90-100779 MECHANICAL PERMIT
CITY OF g I L D I N BUILDING INSPECTION
F��L WAY u G P E R M I T 941-1555
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PERMIT NO. QQ-11']�i M OWNER'S NAME DQR�TY JENNIDZrS JOB ADDRESS 53�5 S W-�SA PT R�
CONTRACTOR P�I,FI.(` �nn�m nTT. rn ADDRESS 1QQ3 DQ['R ST�Z.EET TAC'C1MA CONT. PHONE (�77-L1 7 7
CONT. REG. NO. �ACI�COI��.R� OWNER'S PHONE Q,77-9213 OWNER'S ADDRESS 5325 S W DA�A PT R.D FEDER�i� WT
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 JAONNE JOHNSON DATE OF ISSUE �-�-.3 V DATE OF APPLICATION
BUILDING INFORMATION
NE 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 60 FT. 2•�� BOILER
RECEIVED
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS URINALS FOACED AIR FURNACE ��, AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS GAS HOT WATER HTR. MISC.
SINKS MISC. CONVERSION BURNER BASIC FEE �� RETURNED
DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL 9?n� AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE INSPECTION RECORD
CHANICAL FEE 32.OO
TAL BLDG. FEES Water Line �K Mechanical Inspection Notes:
�ART 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 �� nn Account No. 010-000-322-10-004 Total Fee $ 32_00 Receipt No. �`�/ c� �-
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 T:
OWNER OR AGENT � DATE /'a 3 � �6
MECHANICAL PERMIT
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 ADDFIESS
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
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 HOT WATER HTR. MISC.
SINKS MISC. CONVERSION BURNER BASIC FEE RETURNED
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 OK 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 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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ClryoF� 1,g CITY OF FEDERAL WAY
Q��to,,�o�,�� BUILDING PERMIT APPLICATION .
�Q�pTh/,q�, — Please Print—
BOX 1 TENANT NAME:
OWNER �f"�h �"�n� � n` s SITE LOCATION
OWNER'S ADDRESS � 3�5 5•:�-7. �l�, � C TYi��+'��/���1 PHONE ��-� ' /
DESCRIBE JOB �T iV�':� �" �ce � ; .,�
THE PROPERTY IS OWNED BY: SINGL MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME G ���. �� � • CONTRACTOR'S REG. # C-�- . C.(���i I K�
` , Card MUST be nresented
CONTRACTOR'S ADDRESS [�1'U3 �C.1� `J�dP4'-`� CITY -l'i �'Y� PHONE o� - 1� I �
EXPIRATION DATE
— oR — ����Lt--- �-fl�---�L-s I�---'
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 �4 r�1 � � ►r►�c��" PHONE l-,�� �� i !1 a
/ 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 #
�OX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( SINGLE FAMILY ( ) EW 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 �d � $ ��'�� '
BATHTUBS N0._I—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 EMPLOY ES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
�
OWNER/AGENT: , � � DATE: �" � � ' �v
s��;
ANP-008 3/90
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OFFICE USE ONLY(PLEASE DO NOT WRITE BELOW THIS LINE)
ZON� 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 SQ. 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
a ASSIGNED ADDRESS:
W �a
> � �w
W � w z PARTIAL PLAN CHECK FEE RECEIVED
V �o Amount Da te Receip t#
W J LLJ
� --_-� �m BUILDING DEPARTMENT APPRf�!(AL
RECEIVED V BY DATE ACCEPTED FOR FILING