90-100676 MECHANICAL PERMIT
CITY OF B I L D I BUILDING INSPECTION
FEDERAL WAY U N Ca . P E R M I T 941-1555
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PERMIT NO. 9O—ZZ9OM OWNER'S NAME L D PETERSON JOB ADDRESS 429 S ZH9 ST
CONTRACTOR NORTHWEST USI ADDRESS 1908 S 341 PL FEDERAL WAY CONT. PHONE 661-2852
CONT. REG. NO. NORTHUSZOZaTaT 4/91 OWNER'S PHONE 839-6719 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_ _MECHANICA.L
TAX ACCOUNT NO. NA LEGAL DESCRIPTION NA
ISSUED BY ELIZABETH SNYDER DATE OF ISSUE �' � DATE OF APPLICATION 8l2 f 90
BUILDING INFORMATION
NE NA OCCUPANCY NA TVPE OF CONSTRUCTION MF. _ ANTCAT. nNT.Y BLDG. SO. PT. NA
�_f BACKS: FRONT NA SIDE NA REAR NA STORIES NA HEIGHT LIMIT NA
PLUMBING NO. N0. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING��FT. .�.�0 BOILER
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S) RECEIVED
SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS GAS HOT WATER HTR. �_sn MISC.
SINKS MISC. CONVERSION BURNER BASIC FEE �n_ n n RETURNED
DISHWASHERS TOTAL FIXTURES NnNF. UNIT HEATER TOTAL MECHANICAL �R _ �n AMOUNT ]�j(1NF
VALUATION NON E
GAS PIPING TEST MUST BE WITNESSED BY INSPECr!'OR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE INSPECTION RECORD
MECHANICAL FEE $i 7$ rj Q
)TAL 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 NIECHANICAL PERMIT
AMOUNT DUE $28.50 Account No. 010-000-322-10-004 Total Fee $ ;,2�, � Receipt No. / � �
ALL PERMITS EXPIRE 18 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INF MATION FU NISHED B S TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE M •
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 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
� UMBING 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 HOT 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 �K � Mechanical Inspection Notes: ��fJS� �//'//V� yti%J�`�`
�r PART P/C FEE
PA REVIEW GAS PIPING OK Date $-�°-yc� By �/� �. �
.�ATER SEAVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES NIECHANICAL 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 WILL BE MET:
OWNER OR AGENT DATE
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RECEIVED
p�� Q 2 1990 CITY OF FEDERAL WAY �� /
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BUILDING PERMIT APPLICATION
CIT'Y 4F�EpERAI�WAY
BUII,DlNG DEPT. —P�ease Print—
BOX 1 TENANT NAME: �, , (�, � �Se,v
OWNER rP So`✓ SITE LOCATIO ya S a %' s�
OWNER'S ADDRESS CITY PHONE 3 —
DESCRIBEJOB l./�.�E/'Z /5�p �e�! i� �s-.�•y,.,o �Q,�g,S)
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME /U6��✓�S7` U S/ CONTRACTOR'S REG. #No�7'n�vS/o/J i—'
Card MUST be resented
CONTRACTOR'S ADDRESS � e� 5 3 `� �C- CITY�cd f-cJ-�y PHONE C��e� ' a�sa
EXPIRATION DATE �S`-
�/ — OR—
I HAVE READ CHAPTER 18.27.010 RELA NG 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 e ►.�� S �e9-��J PHONE ���'�-�S�
BOX 4 SEWER DISTRICT - WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION ��
BOX 6 PROPERTY TAX ACCOUNT NUMBER �
LEGAL DESCRIPTION - �.J
(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) MECHANICAL APPLIA CES— BASIC FEE$
N0. WATERCLOSETS GAS PIPlNG, FEET D $
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 U ER 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 IGATION AND DEFENSE OF SUCH CLAIM),WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
AND FILED AGAIN THE CI Y OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY,INCLUDING ITS
OFFICERS AND EM OYEES UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: \ DATE: o `a '��
ANP-008 3/90
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OFFICE USE ONLY(PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL
REMARKS:
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DATE
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL DATE
REMARKS:
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ADD/ALT NEW MULTIFAMILY (UNITS )
MULTIFAMILY ADD/ALT TENANT IMP. OTHER
OCCUPANCY TYPE OF CONSTRUCTION STORES
BUILDING SQ. FT. @ _
BUILDING S�. FT. @ _
^, BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
� BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION
BUILDING DEPARTMENT REMARKS: PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG._FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
�y�p ASSIGNED ADDRESS:
l���,` b�p�y/p�
R��7'j� ���� � �� PARTIAL PLAN CHECK FEE RECEIVED
���`, V�� Amount Date Receipt#
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BUILDING DEPARTMENT APPROVAL
RECEIVED BY DATE ACCEPTED FOR FILING