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BY DATE _ _ BY PLUMBING ROUGH IN WATER LINE OX. DATE __ ___ _BY GAS PIPING O.K.. U.K. TO ENCLOSE FRAMING INSULATION DATE _ __ -BY _ DATE FINAL O.K. TO OC PY DCD PSD DATE _ BY _ PLUMBING GROUNDWORK DATE MECHANICAL INSPECTION DATE _ --BY WALL BOARD AND FIRE WALL i DATE - - -- -- -BY FD P „Mit # I r L � r RECEIVED MAY � 0 �991 CITY OF FEDERAL WAY BUILDING PERMIT APPLICATION DM 1* fcf.DMAL WAY — Please Print — BOX 1 TENANT NAME: OWNER I SITE LOCATION f` - "`r OWNER'S ADDRESS �S��• �. _ CITY HONE DESCRIBE JOB THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP_ —CORPORATION BOX 2 CONTRACTOR'S NAME _ CONTRACTOR'S REG. #fiSE,QT_ !12 Card MUST be presented CONTRACTOR'S ADDRESS �r CITY/&,OL PHONE EXPIRATION DATE OR — I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINI NS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. BOX 3 CONTACT PERSON __ _ _ PHONE, 5_--/�(��3 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 3RD FLOOR_ BASEMENT / _ DECK /. BOX 8 (•—'/-OGLE FAMILY ( ) MULTIFAMILY (NO. OF UNITS = _j ( ) COMMERCIAL/INDUSTRIAL BOX 9 PLUMBING FIXTURES (including rough -ins) N0. WATERCLOSETS BATHTUBS SHOWERS LAVATORIES SINKS DISHWASHERS ELECTRIC HOT WATER HEATER LAUNDRY WASHER OUTLET URINALS DRINKING FOUNTAINS SUMPS, SPRINKLER VACUUM BREAKERS DRAINS OTHER TOTAL FIXTURES ( ) NEW CONSTRUCTION ( ) EXISTING STRUCTURE TOTAL AREA OF PROPERTY 2ND FLOOR _ 1 GARAGE SO FT MECHANICAL APPLIANCES — BASIC FEE $ GAS PIPING, FEET $ NO. FURNACE, ELEC. GAS $ --GAS HOT WATER HEATER $ CONVERSION BURNER $ - —BOILER, SIZE BTU $ AIR HANDLING UNITS $ --HEAT PUMPS, SIZE $ UNIT HEATERS $ SIR COOLING UNITS, SIZE $ COMMERCIAL HOOD $ OTHER _ _ — — -- $ 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 EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION. OWNER/AGENT: / r "- — — _ DATE:-- ANP-008 3/90