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91-101826 MECHANICAL PERMIT CITY OF BUILDING INSPECTION FEDERALWAY BUILDING PERMIT 941-1555 �� 91- /o! PERMIT NO. 91-1563 M OWNER'S NAME GORDON CARVERT JOB ADDRESS �y'' 19TH PL S LOT #C) CONTRACTOR PACIFIC AIR SYSTEMS qDDRESS TH AVE S TACOMA CONT. PHONE 581-5272 CONT. REG. NO. PACIFASO RA OWNER'S PHONE 5 3 OWNER'S ADDRESS 23127 SE 436TH ENUMCLAW, 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 OTHER TAX ACCOUNT NO. 13��0-0060 LEGAL DESCRIPTION ISSUED BY DATE OF ISSUE DATE OF APPLICATION � BUILDING INFORMATIO �ONE OCCUPANCY TYPE OF CONSTRUCTION BLDG. S�. FT. SET BACKS: FRONT SIDE REAR STORIES HEIGHT LIMIT PLUMBING N0. NO. MECHANICAL APPLIANCES AMT. AMT. BOND WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING 50 FT. 2•�� BOILER FIREPT�� NSERTS RECEIVED BATHTUBS LAUNDRY DRAINS COMPRESSOR '�'fJ�i�((S}Z SHOWERS URINALS FORCED AIR FURNACE 6.SO AIR HANDLING UNIT �� NUMBER LAVATORIES DRINKING FOUNTAINS GAS�iOT WATER HTR. MISC. SINKS MISC. CONVERSION BURNER BASIC FEE 2O.O RETURNED DISHWASHERS TOTP.L FIXTURES UNIT HEATER TOTAL MECHANICAL 3S.O AMOUNT VALUATION �+� GAS PIPING TEST MUST BE WITNESSED BY INSPECI'OR. AFFIDAVIT WILL NOT SUFFICE. PEFMIT FEE PLAN CHECK FEE PLUMBING FEE INSPECTION RECORD CHANICAL FEE �.�� .�c�.� ��,TAL BLDG. FEES Water Line �K Mechanical Inspection Notes: PART PIC FEE SEPA REVIEW GAS PIPING OK Date By WATER SERVICE WATER MAIN CHG. S.B.C.C. FEE �.e - .� I� � OTHER FEES MECHANICAL PERMIT _. . � AMOUNT DUE 3�-=�}U .�`�:' ' Account No. 010-000-322-10-004 Total Fee $ 3,��- Receipt No. ALL PERMITS EXPIRE 180 DAYS AFTER ISS �NCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE. I CERTIFY THAT THE INF ATION FU HED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE ' T:j� �� n � ��- �� _ OWNER OR AGENT DATE --� � � • � mit # � / - / �� 3� CITY OF FEDERAL WAY BUILDING PERMIT APPLICATION � —Please Print— BOX 1 TENANT NAME: � OWNER '' SITE LOCATION ( � � `� � OWNER'S ADDRESS S �th CITY �)'ll.(Cr,.CJ�(a `, PHO E �';c��i—�%-�� DESCRIBE JOB ��'S � �1Q�Y� D C� C��I'f" I�'r I��'C��1 I'�1C��1 `��`�-�� {�Y� THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME E C�C��F1 C �I r ��V.'St('C�5 CONTRACTOR'S REG. # Card MUST be presented CONTRACTOR'S ADDRESS � �� O� I ��I' �LJ� - �� , CITY T�C�}�`�C'� PHONE �I'��e� �,� EXPIRATION DATE l�C7 I C�I „ � — 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 �.� � VZ� I�'�YY�Y �� PHONE `7��I ��7� BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER � - 0� '��G,(� 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`bC,� SINGLE FAMILY '� NEW CONSTRUCTION ( ) MULTIFAMILY (N0. OF UNITS = ) ( ) EXISTING STRUCTURE ( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$ N0. WATERCLOSETS GAS PIPING, FEET �Q $ BATHTUBS N0. � FURNACE, ELEC. GAS�_ $ SHOWERS I 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 COMMERCI �HOOD $ SUMPS, SPRINKLER VACUUM BREAKERS - ---- _ - - $ DRAINS $ OTHER $ TOTAL FIXTURES $ 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 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. � C OWNER/AGENT: � ��--k�'� DATE: �� I ANP-008 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 3 PERMIT NO. �3 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 ) MUITI.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. 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 GASrIOT WATER HTR. MISC. SINKS MISC. CONVEFSION BURNER BASIC FEE RETURNED DISHWASHERS TOTP.L FIXTURES UNIT HEATER TOTAL MECHANICAL AMOUNT VALUATION GAS PIPING TEST MUST BE WITNESSED BY INSPEC`i'OR. AFFIDAVIT WILL NOT SUFFICE PERMIT FEE PLAN CHECK FEE LUMBING FEE INSPECTION RECORD :CHANICAL FEE TOTAL BLDG. FEES Water Line �It Mechanical Inspect t@ PART PIC FEE SEPA REVIEW GAS PIPING OK Date By WATER SERVICE WATER MAIN CHG. S.B.C.C. FEE OTHER FEES MECHANICAL PERMIT AMOUNT DUE _ ACCOL1Clt 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 a"�`