90-100586 MECHANICAL PERMIT
CITY OF BUILDING INSPECTION
FEDERALWAY BUILDING PERMIT 941-1555
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PERMIT NO. 90—iZ79 M OWNER'S NAME .MFRAT.D (�T.F.N APMTS JOB ADDRESS i qnn SW C AMPiTS nR �� �"'''
CONTRACTOR WnT.F IND AF.ATINC� ADDRESS 301 O S MTTT.T.TN TAC�CA CONT. PHONE ,�d^'Z]f27
CONT. REG. NO. WnT.F1H101C'_TC OWNER'S PHONE OWNER'S ADDRESS 1 9(1(1 SW CAiurpLTS ilR
TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI-FAMILY (UNITS ) MULTI. ADD. SICaN riRADING OTHER
TAX ACCOUNT NO. ]�A LEGAL DESCRIPTION j�jA
ISSUED BY aTC�APILITE J�HD1SCll�T DATE OF ISSUE DATE OF APPLICATION 7—�n���
BUILDING INFORMATION
NE OCCUPANCY TYPE OF CONSTFiUCTION BLDG. SQ. FT.
..ET 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
LAVAT�RIES DRINKING FOUNTAINS GAS HOT WATER HTR. MISC. BBQ .���
SINKS MISC. CONVERSION BURNER BASIC FEE 20_00
RETURNED
DISHWAaHERS TO7AL FIXTURES UNIT HEATER TOTAL MECHANICAL�.1� 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 2 R_ri O
TAL BLDG. FEES Water Line OIt Mechanical Inspection Notes:
rART PIC FEE
SEPA REVIEW GAS PIPING OK Date By
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE ��'
OTHER FEES MECHANICAL PERMIT
AMOUNT DUE 28.50 Account No. 010-000-322-10-004 Total Fee $ 28.50 Receipt No.
ALL PERMITS EXPIR YS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT T INFORM TION FURNISHED BY ME IS TRU AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WIL BE ME . '�
OWNER OR AGEN � DATE � �� C� �
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CITY OF FEDE'RAL WAY RECEIVEQ
BUILDING PERMIT APPLICATION �,q�G ! t99Q
—Please Print—
BOX 1 TENANT NAME:
OWNER � '� ` � - SITE LOCATION
OWNER'S ADDRESS E��G �Lt) �,A2�1�L'� "��' CITY PHONE
DESCRIBE JOB (IJ `��au, G'�5 �,�t2;U,�`
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME _C.��(F� i,�,�. E�f��F'C2�'c:— CONTRACTOR'S REG. # ��%C%C-� � (-� �v( C'-�..
1 Card MUST be presented
CONTRACTOR'SADDRESS ��i� � � �i%i..1_t�ll CITY ��Z-CZr-L� PHONE ��� -�����-
EXPIRATION DATE �i�-�- Z - G
— 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 �.�TZ�Z.4 ('�?L� PHONE �� -
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 = T) ( ) EXISTING STRUCTURE
( ) COMMERCIAVINDUSTRIAL 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 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 '�(3 C: �r 2t�t� $
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 ASTO 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 EM -EL�S, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: � � DATE: � � U � �
ANP-008 3/90