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07-100307of Federal Way Comm pity Debelopmertt Services Mechanie l'l Permit #: 07- 100307 -00 -Mr P.O. Boz 9718 Fede al Way, WA 98063 -9718 Ph: (253) 35 -2607 Fax: (253) 835 -2609 Inspection Request LI 3) 835-3050* { Project Name: DR BRIAN FILBERT FAMILY DENTISTRY Pr ject Address: 33507 9TH AVE S Bldg B UmE b 926500 20 Project Description: Installation of (2) split systems, duct work, GRDS, pumps, ex s and gas 'ng locations Me hanical Valuation ..................... theQ ........ .............................No .... ............. 1 Fans................. ............................... 8 PERMIT EXPIRES Monday, January 26, 2009 Permit Issued on Friday, January 26, 2007 1 h reby certify that the above information is correct and that the construction on the above described property and t e occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington and the City of Federal Way. O ner or agent: Date; (l z 6 l G y Owner Applicant actor THREE THIRTY SIXTH, LLC EVERGREEN REFRIGERATION INC EV REEN REF G O INC 1611 9TH AVE N 727 NYON VERG 08 EDMONDS WA 98020 SEA A 98108 7 LE Ad 98108 SEA 1 3111e-- Me hanical Valuation ..................... theQ ........ .............................No .... ............. 1 Fans................. ............................... 8 PERMIT EXPIRES Monday, January 26, 2009 Permit Issued on Friday, January 26, 2007 1 h reby certify that the above information is correct and that the construction on the above described property and t e occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington and the City of Federal Way. O ner or agent: Date; (l z 6 l G y THIS, CARD IS TO REMAIN ON -SITE aaF Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-30541, PERMIT #: 07- 100307 -00 -ME Owner: THREE THIRTY SIXTH, LLC Address: 33507 9TH AVE S Bldg B FEDERAL WAY, WA 98003 This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on -site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as possible (read left to right, top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On -going inspections are logged.on the back of this card. ❑ Mechanical Rough -in (4165) ❑ Gas Piping (4125) A ,' ❑ Final - Mechanical (4065) Approved Approved to release test Approved c, tz Z -z,7- o7 By Date By Date By Date r l� i tio0 "ITY of v°� Federal way PERMIT CO.lfhfUN1TYDE6BLOPbfENTSERVIC P� [T , CA TI N 333253-835-2607- RFAX253- 83520`�8�9( \7�(Q �pNQ� pPLI C +T_ ©y ` z zvmc2tjo frede. alwai�rom v1 ejo\ The following is required information – an incomplete application will no - -�- Qo 0 SF MF CO ME EL PL DE Eli FP r /4* ASSESSOR'S TAX /PARCEL # LOT SIZE (SO LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) (Attach separate page for lengthy legal d—rot n) PROJECT • • TYPE OF PERMIT ❑ BUILDING PLUMBING CHANICAL ❑ DEMOLITION ELECTRICAL ❑ZZ7 ❑J//JJJENGINEERING ❑ FIRE PREVENTION SYSTEM PRO CT DESCRIPTION (Provide detailed description of work included on this permit onlUl 6A PROJECT NAME (Name of Business or Owner Last Name) PROPERTY OWNER CONTRACTOR APPLICANT CONTACT LENDER EXISTING USE NAME PRIMARY PHONE -thvtC-%,hw41 j h "C' ( ) - MAILING ADDRESS � � CITY, STATE(�Z, COMPANY NAME U'Ugfw �ul rkba) APPLICANT NAME t* y & - TC,I -V OFFICE PHONE (7,66 )`7V; - 1144 MAILING ADDRESS CITY. STATE, ZIP CELL PHONE FAX NUMBER ( ) " CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER 7-0 v 6-1 ° Li 5- 3- EXP TION DATE / / FAX NUMBER (Zo6 )7(05 PRIMARY PHONE ('106)_)(,3 - lZ4 (4 I s L CONTRACTOR'S REGISTRATION NUMBER (copy of card required with each application) EXPIRAn.QN DATE �v ZLC114A OMPANY NAME APPLICANT NAME OFFICE PHONE MAILING ADDRESS CITY, STATE, ZIP CELL PHONE RELATIONSHIP TO PROJECT ❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe) FAX NUMBER ( ) " N PRIMARY PHONE ('106)_)(,3 - lZ4 (4 I E -MAIL. ADDRESS 1"P NAME - - -- -- ,��r e��%f�ro,�e vex eeyds� MAILING ADDRESS e CITY, STATE. ZIP PHONE PROPOSED USE EXISTING ASSESSED /APPRAISED VALUE $ VALUE OF PROPOSED WORK $ SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC) ❑ NO AREA DESCRIPTION EXISTING S . FT. PROPOSED S . FT. TOTAL S . FT. BASEMENT SUMPS WASHING MACHINES URINALS FIRST VACUUM BREAKERS SECOND %, THIRD PROJECT . .......... � _ �." FLOOR , , I � I - I AREAS - I - - -1 - -1- 1 1 � . � I I - � � 1 1-11 1111, 1 , .. I I � �. - 111-1.111 11 1 1 - 111 11 1 1 1 � I � .1 AREA DESCRIPTION EXISTING S . FT. PROPOSED S . FT. TOTAL S . FT. BASEMENT SUMPS WASHING MACHINES URINALS FIRST VACUUM BREAKERS SECOND THIRD FOURTH ADDITIONAL FLOORS (DESCRIBE) DECK(COVERED ?) GARAGE ❑ CARPORT ❑ NUMBER OF FLOORS.. EffirT. PROPOSED TOTAL VTOTAL.SXI$T1NO 6F SDTA.„,l.P,ROPOSED fiF OTAk &'. n :'' " *NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. MECHANICAL Value of Mechanical Work $ 2 AIR HANDLING UNITS EVAPORATIVE COOLERS BBQS �— FANS BOILERS FIREPLACE INSERTS COMPRESSORS FURNACES DUCTS _ GAS PIPE OUTLETS BATHTUBS (or Tub /shower Combo) SHOWERS DISHWASHERS SINKS GAS PIPE OUTLETS SUMPS WASHING MACHINES URINALS LAVS (Bathroom Sinks) VACUUM BREAKERS GAS LOGS HOODS (Commemiai) RANGES GAS WATER HEATERS WATER CLOSETS ab&t) _ DRINKING FOUNTAINS RAINWATER SYST HOSE BIBBS ELECTRIC WATER HEATERS REFRIG. SYSTEMS WOODSTOVES MISC (Describe) MISC (Describe) 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 the permit application is made. I further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in the 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 &the city, including its officers and employees, upon the accuracy of the information supplied to the city as a part of this application. ._ NAME /TITLE RELATIONSHIP TO ❑ Owner ❑ Agent 7ontractor ❑ Architect ❑ Other V l-t /aI Bulletin #100 - January 1, 2006 Page 2 of 4 k\Handouts\Permit Application