90-101640 MECHANICAL PERMIT
CITYOF BUILDING INSPECTION
DERAL WAY LD I N G
PERM IT 941-1555
FE B U I
96- � o���t�o
PERMIT NO. 90-1 SE1 M OWNER'S NAME BFA TnRNSON JOB ADDRESS 1 1 1 �i SW �(10 ST
CONTRACTOR NW WATFR AFATF.R ADDRESS R?O 1 1�uRAN('� $9' GW TACnMA CONT. PHONE g�d �d(1 d
CONT. REG. NO. NORTHWA�L37TCT 1 2�90 OWNER'S PHONE 9e11—R��� OWNER'S ADDRESS SAMF
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. �+1 �i�7(1-OdR7 LEGAL DESCRIPTION
ISSUED BY RT.T 7.ARFTA_ c*nrn�R DATE OF ISSUE /� � �`�' DATE OF APPLICATION 12�4�9 O
BUILDING INFORMATION N
NA MECHANICAL BLDG. SO. �• NA
ZONE NA OCCUPANCY TYPE OF CONSTRUCTION
SET BACKS: FRONT NA SIDE NA REAR NA STORIES NA 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. 6.50 MISC.
SINKS MISC. CONVERSION BURNER BASIC FEE
ZO.00 RETURNED
DISHWASHERS TOTP.L FIXTURES NONE UNIT HEATER TOTAL MECHANICAL 26.SO AMOUNT NONE
VALUATION NONE
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE INSPECTION RECORD
MECHANICAL FEE �2 G.S O
TOTAL BLDG. FEES Water Line �It 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 $26.50 Account No. 010-000-322-10-004 Total Fee $ � 5 �' Receipt No. %�'��I
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 T ION FURNISHED BY ME TRUE AND CO CT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS ILL BE MET:
OWNER OR AGENT �"'�
. f�' � DATE ,�`�- '��`-�
MECHANICAL PERMIT
CITY OF BUILDING INSPECTION
FEDERALWAY BUILDING � � � � � � 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. IEGAL 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 TA (S)
SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT , NUMBER
LAVATORIES DRINKING FOUNTAINS GAS j�OT WATER HTR. MISC.
RETURNED
SINKS MISC. CONVERSION BURNER BASIC FEE
DISHWASHERS TOTP.L 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 OI{ Mechanical II1Sp2CtlOt'1 Notes:
PART P/C FEE
SEPA REVIEW GAS PIPING OK Date By
WATEF SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES MECHANICAL PERMIT
AMOUNTDUE 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 FURN!SHED 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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Permit # �� � '�-' f�-
RECEIVED
,
DEC - 4 �ggp CITY OF FEDERAL WAY ,
C�7YOFF�q�qq� wAY BUILDING PERMIT APPLICATION
BUIL�ING pEp7' —P�ease Print—
BOX 1 TENANT NAME:
OWNER T� � C'�Y� SITE LOCATION ' ` ` ?�` � �
OWNER'S ADDRESS, � '�- � � C C � CITY F� c�r l,U�°�-T PHONE `�y I-�5r��'�
DESCRIBE JOB � Ci,n �
THE PROPERTY IS OWNED BY: SING E/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME � CONTRACTOR'S REG. #-NC�-1-h�.�.�'lI��I �
S�} Card MUST be presented
CONTRACTOR'S ADDRESS �� � S� CITY ���,l'�i'�n Q- PHONE Lj�S��`��C'`T
EXPIRATION DATE - -
OR—
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITI OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS ITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON �-- ' PHONE ��-I-L.e MC%t/
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER S�CJ�JoZ�% '"� ���� rI
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(N0. OF UNITS = ) ) EXISTING STRUCTURE ��
O COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SQ �,�'
BOX 9 PLUMBING FIXTURES(including rough-ins) MECHANIC L APPLIANCES— BASIC FEE$ .
N0. WATERCLOSETS GAS PIPlNG, FEET • $
BATHTUBS N0. FURNACE, ELE �. 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 $
�RAINS $
- 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 FURTHERAGREE TOSAVE HARMLESSTHE CITYOFFEDERAL WAYASTOANYCLAIM(INCLUDING COSTS,EXPENSES,ANDATTORNEYS'
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.
�� , � ° c�
OWNER/AGENT: �,.1�,� 1 (' e�l� �� �Q� DATE: I�-LE- !�)
ANP-008 3/90