07-101807.r.
city of Federal Way v Mechanical Permit #• 07- 101807 -00 =M E
Community Deelopment 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: WILLIAMS
Project Address: 1226 SW 296TH ST Parcel Number: 062104 9105
Project Description: Installation of gas piping for (1) natural gas outlet and (1) LP gas outlet. For future use of a
generator.
Owner
Applicant
Contractor
DOUGLAS B WILLIAMS
UNIVERSAL REFRIGERATION INC.
UNIVERSAL REFRIGERATION INC.
1226 SW 296TH ST
PO BOX 614
UNIVER1159RF 411!08
FEDERAL WAY WA
AUBURN WA 98071 -0614
PO BOX 614
98023 -3410
AUBURN WA 98071 -0614
Additional Permit Information
Mechanical Valuation ................. ...........................1500 Over the Counter Permit? ................................... ...Yes
Mechanical Fixtures'
....................... "
I hereby ceriify',thatIhe abov
the occupancy and the use
and the City of Federal Way. n
Owner or agent: ��^ � .�, Date:
THIS CARD IS TO REMAIN ON -SITE - -
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 101807 -00 -ME
Owner: DOUGLAS B WILLIAMS
Address: 1226 SW 296TH ST
FEDERAL WAY, WA 98023 -3410
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 'j Approved
By Date By ate // �> By / Date , �/�
� Y
RECEIVED
Federal way PERMIT
COMMUNITY DEVELOPMENT SERVICES 4 2007 SF MF C ME,? EL PL DE EN FP
33325 8rx AVENUE SOUTH • PO BOX 971 A P R 0 '��
FEDERAL WAY, WA 98063.9718 -D'LI CATI O N
253 - 835.2607• FAX 253-835-2
wwrrxi[:jaffer ralwnF.ro zj 1 T OF FED _
BUILDING DEPT.
The following is required information - an incomplete application will not be accepted. Please print legibly (in inlj or type.
�+ PROPERTY •• /•
SITE ADDRESS �f� �(O 2��0 % �I .r7 W SUITE /UNIT #
ASSESSOR'S TAX /PARCEL # D —& 2 Al - l LOT SIZE (sfi
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach separate page for lengfhy legal descrlpdoN
N—PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING XMECKANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this hermit onlu)
PROJECT NAME (Name of Business or Owner Last
PEOPLE •• •
PROPERTY
OWNER
CONTRACTOR
COPY of card required
with qlk application
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAME
PRIMARY PHONE
MAILING ADDRESS
2-cp !�;tv -
CITY, STATE. ZIP
f;!Ve#% 114
I /1&q Of 98oZ3
E -MAIL ADDRESS
COMPANY NAME
APPLICANT NAME
Sc c147(-
OFFICE PHONE
(Z )'M
CITY, STATE, ZIP
CM0 - 06t
- 5'1563
MAILING ADD
PO Fox tiv/ 1444 ,( WV-&A
CITY. STATE, ZIP
tA14 . q-607(—
CELL PHONE
-
CnY OF FEDERAL WAY BU (NESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
17- `I - /070q -4a SG- /2 _.3r _' 07
(7-") 73r -3Y3Z
CONTRACTOR'S REGISTRATION NUMBER
EXPIRATION DATE
E -MAIL ADDRESS
W11yA
41 - / - a8
COMPANY NAME ,
u K c v t.✓`S� � e✓et aw
APPLICANT NAME
$G�_ S'c�'
OFFICE PHONE
(z53) `t - �j "O/
MAILING ADDRESS
CITY, STATE, ZIP
CM0 - 06t
CELL PHONE
( ) -
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other �A✓'
FAX NUMBER
(2$ }'735""- 3tf Z
@cthidca�'�
NAME
Per RCW 19.22095: •
Lender in is required if project value exceeds $7 DOO
MAILING ADDRESS
CITY. STATE, ZIP
PHONE
PROPOSED USE
EXISTING ASSESSED /APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
PROJECT .••
AREA DESCRIPTION
AREAS
EXISTING
S . FT.
PROPOSED
S . FT.
TOTAL
S . FT.
BASEMENT
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
FIRST
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES
SECOND
SUMPS
o YES
o NO
THIRD
CHANGE OF USE?
ADDITIONAL FLOORS (DESCRIBE)
o NO
NEW ADDRESS REQUIRED?
a YES o NO
DECK (❑ COVERED OR ❑ UNCOVERED ?)
UP /SEPA /SU?
o YES
❑ NO
GARAGE ❑ CARPORT ❑
o YES ❑ NO
DEMO PERMIT REQUIRED?
NUMBER OF FLOORS
aabsTGO
MOPOM
TOTAL
TOTAL EJ¢srnro SF
TOTAL FaoFOSM SP
TOTAL Sr
"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 $! (A COPY OF BID OR ESTEUATE MUST BE INCLUDED WITH APPLICATIOM
AIR HANDLING UNITS EVAPORATIVE COOLERS Z- GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC (Describe)
BOILERS FIREPLACE INSERTS HOODS (commerciaq
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG. SYSTEMS
BATHTUBS (orhb /shower comb.)
LAVS (Bathroom Stoksl
URINALS MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS (Toilet)
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES
HOSE BIBBS
SUMPS
o YES
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further, that I
am authorised by the owner of the above premises to perform the work for which the permit application is made. I further agree to hold
harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in the investigation and defense of
such claim), which may be made by any person, including the undersigned, and filed against the City of Federal Way, but only where such claim
arises out of the reliance of the city, including its officers and employees, upon the accuracy of the i%for oration supplied to the city as a part of
this application.
NAME /TITLE
'5"f L .F$
RELATIONSHIP TO PROJECT ❑ Owner Agent Contractor C3 Architect c3 Other
329 - -7
a
o NEW o ADDITION
o ALTERATION
o REPAIR ❑ 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?
a YES o NO
UP /SEPA /SU?
o YES
❑ NO
PLATTED LOT?
o YES ❑ NO
DEMO PERMIT REQUIRED?
o YES
❑ NO
Bulletin #100 - January 1, 2007
Page 2 of 4
k\HandoutsTermit Application