92-100523MECHANICAL PERMIT
CITY OF BUILDING PERMIT
9'Ja0 5��?
BUILDING INSPECTION
941-1555
PERMIT NO. 92-0517M
OWNER'S NAME SAMUEL HAANIO JOB ADDRESS 30648 9TH AVE S
CONTRACTOR NORTHWEST WATER HEATURRESS 8201 DURNAGO ST SW TACOMA CONT. PHONE 984-6404
CONT. REG. NO. NORTHWH103R2 OWNER'S PHONE 839-2265 OWNER'S ADDRESS 30648 9TH AVE S 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. 174500-0020
LEGAL DESCRIPTION
ISSUED BY JOANNE
JOHNSON DATE OF ISSUE- �- DATE OF APPLICATION 4-2-92
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 2 FT. 2.00 BOILER
BATHTUBS
LAUNDRY DRAINS
COMPRESSOR TANK(S)
RECEIVED
SHOWERS
URINALS
FORCED AIR FURNACE 10.00 AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS POT WATER HTR. 6.50 MISC.
SINKS
MISC.
CONVERSION BURNER BASIC FEE 20.00
RETURNED
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL 38.50
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
38.50
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
38.50
Account No. 010-000-322-10-004 Total Fee $ 38.50 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 WIL BE MET:
OWNER OR AGENT
(�
�` DATE ! v
CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
BUILDING INSPECTION
941-1555
PERMIT NO. 17tii
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�10T WATER HTR. MISC.
SINKS
MISC.
CONVERSION BURNER BASIC FEE
RETURNED
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
PART P/C FEE"t1
Water Line OK Mechanical Inspection
Notes:
SEPA REVIEW
GAS PIPING OK Date (� y
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
SET BACKS AND FOOTINGS
DATE -...._BY
OX TO POUR FOUNDATION WALLS
DATE _ ___13Y _ -_
PLUMBING GROUNDWORK
DATE ,BY
PLUMBING ROUGH IN
DATE BY
WATERLINE O.K. . ... . .... ...
GAS PIPING O.K.. -Ul
MECHANICAL INSPECTION
DATE --BY
O.K. TO ENCLOSE FRAMING
DATE BY
INSULATION
DATE _ -_...-BY . ... .... .
WALL BOARD AND FIRE WALL
DATE BY
FINAL O.K. TO OCCUPY
DATE -f*Z- BY
DCD
PSD
I'D
it 4
RSCEIVED r
APR 0 2 1992 CITY OF FEDERAL WAY
Oft OFFEcEa,� BUILDING PERMIT APPLICATION
OU'LOI b D� Y — Please Print —
BOX 1 TENANT NAME:
OWNER SITE LOCATION "gip -`h 14ie
OWNER'S ADDRESS ' , S. CITY ev-- PHONE rt3`j
DESCRIBE JOB V' e. -
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME V't�� �-'�' CONTRACTOR'S REG. # NhRVJ1��4���
Card MUST be presented
CONTRACTOR'S ADDRESS � � U ✓�^'E>i . SU) CITY7ja_e CWZCA— PHONE qSLA
EXPIRATION DATE
&I
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 Vjry-
_� PHONE qS��
BOX 4 SEWER DISTRICT 1iWATER
DISTRICT
BOX 5 ESTIMATED PROJECT COST -
\U EXNTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUM R
$
LEGAL DESCRIPTION
$
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
AIR HANDLING UNITS
BOX 7 BUILDING SQUARE FOOTAGE:
(Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR /
BASEMENT / DECK____J_ 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
SUMPSe SPRINKLER VACUUM BREAKERS
7S
R
TOTAL FIXTURES
MECHANICAL APPLIANCES —
BASIC FEE $
GAS PIPING, FEET
$
NO._ _L_ FURNACE, ELEC. GAS
$
L—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 ASTO 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:
DATE:
ANP -008 3/90