91-100612 MECHANICAL PERMIT
CITY OF BUILDING INSPECTION
FEDERAL WAY B U I L D I N G P E R M I T 941-1555
9�" �otr.o� �
91-645 M PATRICIC LETTERMAIR 3108 SW 300TH PL
PERMIT NO. OWNER'S NAME RESS
CONTRACTOR SEATTLE HEATING ADDRESS ��� CONT. PHONE
coNT. Re�. No. SEATT108JT '�J / OWNER'S PHONE OWNER'S ADDRESS O8 SW 3OOTH PL
TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMEACIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI-FAMILY (UNITS ) MULTI.ADD. SIGN GRADING OTHER
TAX ACCOUNT NO. LEGAL DESCRIPTION
ISSUED BY JOANNE JOHNSON DATE OF ISSUE DATE OF APPLICATION
BUILDING INFORMATION
ZONE OCCUPANCY TYPE OF CONSTRUCTION BLDG.S�. FT.
SET BACKS: FRONT SIDE REAR STOFiIES HEIGHT LIMIT
PLUMBING N0. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING��T. ���Q BOILER
RECEIVED
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS URINALS FORCED AIF FURNACE �QQ AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS GAS�10T WATER HTR. fi_ �in MISC.
RETURNED
SINKS MISC. CONVERSION BURNER BASIC FEE
DISHWPSHERS TOTAL FIXTURES UNIT HEATER TOTAI MECHANICAL � AMOUNT
VALUATION
► GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
UMBING FEE INSPECTION RECORD
CHANICAL FEE �_ri(1
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 38_5� Account No. 010-000-322-10-004 Total Fee $ 38_ S� 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 FURNISNED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE T: /�
�
OWNER OR AGENT � r � � �' �� �� DATE -� � r
MECHANICAL PERMIT
CITY OF BUILDING INSPECTION
FEDERAL WAY B U I L D I N G P E R M I T 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. INDUSTFIAL ADO. 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�iOT WATER HTR. MISC.
RETURNED
SINKS MISC. CONVERSION BUFNER BASIC FEE
DISHWASHERS TOTkL 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 �Ft Mechanical Inspection Notes:
PART P/C FEE ��,5'
SEPA REVIEW GAS PIPING OK -Z�-�9 � Date�� / By ��
WATER 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 FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILI BE MET:
OWNER OR AGENT DATE
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CITY.OF �EDERAL WAY RECEIVED
BUILDING PERMIT APPLICATION Mpy� 1 41991
—Please Print—
� �-� �.��,G�,.�
BOX 1 TENANT NAME:
OWNER /si►' SITE LOCATION �L�� S�uJ• .360
OWNER'S ADDRESS S�/-� CITYc�t•/�,r,r,a,C G�J�.c.f PHONE �38-`� d��
DESCRIBE JOB �, .,t
THE PROPERTY IS OWNED BY: SINGL /M IED � PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME oS'N��/r �Ea�i�ve CONTRACTOR'S REG. #�����'1IJ� �17'�'
�J Card MUST be presented
CONTRACTOR'S ADDRESS /350� /��� �D � CITY�J���edu�- PHONE � ��{-���d
EXPIRATION DATE � �ic. �/;2.�
— 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 PHONE G yy- '�9oZ jj
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
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
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY S� FT
BOX 9 PLUMBING FIXTURES(including rough-ins) MECHANICAL�PPLIANCES— BASIC FEE$
N0. WATERCLOSETS GAS PIPING, FEET �r.- $
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 $
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 FURTHERAGREETOSAVE HARMLESSTHE CITYOFFEDERAL WAYASTOANYCLAIM(INCLUDINGCOSTS,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 EMPLO EES, UPON E ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGEN � � DATE: �� � `//
ANP-OOB 3/90