07-100865i
( City of Federal Way Mechanical Permit #• 07- 100865 -00 -ME
(I
Community Development Services •
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609 Inspection Request Line: (253) 835 -3050
Project Name: EMILY SABBAGH MEDICAL OFFICE BUILDING
Project Address: 34630 11TH AVE S Parcel Number: 215470 0100
Project Description: Adding to existing duct work
Owner Applicant trac
EMILY M SABBAGH EMILY M SABBAG I SA GH
34630 11TH AVE S 34630 11TH AVE 3463 S
FEDERAL WAY WA 98003 FEDERAL WAY WA %OOFEODE A 98003
Mechanical Valuation ......... ...............................
Ducts ....... ..............Alkh . tto
nal VH tion ■w
ter Pe ............
a
AL
ITIONS:
..................... No
10 PERMIT EXPIRES Monday, February 16, 2009
Permit Issued on Friday, February 16, 2007
1 hereby certify that the above information is correct and that the construction on the above described property and
the 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.
Owner or agent: 277- Date:
i
• - THIS CARD IS TO REMAIN ON -SITE
CITY OF Community Development Inspection Reco'-d
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 100865 -00 -ME
Owner: EMILY M SABBAGH
Address: 34630 11 TH AVE S
FEDERAL WAY, WA 98003 -6711
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) ❑ Final - Mechanical (4065)
Approved Approved to release test Approved
By Date By Date By Date yl6l-g�;7
cP� -l� CoV'(,r
Federal Way MUM
NED � (�
PERMIT
COMMUNM DEVELOPMENT SERVICES SF MF CO EEL PL DE EN FP
33325 FEDERAL WAY, WA98063.9° 8 j' 1=
TO
2535-2607• FAX 253.835.2609 "APPLICATION
rT,/ wum. 0
CITY OF FEDERAL WAY
The following is regtBkAIC%kKQrDtFtFc;6 - an incomplete application will not be accepted. Please print legibly (in ink) or type.
PROPERTY •- •
SITE ADDRESS SUITE/UNIT ik 0
ASSESSOR'S TAX /PARCEL # - LOT: SIZE (s• )
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(An.wh -P—ft Pagefar kvft Iva) dnoodenl
■ PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING 0 'PLUMBING MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑, FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only/
Qrc
PROJECT NAME (Name of Business or Owner Last Name)
PROPERTY
OWNER
CONTRACTOR
COPY of cud ngolred
with each epplleetlon
APPLICANT
PROJECT
CONTACT
LENDER
l
NAME
PRIMARY PHONE
1
MAILING RESS
?4 3o 4 VC 31
MAILING ADDRESS �CEM t
E -MAIL ADDRESS
1.
EXPIRATION DAT
COMPANY NAME
1
APPLICANT NAME
OFFICE PHONE
MAILING RESS
?4 3o 4 VC 31
CITY, STATE, ZIP II
Ct
CELL PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DAT
FAX NUMBER
CONTRACTORS REGISTRATION NUMBER
EXPIRATION DATE
E -MAIL ADDRESS
COMPANY NAME /
APPLICANT NAME
OFFICE PHONE
MAILING AD DRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
o Architect ❑ Tenant []Agent ❑ Other
( ) _
NAME _ - PRIMARY PHONE E -MAIL ADDRESS
M A ( .2106, ) >7A - 2 c- /y
NAME
Per RCW 19,27.095:
Lender information is required if project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP PHONE
EXISTING USE t� ` L/t .(� PROPOSED USE tIV- 6t (6c- " � l
EXISTING ASSESSED /APPRAISED VALUE $ _.VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 01,YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES 0410
WATER SERVICE PROVIDER W- SAKEHAVEN ❑ HIGHLINE 0 TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER D'LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
Indicate number of each type of fudure to be installed or relocated as. part of this project. Do not include existing fixtures to remain.
auc+wanaua.n,+
Value of Mechanical Work $ c f (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS PIPE OUTLETS
WOODSTOVES
BBQS
FANS
GAS WATER HEATERS
%C7 M1SC (Describe)
BOILERS
FIREPLACE INSERTS
HOODS jcommerdop
(�Qy �c�S t�` j�r�G� 6J
COMPRESSORS
FURNACES
RANGES
o YES ONO.
DU .TS
GAS LOG SETS -
REFRIG. SYSTEMS
PLATTED LOT?
o YES o NO
DEMO PERMIT REQUIRED? o YES
o NO
G ,
BATHTUBS (or 74 /shouter combo)
LAVS w6 ftwm wiles)
URINALS
MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS rroneq
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES
HOSE BIBBS
SUMPS
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 of 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 L', o� �1 DATE
(Signat MUC)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent ❑ Contractor ❑ Architect ❑ Other
o NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IMPROVEMENT.
BUILDING SHELL ONLY?
o YES o NO
BASIC PLAN? o YES
o NO
ZONING DESIGNATION
CHANGE OF USE? o YES
o NO
NEW ADDRESS REQUIRED?
o YES ONO.
UP /SEPA /SU? o YES
o NO
PLATTED LOT?
o YES o NO
DEMO PERMIT REQUIRED? o YES
o NO
Bulletin #100 — January ), 2007 Page 2 of 4 WlandoutsTermit Application .