91-101817CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
v -/o/3/7
BUILDING INSPECTION
941-1555
91-1787 M BYUNG JONG S. 316TH STREET
PERMIT NO. OWNER'S NAME QB ADDRESS3859
NORT T �
CONTRACTOR
ADDRESS 19U8 S. 341ST SUITE y CONT. PHONE 661-2852
CONT. REG. NO.
NORTHUS101JJ OWNER'S PHONE 946-9484 OWNER'S ADDRESS 3859 S. 316TH STREET 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.
570860-0070 LEGAL DESCRIPTION
ISSUED BY JOANNE
JOHNSON DATE OF ISSUE - DATE OF APPLICATION 12-31-91-
2-31-91BUILDING
BUILDINGINFORMATION
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 FT. BOILER
RECEIVED
BATHTUBS
LAUNDRY DRAINS
COMPRESSOR TANK(S)
SHOWERS
URINALS
FORCED AIR FURNACE 10-00 AIR HANDLING UNIT NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS �iOT WATER HTR. MISC.
RETURNED
SINKS
MISC.
CONVERSION BURNER BASIC FEE 20-0
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL 30-n AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
_RMIT FEE
PLAN CHECK FEE
PLUMBING FEE
INSPECTION RECORD
30.00
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.
S.B.C.C. FEE
OTHER FEES
30.00
MECHANICAL PERMIT
Account No. 010-000-322-10-004 30.00 < < 3 L
AMOUNT DUE
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
I ORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WI
B5 'ET:
�''-
OWNER OR AGEN
DATE
'4eet'Ve
DEC 3 �
orry OF f f991
• Permile q k-
CITY
OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
`I I
I �!_T"" t. F: - (-_.
K.C. Plat Recording #
BOX 1
TENANT NAM :
1ST FLOOR / 2ND
FLOOR /
3RD FLOOR / BASEMENT /_ DECK /
OWNER__0V 1An aW
SITE LOCATION 31
.5Y'
OWNER'S ADDRESS
CITY 91d LL
PHONE -
( ) COMMERCIAL/INDUSTRIAL
DESCRIBE JOB
SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES — BASIC FEE $
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP
CORPORATION
BOX 2
CONTRACTOR'S NAME
A1nt7ffiGs.,C5f Lt CONTRACTOR'S
REG. # Alar*, L &i/,r_r
GAS HOT WATER HEATER
CONTRACTOR'S ADDRESS
<
/900 5 341�pl- 6�. `� CITY L
Card MUST be presented
PHONE-
$
EXPIRATION DATE
=ti`— `j Z
$
DISHWASHERS
AIR HANDLING UNITS
—OR—
E TRIC HOT WATER HEATER
HEAT PUMPS, SIZE
I HAVE READ CHAPTER 18.27.010
RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
UNIT HEATERS
CHAPTER 18.27.110 WHICH
PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
AIR COOLING UNITS, SIZE
BOX 3
CONTACT PERSON
2
PHONE 4�'/- 2,15 -2 -
BOX 4
SEWER DISTRICT
WATER DISTRICT
DRAINS
BOX 5
ESTIMATED PROJECT COST
EXISTING BUILDING VALUATION
BOX 6
PROPERTY TAX ACCOUNT NUMBER
,f -1--C> `�, EC) ._ GOAL,
$
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_____J
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 $
N0. WATERCLOSETS
GAS PIPING, FEET 1
$
—BATHTUBS
NO._ I FURNACE, ELEC. GAS $
ERS
GAS HOT WATER HEATER
$
L ATORIES
CONVERSION BURNER
$
INKS
BOILER, SIZE BTU
$
DISHWASHERS
AIR HANDLING UNITS
$
E TRIC HOT WATER HEATER
HEAT PUMPS, SIZE
$
AUNDRY WASHER OUTLET
UNIT HEATERS
$
URINALS
AIR COOLING UNITS, SIZE
$
DRINKING FOUNTAINS
COMMERCIAL HOOD
$
SUMPS, SPRINKLER VACUUM BREAKERS
------,--OTHERt- - _
$
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 AINST_'Hf%�ITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS A 6.ZMPLOYEE�,, UPON THE.AC_�URACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT:K�rJc.c�-\ l,l DATE: c�
ANP -008 3/90