91-100379 MECHANICAL PERMIT 9)-��a�379
C:T Y='OF BUILDING INSPECTION
�EDERAL WAY BU I LD I NG PERM IT 941-1555
35425 16TH AVENIIE S
91-338 M R & W TRUCRING
PERMIT NO. OWNER'S NAME JOB ADDRESS
CONTRACTOR F &HEATIN DDRESS TACOMA AVE S TACOMA WA CONT. PHONE 627-4417
CONT. REG. NO. OWNER'S PHONE - 633 pWNER'S ADGRESS 35425 162'H �l� $
TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI-FAMILY �UN�IT2S��)9MOU��ADD. SIGN GRADING OTHER
TAX ACCOUNT NO. LEGAL DESCRIPTION
ISSUED BY JOANNE JOFINSON DATE OF ISSUE - DATE OF APPLICATION 3-26-91
BUILDING INFORMATION
NE OCCUPANCY TYPE OF CONSTRUCTION BLDG. SQ. 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
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S) RECEIVED
SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS GAS�iOT WATER HTR. MISC.
RETURNED
SINKS MISC. CONVERSION BURNER BASIC FEE �O�O.O
DISHWASHERS TOTP.L FIXTURES UNIT HEATER �9 TOTAL MECHANICAL �QO 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 2 9.O O
TAL BLDG. FEES Water Line DIt Mechanical Inspection Notes:
PART PIC FEE
SEPA REVIEW GAS PIPING OK Date By
WATEFi SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES MECHANICAL PERMIT
AMOUNT DUE 29.00 Account No. 010-000-322-10-004 Total Fee $ 29.pp Receipt No. oLc'j
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:
^WNER OR AGENT �b��i�'1��GT�I� .,�Q�p DATE �-�- I� 1�
I�/
�rmit # •
CITY OF FEDERAL WAY � '
BUILDING PERMIT APPLICATION
—Please Print—
BOX 1 TENANT NAME: �{ (� 7�,(,CC(G� �J
OWNER �N�bf2.��IJ 7�(C(�/ G SdC .� GSITE LOCATION � b _ S'•
OWNER'S ADDRESS �3 Ca c p�K �c= CITY �E��e-a� LO�g��� pHONE �75F � �1v3 d�_
DESCRIBE JOB �o./JL4�C��u� �� L(RJI� /��T�2
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME t��/ S C�Oh1lI7 /t�' O �N� CONTRACTOR'S REG. #�FEkC12 /L7 n7 �,
Card MUST be presented
CONTRACTOR'S ADDRESS e�S3� �TRC�►?�/9 f3�'E: SO CITY �T�COM A (�J/$' PHONE �0��' �-�/ J'7
EXPIRATION DATE 6///�/ Q/
— OR—
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON PHONE
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER_ ��J'� �O�{ - �477
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / _ DECK / GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (N0. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAVINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$ '2-�� ���
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 $
DRAINS $
OTHER $
TOTAL FIXTURES $
TOTAL MECHANICAL FEE $ �-.Y-�G
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 TH�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 CITY OF ERAL WAd�, BUT ONL 1NHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUD�NG ITS
OFFICERS AND EMPLO ES, U N THE AC,C ACY OF E INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLIGATION,,
�,; .� �
OWNER/AGENT: �'� �' DATE: ���,— � �
ANP-008 3/90
. OFFICE USE ONLY(PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE 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. AD�Y/ALT NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ADD/ALT ;' NEW MULTIFAMILY (UNITS )
MULTIFAMILY ADD/ALT TENANT IMPj� OTHER
OCCUPANCY YPE OF CONSTRUCTION STORES
BUILDING S . FT. @ _
BUILDI SQ. FT. @ _
BUIL G SQ. FT. @ _
BUftDING 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 � �v
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE — ` c'�
Q � 3 ASSIGNED ADDRESS: -��-� � � � .
W E"
� °=' �W
(jJ N �pz PARTIAL PLAN CHECK FEE RECEIVED
� Q �S Amount Date Receipt#
LL � �o=D � BUILDING DEPARTMENT APPROVAL
RECEI� BY � DATE � — L� — ( � ACCEPTED FOR FILING