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91-101244 MECHANICAL PERMIT 91'�l� � y CI1`Y OF BUILDING INSPECTION FEDERAL WAY B U I L D I N G P E R M I T 941-1555 PERMIT NO. 91-1193 M OWNER'S NAME �RJORIE RHODES JOB ADDRESS 28201 20TH AVE S CONTRACTOR NORTHWEST USI ADDRESS 1908 S 341ST PL SUITE 9 FEDERAI, WAY CONT. PHONE 66 - CONT. REG. NO. NORTHUSIOZaTJ OWNER'S PHONE 839-8213 OWNER'S ADDRESS 28201 20TH AVE S FEDERAL TPIAY TYPE JOB: NEW AESIDENCE 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. 422231—OS�IO LEGAL DESCRIPTION ISSUED BY JOANNE JOHNSON DATE OF ISSUE � DATE OF APPLICATION 8-30-91 BUtLDiNG INFORMATION ZONE 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 47 FT. 2-�� BOILER RECEIVED BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S) SHOWERS URINALS FORCED AIR FURNACE �-O.OO AIR HANDLING UNIT NUMBER LAVATORIES DRINKING FOUNTAINS GAS�iOT WATER HTR. 6.5O MISC. SINKS MISC. CONVERSION BURNER BASIC FEE ZO.OO RETURNED DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL 3g.5O AMOUNT VALUATION GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE. iMIT FEE PLAN CHECK FEE PLUMBING FEE INSPECTION RECORD MECHANICAL FEE 3 R_ri O TOTAL 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 OTHER FEES MECHANICAL PERMIT AMOUNT DUE 38.50 Account No. 010-000-322-10-004 Total Fee $ 38.50 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 —7 DATE �` �� /ED Permit -- �' � - ✓/ �i�j _�� AUG 3 0 1991 CITY OF FEDERAL WAY or��a�oE�r Av BUILDING PERMIT APPLICATION —Please Print— BOX 1 TENANT NAME: OWNER " �- ' SITE LOCATION OWNER'S ADDRESS . > � `J - ITY PHONE 3� - ��I � DESCRIBE JOB �' . l�L.� � THE PROPERTY IS OWNED BY: SINGL /MARRI PARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME l� DI �x�� (,�SZ CONTRACTOR'S REG. #_1��hU516/.7`T Card MUST be presented CONTRACTOR'S ADDRESS US � �5� • S '� � CITY � t.-r�t, PHONE 6�I��5�- EXPIRATION DATE L1- '�— L — 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 ' �5 �'� PHONE -Z��Z- BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER C/ 22-Z 3 —�S 7� 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 Y7� $ 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 $ 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 HARM LESS THE CITY OF FEDERAL WAY AS TO ANY CLAI M(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 EMPLOY ES, UPON THE CCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION. OWNER/A6ENT: � ' DATE: �� / ANP-008 3/90 .�..�.r.-- . . . . ...�wR't. . . . . - q��„. .�' . ' . ..e.. .'.+'4�'ovCeffitn3�`�YA+"#Ya7".'�'��+5#'wa^"Y ..... .�,W�t""1i:,...� OFFICE USE ONLY (PLEASE DO NOT WRIT� oELOW 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. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT NEW COMMERCIAL COMM. ADD/ALT NEW MULTIFAMILY (UNITS ) MULTIFAMILY ADD/ALT TENANT IMP. OTHER OCCUPANCY TYPE OF CONSTRUCTION STORES BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING 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 TOTAL BLDG. FEES PART P/C FEE SEPA REVIEW S.B.C.C. FEE OTHER FEES AMOUNT DUE ASSIGNED ADDRESS: ��'��'�'�� PARTIAL PLAN CHECK FEE RECEIVED AUG � O ,�g9,� Amount Date Receipt# GfTy pF�EOERAL WAY BUILDING DEPARTMENT APPROVAL �1��E� BY DATE ACCEPTED FOR FILING 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 GFADING OTHER TAX ACCOUNT NO. LEGAL DESCRIPTION "'SUED 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 N0. NO. MECHANICAL APPLIANCES AMT. AMT. BONO 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. 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 INSPECTOR. AFFIDAVIT WILL NOT SUFFICE. PERMIT FEE PLAN CHECK FEE UMBING FEE INSPECTION RECORD ...ECHANICAL FEE TOTAL BLDG. FEES Water Line OI{ Mechanical Inspection Notes: PART P/C FEE � SEPA REVIEW GAS PIPING OK Date �,Z �y --2�� WATER SERVICE WATER MAIN CHG. S.B.C.C. FEE OTHER FEES MECHANICAL PERMIT AMOUNTDUE _ ACCOUClt 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 I' II I I J J Y C° Z m, � °� O ' � ' � I p o ' W � � � z � a ' o I � � � Z Z � � J Q i C7 � i Q Z ( Z ' O� I m Q � LL1 U H � 1-W- W Q d 0 � 0 � � I� I �I I J � �, j � o � I �, I I a . Z 0 � m I ; m a � � i ; � � O I Y �- i O � I � Z � ' Z (} O ' O , � z a �- : W a � � F � � � � o 0 0 � � z o 0 ll ' I i i I ' �� I ; �. � i I z z � m m Q m a m O II z ! � � ,� O = � W �i UC��\,I � il � 'i O ' O� O � � � a � � I �r� � a^� Y I Z � W i Y �l! a m p O �. m w � w � w Q w � � � � � � W Q J Q Y Q z Q cn o a o O o � o