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91-101686 MECHANICAL PERMIT CITY OF BUILDING INSPECTION FEDERAL WAY B U I L D I N G P E R M I T 941-1555 91-/0�6 s� PERMIT NO. q�-� F►7R M OWNER'S NAME DOUG WHITE JOB ADDRESS 32826 13TH AVE SW CONTRACTOR NnRTRWFST 17ST ADDRESS Z�Og 341ST PL S FEDERAL WAY CONT. PHONE 952-5433 CONT. REG. NO. NQRTHTTSI O1.T.T OWNER'S PHONE 874-8676 OWNER'S ADDRESS 32826 13TH AVE SW FEDERAL WAY 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. �2F+d9d-Q�1�O LEGAL DESCRIPTION ISSUED BY .TOANNE JOHNSON DATE OF ISSUE DATE OF APPLICATION 11-21-91 BUILDING INFORMATIO ZONE OCCUPANCY TYPE OF CONSTRUCTION BLDG. SO. 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. �Q O BOILER RECEIVED BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S) SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER LAVATORIES DRINKING FOUNTAINS GAS jiOT WATER HTR. h�S LOGS �Q RETURNED SINKS MISC. CONVERSION BURNER BASIC FEE �Q_00 DISHWASHERS TOTP.L FIXTURES UNIT HEATER TOTAL MECHANICAL �� AMOUNT VALtJATION GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE. RMIT FEE LAN CHECK FEE PLUMBING FEE INSPECTION RECORD MECHANICAL FEE 2 H.rJ 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 � i� AMOUNT DUE 28.50 Account No. 010-000-322-10-004 Total Fee $ 28-50 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 IV�jrT: � L� „ '� OWNER OR AGENT DATE �/ �� ,�. � Perm' ��/l� , S� .�� '�►�'�'� . NOV 2 � �91 CITY OF FEDERAL WAY c�� _ BUILDING PERMIT APPLICATION ��AY —Please Print— �+C BOX 1 TENANT NAME: OWNER '��.� _ `c; ��:�.,��p. SITE LOCATION 3��_��- �- ( � �:_.��_. `:�. t,_ � OWNER'S ADDRESS 3,�'�� - �-3< :,c�. `-% c t,, CITY �e ` ; .. ` PHONE�' i_`/ -�'��, DESCRIBE JOB Z � � �l--l- c�� ` l. � � THE PROPERTY IS OWNED BY: SINGLE/MARRIE PARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME c,��h��C'_";�t �.�.`-�. l , CONTRACTOR'S REG. #N�Et-�. l�S l[>l s s Card MUST be presented �- Sf' — . C' CONTRACTOR'S ADDRESS I `��(� 3�I( P(. S. CITY �E' 4rt l.�< PHONE �S�-5`l 3 3 EXPIRATION DATE �l �S'`�/ — 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 �-�-Y��`-, 1r•.. (.',_ __ PHONE��S Z -:��`y-�3 BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER �^1a��f 1�� C�E�E;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 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION ( ) MULTIFAMILY (N0. OF UNITS = ) ( ) EXISTING STRUCTURE ( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANIC�AL APPLIANCES— BASIC FEE$ N0. WATERCLOSETS GAS PIPING, 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 L-oe, `_� ��:�� . $ DRAINS $ OTHER $ TOTALFIXTURES $ TOTAL MECHANICAL FEE $ I CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY IfNOWLEDGE 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 ASTO 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 T�i�CIT`l, INCLUDING ITS OFFICERS AND EMP �S, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF TH15 APPLICATION. �� OWNER/AGENT: ` ' DATE: � �� ANP-008 3/90 OFFICE USE ONLY (PLEASE D0�'JOT WRITE BE�OW 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: R��E��VI�D NOV 21 1991 PARTIAL PLAN CHECK FEE RECEIVED Amount Date Receipt# 1•ry{��EUERAL VYAY BUILDIN(�lOEPT BUILDING DEPARTMENT APPROVAL RECEIVED BY DATE ACCEPTED FOR FILING MECHANICAL PERMIT CITY OF BUILDING INSPECTION FEDERAL WAY B 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 ADDFiESS 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 N0. LEGAL DESCRIPTION ISSUED BY DATE OF ISSUE DATE OF APPLICATION BUILDING 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 FT. BOILER fiECEIVED 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 PERMIT FEE PLAN CHECK FEE "LUMBING FEE INSPECTION C :CHANICAL FEE TOTAL BLDG. FEES Water Line �K Mechanical In 1 S. 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 AMOUNTDUE Account No. 010-000-322-10-004 Total �� 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