91-101335MECHANICAL PERMIT
CITY OF
FEDERAL WAY
BUILDING PERMIT
BUILDING INSPECTION
941-1555
PERMIT NO. 91-1286
M OWNER'S NAME LLOYD MCDONALD JOB ADDRESS 2830 SW 327TH STREET
CONTRACTOR ABC -.AS
INSTALLATIONS ADDRESS 9923 64TH AVE CT E PUYALLUP CONTT, PHONE 845-7482
CONT REG. NO.
OWNER'S PHONE 838-4795 OWNER'S ADDRESS 2830 SW 327TH STREET F4EDERAL WA
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 CTHER
TAX ACCOUNT NO-
24(ig-SO-0050 LEGAL DESCRIPTION
ISSUED BY JOANNF
TnHN-gON DATE OF ISSUE DATE OF APPLICATION 9-17-91
BUILDING INFORMATION
`ONE
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
RECEIVED
BATHTUBS
LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS
URINALS FORCED AIR FURNACE AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS GAS �iOT WATER HTR. 6 _ SO MISC.
RETURNED
SINKS
MISC. CONVERSION BURNER BASIC FEE 2 n _ n
DISHWASHERS
TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL 9-6-
AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
'PLUMBING FEE
INSPECTION RECORD
2 5 - 5 0
MECHANICAL FEE
ITAL BLDG. FEES
Water Line OK Mechanical Inspection Notes:
,-ART P/C FEE
GAS PIPING OK Date By
SEPA REVIEW
WATER SERVICE
WATER MAIN CHG.
.B.C.C. FEE
OTHER FEES
MECHANICAL PERMIT
26.50
Account No. 010-000-322-10-004 Total Fee $ 26.50 Receipt No.
AMOUNT DUE
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:
��
F
OWNER OR AGENT
DATE
MECHANICAL PERMIT
CITY OF PERMIT
FEDERAL WAY BUILDING
BUILDING INSPECTION
941-1555
PERMIT NO. OWNER'S NAME JOB ADDRESS
CONTRACTOR ADDRESS CONT PHONE.
CONTT, REG. NO. OWNER'S PHONE OWNER'S ADDRESS
TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC
NEW MULTI -FAMILY (UNITS ) MULTI. ADD. SIGN GRADING OTHER
TAX ACCOUNT NO. LEGAL DESCRIPTION
ISSUED BY
DATE OF ISSUE
BUILDING INFORMATION
DATE OF APPLICATION
ZONE
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
RECEIVED
BATHTUBS
LAUNDRY DRAINS
COMPRESSOR
TANK(S)
SHOWERS
URINALS
FORCED AIR FURNACE
AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS YIOT WATER HTR.
MISC.
RETURNED
SINKS
MISC.
CONVERSION BURNER
BASIC FEE
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER
TOTAL MECHANICAL
AMOUNT
PUBLIC ADD.
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE INSPECTI
,=CHANICAL FEE
TOTAL BLDG. FEES Water Line OK Mechanical Inspe N
PART P/C FEE
SEPA REVIEW GAS PIPING OK Date By
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE S
OTHER FEES MECHANICAL PERMIT
AMOUNT DUE 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
RECEIVED Permit # � �Lo11
SEP 17 1991 CITY OF FEDERAL WAY
Ony0FFEDERAr.BUILDING PERMIT APPLICATION
BUIII.[?jlhiG DFPTwAr — Please Print —
BOX 1 TENANT NAME:
OWNER SITE LOCATION -' - &) -2 7 T
OWNER'S ADDRES s CITE( PHONE ma's 8 5( 29 r
DESCRIBE JOB
THE PROPERTY IS OWNED BY: SINGLEMARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME'• --�' CONTRACTOR'S REG. #
Card MUST be presented
CONTRACTOR'S ADDRESS `F CITY PHONE 8 � 5 9 91 -6 -2—
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 PHONE &Y _ 'r of ~`'
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER Q 0 �^
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 ( ) SINGLE FAMILY
( ) MULTIFAMILY (NO. OF UNITS = )
( ) 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
DRAI NS
OTHER _
TOTAL FIXTURES
( ) NEW CONSTRUCTION
( .XEXISTING STRUCTURE
TOTAL AREA OF PROPERTY
2ND FLOOR
GARAGE
MECHANICAL APPLIANCES — BASIC
GAS PIPING, FEET 0 —
N0. FURNACE, ELEC. GAS
_GAS HOT WATER HEATER
CONVERSION BURNER
BOILER, SIZE BTU
AIR HANDLING UNITS
HEAT PUMPS, SIZE
UNIT HEATERS
AIR COOLING UNITS, SIZE
COMMERCIAL HOOD
OTHER
TOTAL MECHANICAL FEE
SO FT
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 EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT:DATE: 7 r F
ANP-009 3/90