07-101929r, -%
City of Federal Way
comir�unity Development Services
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609
Project Name: WORLD VISION
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Mechanical Permit #: 07- 101929 -00 -ME
Project Address: 3450 S 344TH WAY Suite 110
Project Description: TI - STFI - Supply run relocation.
Inspection Request Line: (253) 835 -3050
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Parcel Number: 222104 9040
Owner
Applicant
Contractor
LBA REALTY
MCKINSTRY CO LLC
MCKINSTRY CO LLC
660 SW 39TH ST SUITE 255
5005 3RD AVE S
MCKINCL942DW 3/16/2008
RENTON WA 98055
SEATTLE WA 98124
5005 3RD AVE S
SEATTLE WA 98124
Additional Permit Information
Mechanical Valuation ................. ...........................2988 Over the Counter Permit?....... ............................... No
Mechanical Fixtures
Ducts..*"!, . ..................... .........
PERMIT EXPIRES Saturday, April 11, 2009
Permit Issued on Wednesday, April 11, 2007
I 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 of Feder ay.
Owner or agent: Date: 15�—/ / —07
��u��I
THIS CARD IS TO REMAIN ON -SITE
CITY OF 4A Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 101929 -00 -ME
Owner: LBA REALTY
Address: 3450 S 344TH WAY Suite 110
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) ❑ Final - Mechanical (4065)
Approved Approved to release test Approved
By Date By Date By Date
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CITY OF �".`"aw•v','. • 1W169 •r'VEYa'
Federal way PERMIT ll t
COMMUNITY DEVELOPMENT SERVIPR 1 1 2007 SF MF CO ME L PL DE EN FP
33325 8n� AVENUE SOUTH • PO 971 9 18 APPLICATION
FEDERAL WAY. WA 98063 -9718
253835 -2607• FAX 253 Oe � 0 E R A t WAY O�
Lrww.c(iyn((crlcrahnn �} i14
9UILDING DEPT.
The following k required information -an incomplete application will not be accepted. Please print legibly (in ink) or type.
PROPERTY 1 • • Ca
SITE ADDRESS / �. 3 L!. W d Y / Sd 001 SUITE /UNIT #
ASSESSOR'S TAX /PARCEL # Z 7— ' 0 7 - O LOT SIZE (sf
LEGAL DESCRIPTION (e,g. Acnte Estates, Lot 1) 56C ATY-Al-ClV-67) 5i>Zf7__
Inlmd, scnarcne rxaiejbr 1—gligr legal descdpli 0
MLEEMM 1 • •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING YMECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu)
r ,f .. 9=2 ,
PROJECT NAME (Name of Business or Owner Last Name)
PROPERTY
OWNER
CONTRACTOR
COPY of card rcqutred
with each appllcatlan
APPLICANT
PROJECT
CONTACT
LENDER
c
NAME ^ 4 ) r � v r 4 d
/i w o f
j I l (-L
PRIMARY PHONE
-
MAILING ADDRESS
R 3a 4o
ITY, STATE, ZIP
Ise n(w
WA �'U6
E -MAIL ADDRESS
COMPANY NAME
�s
G�
APPLICANT N'?> P i l
C]�t`� ���uLL77
OFFICE PHONE
(ZQ 6 T7 6 S
-7733
MAILING ADDRESS
oo s-
CITY, ST , ZIP
A-,
CELL PHONE
( Vi.) 39(6
-4174q
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
! - o- oo0003- 00 -`3c
IRATION DATE
iz -3) -o7
FAX NUMBER
(2a (*)65-
-173/
CONTRACTOR'S REGISTRATION NUMBER
0 C V- f N LLl y Z p W
EXPIRATION DATE
3 -1 6 —ZOo8j
E -MAIL ADDRESS
Lo u g@,IVk,�G�iv5�2 .
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other
FAX NUMBER
NAME L
J Wry. t_�
PRIMARY PHONE
( )
-
E -MAIL ADDRESS
NAM
Q%V R vL,
Per RCW 19.27.095:
Lender information is required if project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
EXISTING USE bYlyl L� S� P✓� G� PROPOSED USE 42Pr16C 0 �
EXISTING ASSESSED /APPRAISED VALUE $ I y. Q7/j 300 VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ) YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REgUIRED? ❑ YES 410
WATER SERVICE PROVIDER LAKEHAVEN ❑ HIGIILINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
1"7
-V
.e
PROPOSED
S . FT.
TOTAL
S . FT.
AREA DESCRIPTION
EXISTING
S . FT.
BASEMENT
BOILERS
FIREPLACE INSERTS
HOODS )comm 1.0
FIRST
FURNACES
RANGES
DUCTS
SECOND
REFRIG. SYSTEMS
CHANGE OF USE? ❑ YES
c NO
THIRD
UP /SEPA /SU? ❑ YES
c NO
ADDITIONAL FLOORS (DESCRIBE)
DEMO PERMIT REQUIRED? o YES
c NO
DECK (❑ COVERED OR ❑ UNCOVERED ?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
Ex1STINr
PROPOSED
TOTAL
TOTAL. MST11105F
TOTAL PROPORFD SF
TOTAL SF
* *NEW HOMES ONLY ** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
� 71XTURES
Indicate number of each type of Jtxture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL. S (,
Value of Mechanical Work $_ (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 MISC (Describe)
BOILERS
FIREPLACE INSERTS
HOODS )comm 1.0
COMPRESSORS
FURNACES
RANGES
DUCTS
GAS LOG SETS
REFRIG. SYSTEMS
BATHTUBS) rTub /sno,eercomh)
LAVS )Bath- Sink.)
URINALS MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS Ironer
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. L
NAME /TITLE Jura tGr /N !( DATE 7 t/-7
ignature) 1lltlel
RELATIONSHIP TO ROJECT ❑ Owner ❑ Agent VI.-tractor ❑ Architect O Other
:FOR OFFICE USE ONLY
❑ NEW c ADDITION
❑ ALTERATION
c REPAIR ❑ TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO
BASIC PLAN? o YES
c NO
ZONING DESIGNATION
CHANGE OF USE? ❑ YES
c NO
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
UP /SEPA /SU? ❑ YES
c NO
PLATTED LOT? ❑ YES ❑ NO
DEMO PERMIT REQUIRED? o YES
c NO
Bulletin #100 —January 1, 2007 Page 2 of 4 k\Handouts\Permit Application