07-102032~ City of Federal Way
Community Development Services Mechanical Permit #: 07- 102032 -00 -ME
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: ROUND TABLE @ FEDERAL WAY MARKETPLACE
Project Address: 34410 16TH AVE S Suite 101 Parcel Number: 250090 0040
Project Description: Installation of exhaust hood for pizza oven, swamp cooler (part of exhaust system), exhaust
hood for dishwasher and refrigerant system lines.
Owner
Applicant
Contractor
OLGA LUNDGREN
OLGA LUNDGREN
HVAC R SERVICES
NOTHING BUT NET INC., DBA ROUND
NOTHING BUT NET INC., DBA ROUND
HVACRRS950M5 (7/25/07)
TABLE PIZZA
TABLE PIZZA
20614 SE GREEN VALLEY RD
4718 HYADA BLVD NE
4718 HYADA BLVD NE
AUBURN WA 98092
TACOMA WA 98422
TACOMA WA 98422
Additional Permit Information
Mechanical Valuation .................. ..........................34925 Over the Counter Permit?....... ............................... No
���3Ib
THIS CARD IS TO REMAIN ON -SITE
CITY OF Community Development Inspection Rico r-'4
. Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 107- 102032 -00 -ME
Owner: FEDERAL WAY MARKETPLACE INVESTORS LLC
Address: 34410 16TH AVE S Suite 101
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 i Date __l _c- By e_ Date S -23•o %By e� Date '7.2
For inspector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
CITY OP.. .. :3 Z.
Federal Way p0� PERMIT
` - — — — — —
COMMUNITYDEVELOPMEWSERVIC R ? SF MF CO EEL PL DE EN FP
33J ?5'8- AVENUE SOUTH • PO BOX 9 b
„ FEDERAL WAY, X 980.9718 P P LI C AT I O N To 5—
253 -835 -2607• FAX 253.835.2609 F vG P
iinuw. cihral7edrrnhoau.car�{I�A,�s�� Q �
The following is required information - an incomplete application will not be accepted. Please print legibly (in ink) or type.
� PROPERTY / INFORMATION �t
SITE ADDRESS !i �f Lffn !a' ii
�`i2 vdyl- SUITE /UNIT #
ASSESSOR'S TAX /PARCEL # 6 D _ Z> o O
— — LOT' SIZE (SO
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach separate pagefar lengthy legal deaoiption)
PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING O PLUMBING /MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this Permit onlul
PROJECT NAME (Name of Business or Owner Last Name) X_L,, r V!3
PEOPLE • •
PROPERTY
OWNER
CONTRACTOR
COPY of evd rogot »d
with each application
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAME
ZI 417 k%i7�/�J
PRIMARY PHONE
MAILING ADDRESS
3 i3�frz.c:� ,
CITY, STATE, ZIP
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E -MAIL ADDRESS
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�PPL•ICANT NAB..
1� -+CJ. � n fe rn 1
/OFFFFjI�CE PHONE
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M 1 N A DR J _ n
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ITY, ATE 1P
CELL PHONE
-
CITY OF FEDERAL WAY BUSINESS UCENSE NUMBER
2p
EXPIRATION DATE
FAX NUMBER
MSY )5-k-7
-0376
CONTRA\CTIORS REGISTRATION NUMBER
V �
EXPIRATION DATE
'7 2 ��- O
E-MAIL ADDRESS
�CA%h
COMPANY NAME P
be, //vC Xc,,46
APPLICANT NAME
OFFICE PHONE
rIVe-.— ;%
PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIPTO PROJECT
❑ Architect Tenant ❑ Agent ❑ Other
FAX NUMBER
( 2S3 ) 9,,S -2- Z-2S-
NAME PRIMARY PHONE E- MAILADDRESS
icy ar, 8L1 1 LUnlDl2�,-v ) -
NAM //
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Per RCW 19.27.095:
Lender triformation is required ifproject value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
PROPOSED USE
EXISTING ASSESSED /APPRAISED VALUE $ _ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES O NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE (7 TACOMA O PRIVATE (WELL(
SEWER SERVICE PROVIDER O LAKEHAVEN ❑ HIGHLINE 0 PRIVATE (SEPTIC)
•
? /-i
--% --[
AREA DESCRIPTION
EXISTING
: S FT
PROPOSED
TOTAL '
S I.
BASEMENT
FANS
GAS WATER HEATERS MISC (Describe)
BASIC PLAN? o YES
FIRST
ZONING DESIGNATION
BOILERS
FIREPLACE INSERTS
SECOND _, e
_� COMPRESSORS
FURNACES
GAS LOO SETS
RANGES
REFRIG. SYSTEMS
THIRD
UP /SEPA /SU? o YES
o NO
PLUMBING
ADDITIONAL FLOORS (DESCRIBE)
BATHTUBS (or Tub /Sh.,Cumbo)
LAVS (8ethroomsww)
DECK (❑ COVERED OR ❑ UNCOVERED?)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
GARAGE ❑ CARPORT ❑
SHOWERS
WATER CLOSETS troflet►
ELECTRIC WATER HEATERS
'
NUMBER OF FLOORS
EXISTING
PROPOSED
TOTAL
TOTAL Xxnn7m Rr
TOTAL PROPOSED OF
TOTAL eF
**NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fmture to be installed or relocated as part of this project. Do. not include existing fixtures to remain.
MEGFIA1Vl4AL
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)
BASIC PLAN? o YES
❑ NO
ZONING DESIGNATION
BOILERS
FIREPLACE INSERTS
HOODS (com rdaq
_� COMPRESSORS
FURNACES
GAS LOO SETS
RANGES
REFRIG. SYSTEMS
DUCTS; _ :.
UP /SEPA /SU? o YES
o NO
PLUMBING
o YES o NO
BATHTUBS (or Tub /Sh.,Cumbo)
LAVS (8ethroomsww)
URINALS MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS troflet►
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES
HOSE BIBBS
SUMPS
I cerft 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. / '4 17
NAME /TITLE
RELATIONSHIP TO PROJECT Pk:�Owner ❑ Agent ❑ contractor ❑ Arcnitect U
o NEW a
ADDITION
o ALTERATION
o REPAIR o TENANT IMPROVEMENT.
BUILDING SHELL ONLY?
o YES o NO
BASIC PLAN? o YES
❑ NO
ZONING DESIGNATION
CHANGE OF USE? o YES
ONO
NEW ADDRESS REQUIRED?
o YES o NO
UP /SEPA /SU? o YES
o NO
PLATTED LOT?
o YES o NO
DEMO PERMIT REQUIRED? o YES
o NO
Bulletin #100— January 1, 2007 Page 2 of MhandoutsTermit Application .
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