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91-100034 MECHANICAL PERMIT 7i op a 3 y CITY OF NG INSPECTION FEDERAL WAY BUILDING ERM IT BUILDING941-1555 PERMIT NO. 91-0012M OWNER'S NAME BETTY SMALL JOB ADDRESS 1309 S 293 PL CONTRACTOR PACIFIC GAS HEATING/AI, DREss 2702A 112 AVE E TACOMA CONT. PHONE 536-7997 CONT. REG. NO. PACIFGH11ONE 7/91 OWNER'S PHONE 941-2031 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 MECHANICAL TAX ACCOUNT NO. 516200-0420 LEGAL DESCRIPTION NA 41"UED BY ELIZABETH SNYDER DATE OF ISSUE1 6 DATE OF APPLICATION 12/31/90 BUILDING INFORMATION ZONE NA OCCUPANCY NA TYPE OF CONSTRUCTION MECHANICAL SET BACKS: FRONT NA SIDE NA BLDG. NA REAR NA STORIES NA HEIGHT G. LLIMIT NA PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING 50 FT. 2.00 BOILER BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S) RECEIVED SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER LAVATORIES DRINKING FOUNTAINS GAS pOT WATER HTR. MISC. LOGS 6 50 SINKS MISC. CONVERSION BURNER BASIC FEE 20 00 RETURNED DISHWASHERS TOTAL FIXTURES NONE UNIT HEATER TOTAL MECHANICAL 2R 5Q AMOUNT NONE VALUATION NONE 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. 1_42:2, 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 "� >��.x DATE I 1i 1 f 6j / 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 pOT 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: /YI;'(hi, /S_ c-,-/l 4/-76",c 03- PART /3PART P/C FEE SEPA REVIEW GAS PIPING OK c.-_2 --4// 03 Date 2b-j/By jn A;ii ii-/.) 6 A > AA/A,G- 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 D m D 0 D -o D m .rt \ m D m • m m co \. V1 Oii ° °° D rn 0 0 0 z O m O O l * 8 ( m = o c CO v CO z' . '..,;(4 k.-74, 1 0 , ° Z 1 0 cn 0 nQ 0 Z D O U� D T rn y mr -0 m m -1 Ns D m ° ..d r m v, O z O \i z m . m ° � � i1. c z 0 1 , -< z — � 1sts t 0-, u' Q r m = m Cm ` 0 D W Z I Z D {j 0 r DO D D Z ° Z c a z m T 0 a ooo 03 r 1 f I 1 • Pipit # qi, - ()DI -2---- i CITY OF FEDERAL WAY 11( --- BUILDING PERMIT APPLICATION — Please Print— BOX 1 TENANT NAME: { \--v- S'Yna`1 OWNER SCow2 SITE LOCATION SCtm C_ 1 OWNER'S ADDRESS ZCI G • 2c13 P1 CITY i-� tA PHONE G& 1 , / DESCRIBE JOBG L THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME :,_.. 6_ or ' i 1 ' - £ l_ CONTRACTOR'S REG. # Ai FG- Card MUST be presented CONTRACTOR'S ADDRESS c9:7)4.1-41" \ 11ACITY 'MA PHONE 5340-,gg7 EXPIRATION DATE '7I 5)9 I — OR — I HAVE READ CHAPTER 18.27.010 RELA NG`0 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 BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER 51(p04 — OL(2..d 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) MECHANICAL APPLIANCES — BASIC FEE$ NO. WATERCLOSETS GAS PIPING, FEET 5O $ 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 G-iNs L0q $ 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 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: z__— DATE: k.,.-- 13 i /CO ANP-008 3/90