90-101565 MECHANICAL PERMIT 9 � � �� ����
Y OF BUILDING INSPECTION
� �EDERAL WAY B U I L D I N G P E R M I T 941-1555
PERMIT NO. 9O-17C)9M OWNER'S NAME �BERT SAUNDERS JOB ADDRESS 3001 S ZSH ST �154 FEDERAI, WAY
CONTRACTOR NORTAWEST USI ADDRESS 19OH S 341 PL �9 FEDERAL WAY CONT. PHONE 661-2852
CONT. REG. NO. NORTHUSZOZ�T�T 4/91 OWNER'S PHONE 839-8970 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 GAADING OTHER �CHANICAL
TAX ACCOUNT NO. 042104-91SS LEGAL DESCRIPTION NA
'-SUED BY FT.T 7.ARF.TH SNYDER DATE OF ISSUE DATE OF APPLICATION 11�H�9 O
BUILDING iNFORMATION
ZONE ]�jA OCCUPANCY NA TYPE OF CONSTRUCTION MECHANICAL BLDG. SQ. FT. NA
SET BACKS: FRONT ]�A SIDE NA REAR NA STORIES NA HEIGHT LIMIT NA
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING_],.�FT. �QQ BOILER
RECEIVED
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS URINALS FORCED AIR FURNACE �Q�OO AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS GAS�IOT WATER HTR. ��O MISC.
RETURNED
SINKS MISC. CONVERSION BURNER BASIC FEE �QO
DISHWASHERS TOTP.L FIXTURES �jQ]�� UNIT HEATER TOTAL MECHANICAL �..�.Q AMOUNT NONE
VALUATION �(���
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
UMBING FEE INSPECTION RECORD
...ECHANICAL FEE �3 H.5O
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
AMOUNT DUE $38.50 Account No. 010-000-322-10-004 Total Fee $ 38.50 Receipt No. 2`��y —
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
1 CERTIFY THAT THE FO�TION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
i
REQUIREMENTS WI BE M
. (:JYNER OR AGENT DATE �/ —�✓ ' v"
�._. J�
MECHANICAL PERMI'Z
CITY OF BUILDING INSPECTION
FEDERALWAY 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
UED BY DATE OF ISSUE DATE OF APPLICATION
BUILDING INFORMATION
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 AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS GAS�10T 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
UMBING FEE INSPECTION RECORD
NIECHANICAL FEE
TOTAL BLDG. FEES Water Line �K Mechanical Inspection Notes: �� 't ����Q C-C
PART PIC FEE ���( �� ^ -F � _/�
SEPA REVIEW GAS PIPIN OK ( � - �r Date j-3" � By �L ��- �((G'�E'-� � �� �( �� �`(�o
WATER SERVICE _ "'� .� � � �'j ���
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 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
L
P iit #� L% - i %�: � --�r
,
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 TENANT NAME:
OWNER SITE LOCATION
OWNER'S ADDRESS� �,D f �S• ���"' `� #iSS� CITY �F� 2,�Y PHONE -
DESCRIBE JOB ��YS�u// G-�S ��r�'/IiaCe �` /��d /��-�'�Y-
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG. #,�D�'�'f� �S /D/+l�
Card MUST be presented
CONTRACTOR'S ADDRESS �7(�8 �S f �5'����/�L.� CITY ^ PHONE 1v r:�/-07��Sc�
EXPIRATION DATE �S- y�
— 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 /1�' �, PHONE��"��,5�
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER � 07 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(N0. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICA`I APPLIANCES— BASIC FEE$
N0. WATERCLOSETS � GAS PIPING, FEET �� $
BATHTUBS N0. / 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 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 EMP S, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: DATE: � v
ANP-008 3/90