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SET BACKS AND FOOTINGS
DATE -BY--- ___
O.K TO POUR FOUNDATION WALLS
DATE BY
PLUMBING GROUNDWORK
DATE _BY
PLUMBING ROUGH IN
DATE _-_ ---BY----. _
O.K. TO ENCLOSE FRAMING
DATE _ BY .__ _
WATER LINE O.K.
GAS PIPING O.K. _ _
MECHANICAL INSPECTION
DATE
INSULATION
DATE _ BY _
WALL BOARD AND FIRE WALL
DATE BY
FiNA� O.K. TO OCCUPY
DATE�'��BY ��
DCD
PSD
FD
AP vli�D
CITY OF FEDERAL WAY gUf�cN�aFa SAY
BUILDING PERMIT APPLICATION r.
— Please Print —
OWNER'S ADDRESS 30qqqD CITY PHONE
DESCRIBE JOB R,04Aatwe.,dex
THE PROPERTY IS 0 NED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME D 47 Y S-t U S X CONTRACTOR'S REG. #
Card MUST be presented
CONTRACTOR'S. ADDRESS I U S 3 1 P4 5vdc CITY Pe r Ot'� PHONE-?-S:a
EXPIRATION DATE
— 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 IJlu i S /Q & PHONE �ZSa - SYL-3 3
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION -------..
t BOX 6 PROPERTY TAX ACCOUNT NUMBS
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR 1
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SO FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
( MECHANICAL PLIANCES
— BASIC FEE $
(� • UL
N0. WATERCLOSETS
GAS PIPING, FEET
$
BATHTUBS
NO. 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
$
T
DRINKING FOUNTAINS
COMMERCIAL HOOD
$
SUMPS, SPRINKLER VACUUM BREAKERS
OTHER
$
AINS
�P ^4 P ^-� 0
$
OTHER
$
TOTAL FIXTURES
$
_ .
TOTAL MECHANICAL FEE
$
I CERTIFY UNDE
BEST OF MY KN
FORM THE WORK
OWNER/AGENT:
LTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE
AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PER-
K ICH PERM PLICATION IS MADE. �j
DATE: � —a S� / Z)
ANP-006 2/90