92-100875 MECHANICAL PERMIT 9a'/�4$7 S
CITY OF BUILDING INSPECTION
FEDERALWAY BUILDING PERMIT ss,-4140
PERMITNO. 92-0920 M OWNER'SNAME CARL COLE SITEADDRESS 28107 20TH AVE S
CONTRACTOR PUGET SOiJND HEATING �RESS 11130 BRISTOL CT NW GIG HARBOR CONT.PHONE 858-7939
coNT.aeG.No. 1'UGETSH132RJ EXP.12�92 OWNER'S PHONE 839-29�2 OWNER'S ADDRESS 28107 20TH AVE S FEDERAI, WAY
TYPEJOB: NEWRESIDENCE ADDITION NEWINDUSTRIAL NEWCOMMERCIAL COMMERCIALADD. INDUSTRIALADD. NEWPUBLIC PUBLICADD.
NEW MULTI-FAMILY (UNITS )MULTI.ADD. SIGN GRADING OTHER
TAXACCOUNTNO. '42223�--OS4O LEGALDESCRIPTION
ISSUED BY JOANNE JOHNSON DATE OF ISSUE "- �`"` �` DATE OF APPLICATION 6-12-92
BUILDING INFORMATION
ZONE SET BACKS:FRONT SIDE REAR HEIGHT LIMIT
OCCUPANCY TYPE OF CONSTRUCTION CENSUS NO. TYPE OF HEAT BLDG.SQ.FT. STORIES
PLUMBING NO. NO. MECHANICAL APPIIANCES AMT. AMT. BOND
WA,�,cR CLOSETS ELEC. HOT WATER HEATER GAS PIPING FT. '�� GAS LOGS RECEIVED
BATHTUBS LAUNDFiY DRAINS FORCED AIR FURNACE �-O.OO DUCT WORK
SHOWERS URINALS GAS HOT WATER HTR. 6.5O AIR HANDLING UNIT NUMBER
LAV~ATORIES DRINKING FOUNTAINS CONVERSION BURNER MISC.�NGE 6.SO
SINKS MISC. BBQ BASIC FEE
ZO.00 RETURNED
DISHWASHERS TOTAL FIXTURES DRYER TOTAL MECHANICAL 4 5.O O AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
UMBING FEE INSPECTION RECORD
CHANICAL FEE 4 5.O O
TOTAL BLDG. FEES Water Line �K Mechanical Inspection Notes:
PART P/C FEE
SEPA REVIEW GAS PIPING OK Date By
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES NIECHANICAL PERMIT /�
AMOUNT DUE 5.0 0 Total Fee $ 4 5.0 0 Receipt No. �7 3 `�
ALL PERMITS EXPIRE YS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT TH INFORWI�ITION FU�NISHED BY ME IS �UE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
hEQUIREMENTS WI L BE ME :� ,n ^
�rl � `��/ � 1 � �� �
C�WNER OR AGENT "l DATE �
•
Permit # �=2 ' �� �/
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
—Please Print—
BOX 1 TENANT NAME:
OWNER L*�1�L .Oi.� SITE LOCATION �b1��7 '',�tiAE 5
OWNER'S ADDRESS ���y7 aZCS�tif� S CITY � " L Gf.9�tf- PHONE �%�f 7Z
DESCRIBE JOB �`T ''� ��.tl l'�' t-t�q'�'.r��j�=�� '- - � 5 ��� �ci� ,
THE PROPERTY IS OWNED BY: SINGL /MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME ��T �C'c-'.zs� > -�tTf�ts C'- �D, CONTRACTOR'S REG. #f�����'�3Z�'�
Card MUST be presented
CONTRACTOR'S ADDRESS III�'' 1����i�C � .�V l�t.y CITY aEC� �`+�t C��Z+r' PHONE�`:��"�7`j�%
EXPIRATION DATE �T� �.,
— 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 �1C�' ►'�l 1Jl-l��' PHONE gs�"7`1�3�
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER�-�-?7 2�I -- �15�
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
( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$
N0. WATERCLOSETS GAS PIP NG, 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 � c/ $
DRAINS � � � $
_�OTHER C�s ��-'���' $
TOTAL FIXTITR€S $
TOTAL MECHANICAL FEE $
I CERTIFY UNDER PENALTY OF PERJURY T �THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
AND FURTHER THAT I AM AUTHORIZED BY TH (�.1�(NER 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 I TIGATION AND DEFENSE OF SUCH CLAIM), WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
AND FILED AGRINS THE ITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND E PLOYEE , UPON HE OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: l'� � � DATE: "'' / l Z�
ANP-008 3/90
MECHANICAL PERMIT
CITY OF g I L D i N P BUILDING INSPECTION
FEDERAL WAY U G E R M I T 661-4140
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PERMIT NO. 0��1'�(�qME gITE ADDRESS ��'� ;
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CONTRACTOR ADDRESS � � s �$�p C�ONT.PHONE T ' '
ti �.5".�. � .;� � .'Y.{..., , . ! :.. �![4'� i � �.. iSt s""�T �� a . '_1Vf"y.
. . . ,, _,..t �� �.
CONT.REG.NO. � ' EXP. OWNER'S PHONE OWNER'S ADDRESS " ' ' ' ' �•`
TYPEJOB: NEWRESIDENCE ADDITION NEWINDUSTRIAL NEWCOMMERCIAL COMMERCIALADD. INDUSTRIALADD. NEWPUBLIC PUBLICADD.
NEW MULTI-FAMILY (UNITS���MU�T�/�Qp. SIGN GRADING OTHER
�
1 . l� ,
TAX ACCOUNT NO. �� LEGAL DESCRIPTION
ISSUED BY �`� ` " � DATE OF ISSUE DATE OF APPLICATION ���'''`�-�'�
BUILDING INFORMATION
ZONE SET BACKS:FRONT SIDE REAR HEIGHT LIMIT
OCCUPANCY TYPE OF CONSTRUCTION CENSUS NO. TYPE OF HEAT BLDG.S�.FT. STORIES
PLUMBING NO. N0. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING FT. �� GAS LOGS RECEIVED
BATHTUBS LAUNDRY DRAINS FORCED AIR FURNACE DUCT WORK
SHOWERS URINALS GAS HOT WATER HTR. -���~ AIR� IT NUMBER
LAVATORIES DRINKING FOUNTAINS CONVERSION BURNER MISC. ��� �r��
SINKS MISC. BBQ BASIC FEE —��� RETURNED
DISHWASHERS TOTAL FIXTURES DRYER TOTAL MECHANICAL ���� AMOUNT
VALUATION
GAS PIPING TFST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
1MBING FEE INSPECTION RECORD
..,�CHANICAL FEE ��� �
TOTAL BLDG. FEES Water Line �K Mechanical Inspection Notes:
PART P/C FEE � PIPIN rOK T�(D� � '�IJ3t�I�` � B `"�� ���"� � � �
SEPA REVIEW `� Y
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES P'IECHANICAL PERMIT �g_ „
AMOUNT DUE � h TOtdl F@@ $ "�"' ' £ 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 � � �� -"
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