93-102301 � � 9�. /v��o1
CITY OF FBDBRAL WAY MEC ICAL PE1�IVIIT P$RISSU$D: 09/13/9385
33530 First Way South
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 gXPIRgS: 03/12/94
ADDRBSS:845 S DASH POINT RD
NO. : 052104-9146
PROJECT DESCRIPTION:flYIIC - IISlALL GAS HOi fiAlBF HBAlSF.
Oii1g8 COIiBAClOt L&IDBY
LBSLIg HApi01tG �OFiHi1SSi NAiBF HB11iBH
8!` " "IISH POIIti QD 8201 D0�11160 Si SN
tl IfA� fiA 98003 tACOMA, NA MA 95499
839-7071 484-6404
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FOSL iYPBS.:GAS YIUS..........: 0 BOILBFS/COMPFBSSOHS FBBS:
G11S PIPIlf6..: 0 ft HOOD..........: 0 0-3 HP......: 0 MgC PH![i ISSOAACg... j 10.00
FOYI<100I..: 0 DOCT fiOHL.....: 0 3-15 HP.....: 0 � � ° ��� � �� MSC APPLIAaCB PS65.� � b.50
� ...
Gi1S HiI't....: 1 NOOD SiOYgS...: 0 15-30 HP....: 0 ' .'� ` �'"�'�������'� � �
COIY BOg�BB: 0 FOF�>1Q01.....: 0 30-50 flP....: 0 ��:�' ��� �� , . ,� � �
BBQ........: 0 MISC..........: 0 S+ BP.......: Q ,
611S D�?BY..: 0 AIB fll1�DLI�6 O11IiS POBL ?l1I�S--------- f�
pAIG6......: 0 <=10,000 CP�; 0 A90Y6 GFOOID: 0 �
6115 LOGS...: 0 > 10,000 CPlt: 0 OADB8GBa01D.: 0
?0lAb PB6S � 16.50
Inspection pecord liater bine OL Mechanical Inspection Aotes:
GAS PIPIIG OI Date By
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t •
SE7BACKS & FOOTINGS I 3 _ �
Date By �
F4UNDATION WAi:LS
Date B y
PLtJMBING GROUNDWORK
Date By
UNDERFlOOR FRAMING ''
Date By
SHEAR WAtLS
Date By
PLUMBING ROUGH-IN
Date By
GAS PIPING
Date By
MECHANICAL ROUGH-IN
Date By
MECHANICAL (OTHER)
Date By
FRAMING
Date By
INSULATION
Date By
GWB - 1 ST LAYER
Date By
GWB - 2ND'LAYER
Date By
SUSPENDED CEILING
Date By
PLANNING FINAL
Date By
ENGINEERING FINAL
Date By
FIRE FINAL
Date By
BUILDING FlNAL
Date By
OTHER
Date By
OTHER
Date By
CD0193
• • Per 't # ����'J' D��d�
� �-
CITY OF FEDERAL WAY ' "� �
, r D
BUILDING PERMIT APPLICATION �_; i
— Please Print—
BOX 1 TENANT NAM : �
OWNER O� � SITE LOCATION L � ,
OWNER'S ADDRESS �` c' CITY ���C�.�= PHONE
DESCRIBE JOB �'nc�� � `
THE PROPERTY IS OWNED BY: SIN E/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME (�J,�) l 1� ���� CONTRACTOR'S REG. # �R�TI�I,�� In3I��
Card MUST be presented
CONTRACTOR'S ADORESS ��CO� QJ�,RQ iY�1C�(') �SLI"CITY f����Q PHONE G��{'L.��O�
EXPIRATION DATE ta��G�3
— 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 . I ^ PHONE
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST � EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER _, >��-�I C�'�I — �1 l t-I�
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legai description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARA6E /
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 APPLIANCES— BASIC FEE$
N0. WATERCLOSETS GAS PIPING, FEET �� $
BATHTUBS N0. FURNACE, ELEC. GAS $
SHOWERS _.I_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 UNOER 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, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: �� � ��JCJ lJ'l���� DATE: l �
ANP-OOB 3/90