92-100693 MECHANICAL PERMIT
CITY OF BUILDING INSPECTION
FEDERAL WAY B U I L D I N G P E R M I T 941-1555
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PERMIT NO. 92-738 M OWNER'S NAME GORDON CALVERT JOB ADDRESS 29410 19 PL S
CONTRACTOR PACIFIC AIR SYST ADDRESS 11121 34 AVE S TACOMA CONT. PHONE 581-5272 ,
CONT. REG. NO. PACIFASO93RA OWNER'S PHONE 825-4123 OWNER'S ADDRESS
TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAI ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI-FAMILY (UNITS ) MULTI.ADD. SIGN GRADING OTHER
TAX ACCOUNT NO. 13100O-OOZO LEGAL DESCRIPTION
ISSUED BY E SNYDER DATE OF ISSUE DATE OF APPLICATION 5/11/92
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 75 FT. 2•�� BOILER
RECEIVED
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS GAS jiOT WATER HTR. MIS(�I�P�CE F).SO
SINKS MISC. CONVERSION BURNER BASIC FEE 2O.OO RETURNED
DISHWASHERS TOTP.L FIXTURES -��r�r�COORTOP E).SO TOTAL MECHANICAL35.OO 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 $3 5.O O
�GfAL 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 � I ��
OTHER FEES MECHANICAL PERMIT
AMOUNT DUE 35.00 Account No. 010-000-322-10-004 Total Fee $ 35.00 Receipt No.
ALL PERMITS EXPIRE 180 DAYS AFTER ISS ANCE IF NO WOHK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAfi AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFOR TI N F HED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APP CABLE CITY OF FEDERAL WAY
' REQUIREMENTS WILL BE M : ` "`
�
7 -� / ��'
OWNER OR AGENT � DATE �
�
� ��i�� rmit # ���
��
MAY 1 1 1gg2 CITY OF FEDERAL WAY �
'°���'`�"-�Y BUILDING PERMIT APPLICATION
���' — Please Print— �I _
(Q-�; ��-
BOX 1 TENANT NAME:
OWNER ''� SITE LOCATION �- � r - 1
OWNER'S A DRESS �7 . - � � CITY F `�� PHONE --- I� -�
DESCRIBE JOB �� �? -� �:� L ��� rrl �� Yl � � ' �;�f' "�1 �
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME '7 � `°, � �r 4 CONTRACTOR'S REG. # r f��r1-Fl�}:�C'��,���I`),�-
Card MUST be presented
CONTRACTOR'S ADDRESS I I I C�� ".�`� ���F� �r CITY ��C-(_�r'�� PHONE 17�=J` ��(�.7 u�
EXPIRATION DATE � ��.�� � � 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 f"� f� � <�=-�( I IZ�!�, PHONE �/ " �)���%.::�
�
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING UILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER � C� ' ��' � "� ��_� �
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 (�j(') SINGLE FAMILY ( ;�NEW CONSTRUCTION
( ) MULTIFAMILY (N0. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES(including rough-ins) MECFlANICAL APPLIANCES— BASIC FEE$ 1 L��c��
N0. WATERCLOSETS GAS PIPING, FEET ��} $ ��
BATHTUBS N0. � � "' -, ����. GAS�_
SHOWERS �F--� 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 COMMERCAL H00� $
SUMPS, SPRINKLER VACUUM BREAKERS _�OTHER - j�'�'���-� $ �
D INS I {y�(�jT�%]'�--� $ ��1
0 ER --T $
AL FIXTURES $
TOTAL MECHANICAL FEE $�
I CERTIFY UNDER PE ALTY 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: 1 �- . � � ' �J DATE: � I <'
ANP-DOB 3/90
MECHANICAL PERMIT
CITY OF BUILDING INSPECTION
FEDERAL WAY B U I L D I N G P E R M I T 941-1555
PERMIT NO. OWNER'S NAME JOB ADDRESS
CONTRACTOR ADDRESS CONT. PHONE
CONT. REG. NO. OWNER'S PHONE OWNER'S ADDRESS
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. S0. 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 jiOT WATER HTR. MISC.
RETURNED
SINKS MISC. CONVERSION BURNER BASIC FEE
DISHWASHERS TOTP.L FIXTURES UNIT HEATER TOTAL MECHANICAL �^-: AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPE � � L NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE (� (i
UMBING FEE INSPECTI I,��
:CHANICAL FEE �
TOTAL BLDG. FEES Water Line OFt Mechanical O O 2S:
PART P/C FEE �[�
SEPA REVIEW GAS PIPING OK Date ` By "�
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE n
OTHER FEES MECHANICAL PERMIT �I ti
AMOUNTDUE Account No. 010-000-322-10-004 tal Fee Receipt No.
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PER� IRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLE GE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET:
OWNER OR AGENT DATE
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