a5379O -'C,C-/ SI')
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 ( -r SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT (y
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHAN CpL APPLIANCES — BASIC FEE$ 2 0 v17
NO. WATERCLOSETS GAS PIPING, FEET $ _Z__ ,.
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 OTHER $
DRAINS $
OTHER $ On
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 EMPLO :t6:e
YEES, PON TH ACCURACY OF T INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
6-c t.__
OWNER/AGENT: �� DATE: • __• / //
ANP-008 3/90
• • • •
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL
REMARKS:
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DATE
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL DATE
REMARKS:
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ADD/ALT NEW MULTIFAMILY (UNITS
MULTIFAMILY ADD/ALT TENANT IMP. OTHER
OCCUPANCY TYPE OF CONSTRUCTION STORES
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION
BUILDING DEPARTMENT REMARKS: PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
ASSIGNED ADDRESS:
LLI It
x Q PARTIAL PLAN CHECK FEE RECEIVED
I :I' o 0 Amount Date Receipt#
C•.., w z
U
LLI w BUILDING DEPARTMENT APPROVAL
RECEIVOJ BY • DATE ACCEPTED FOR FILING