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91-101556 , MECHANICAL PERMIT CITY OF BUILDING INSPECTION FEDERAL WAY B U I L D I N G P E R M I T 941-1555 Q�I-to�s.�lo PERMIT NO. 91-1524 M OWNER'S NAME GRANT & COLLEEN RODLAND ,JOB ADDRESS 126 SW 304TH STREET CONTRACTOR OWNER ADDRESS CONT. PHONE CONT. REG. NO. OWNER'S PHONE 839-1816 OWNER'S ADDRESS SW TH 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. 91OHSO-0030 LEGAL DESCRIPTION UED BY JOANNE JOHNSON DATE OF ISSUE DATE OF APPLICATION 10-29-91 BUILDING INFORMA ION ZONE OCCUPANCY TYPE OF CONSTRUCTION BLDG. SQ. FT. SET BACKS: FRONT SIDE REAR STORIES HEIGHT LIMIT PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND WATEF CLOSETS ELEC. HOT WATER HEATER GAS PIPING FT. 2-�� BOILER RECEIVED BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S) SHOWERS URINALS FORCEO AIR FURNACE lO.OO AIR HANDLING UNIT NUMBER LAVATORIES DRINKING FOUNTAINS GAS�IOT WATER HTR. 6.SO MISC. SINKS MISC. CONVERSION BURNER BASIC FEE 2O.OO RETURNED DISHWASHERS TOTP.L FIXTURES UNIT HEATER TOTAL MECHANICAL 3H.SO AMOUNT VALUATION GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE. PERMIT FEE \N CHECK FEE UMBING FEE INSPECTION RECORD MECHANICAL FEE �f� �i(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_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 INFORMATI FURNISHED BY IvIE 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 �� 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. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD. NEW MUITI-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 COMPFESSOR TANK(S) SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER LAVATORIES DRINKING FOUNTAINS GASrIOT 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 �K 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 AMOUNTDUE _ ACCOUClt 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 OATE 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 /, V �i i I I, Ili J J Y °� Z C°, � `n a� p W o � � � ; � i o o �� w -�'� u- : z � �"! o i O '' z ` � Q ' C7 I' Q �I � I� C7 ' U f Q ' Z i Z � m � pp Q �c' W U H J F ~ w a a a � o � o I � � i J � � II C� J N ¢ a � � I Qj Z � 0 F= m -� m Q ' �, ' o ;I i � i � O � o Y � ¢ � w Z O I Z � � I z n- J a �_ O w d a ~ � 1-- ctJ � H � O 0 � C7 Z � � I � I ( ; i � J � I, I Z I � t- m m � m r m O I Z � � I I LL I LL zU' W U R-'�'' � i � � i O � '� a � I O 'I Q I, � �.` Y f � w Y ir Z a m � o �� - ; m w � w � w Q w Y Z cWi� o a o O o � o ��'�� Per # � � '� � 5��-� 0� �'�a �,�� 29 �� CITY OF FEDERAL WAY ' et►rt�,�� BUILDING PER�eMIPTtAPPLICATION BOX 1 TENANT NAME: OWNER �z�4�vr Co�L� RODLAN� SITE LOCATION OWNER'S ADDRESS �I Z� 5.4.l. �-T-" ST, CITY F��Q-Ai WAy PHONE 839 - l�'3�� D�SCRIBE JOB ►NsrA�� P�P�N� �fL �As F (LNJ/�lG,� w�-rER 1-tEA� TF�E PROPERTY IS OWNED BY; SINGL ARRIED _ PARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME Gi�N-f P�At.AaJ� ( o�,.ia E R- CONTRACTOR'S REG. # Card MUST be presented CONTRACTOR'S ADDRESS CITY PHONE EXPIRATION DATE � — 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 G�n�T �P'-�u D PHONE 839 - 1$ 1 6 BOX 4 SEWER DISTRICT 5�PT1�- WATER DISTRICT FEDEKAr` wA�/ ----80X 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER �T l 08 SO - �30 LEGAL DESCRIPTfON (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 (�C� SINGLE FAMILY ( ) NEW CONSTRUCTION ( ) MULTIFAMILY (N0. OF UNITS = ) ( ) EXISTING STRUCTURE ( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT BOX 9 PLUMBING FIXTURES(including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$ Z f� L'� N0. WATERCLOSETS GAS PIPING, FEET $ -1.�L.`� BATHTUBS N0. FURNACE, ELEC. GAS G $ �• �u 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 $ AINS $ 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 JJPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION. � ,�'�-��=-�' ' =�� OWNER/AGENT: `� DATE: t"' % i ANP-008 3/90