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07-102568Y�- 1% City of Federal Way FlLiihanical Permit #• 07102568 -00 -dill P- CommuT�tit y 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: ROUND TABLE @ FEDERAL WAY MARKETPLACE Project Address: 34410 16TH AVE S Suite 101 Parcel Number: 250090 0040 Project Description: Gas piping for new restaurant. Owner Applicant Contractor FEDERAL WAY MARKETPLACE TACOMA PLUMBING & HEATING TACOMA PLUMBING & HEATING INVESTORS LLC PO BOX 44601 TACOMPH271PR (5!2!08) 3700 BEAZER RD TACOMA, WA PO BOX 44601 BELLINGHAM WA 98226 98445 TACOMA, WA 98445 Additional Permit Information Mechanical Valuation ................. ...........................4367 Over the Counter Permit?....... ............................... No Mechanical Fixtures ............................. as- Ptpe Outlets.................. .... 6 Owner or Date: 1 1 2Gy� THIS CARD IS TO REMAIN ON -SITE F CITY OF Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050 PERMIT #: 07- 102568 -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 Date By E.l� Date .0 By G � Date 7 . t at -a"7 % For inspector reference only ❑ Rough Electrical ❑ FINAL - Electrical Approved Approved By Date By Date 7�A�� pec, ryA 00 91 - OC) — C- 0 ntror 'A 6 a Federal way PERMIT COMMUNITY DEVBLOPMENTSERVICES SF MF CO 6DEL PL DE EN FP 333258nl AVENUE SOUTH • BOX 9718 APPLICATION FEDERAL WAY, FAX 63 3 -9718 / ( � ' 253- 835 -2607• FAX 253. 853.8 35.2609 1 unu w. citRyedemt u!a .rom The following is required irformation - an incomplete application will not be accepted. Please print legibly (in ink) or type. PROPERTY INFORMATION SITE ADDRESS _ �'E 9 /�� t�� SUITE /UNIT # ASSESSOR'S TAX /PARCEL # LOT SIZE (st) LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) (Attach separate page,(nr lengthy tegal descrtptionl PROJECT • ' • TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING W MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide description of work included on this permit onlul 1al021117 4f I - If PROJECT NAME (Name of Business or Owner Last Name) PROPERTY OWNER CONTRACTOR COPY of caM requl.d ^tom with each appllcatfuv L—�) APPLICANT PROJECT CONTACT LENDER EXISTING USE PEOPLE INFORMATION NAME Pcl- r J cuU if m --- P(- ( h V as r-, ies L C C- PRIMARY PHONE ( ) - MAILING ADDRESS 1 CrrY, STATE, ZIP FAX NUMBER ( ) - E -MAIL ADDRESS o© 2 e- Rcl PRIMARY PHONE E -MAIL ADDRESS COMPANY NAM TACO . 1 ��in a APPLICANT NAME 1 <, II -ko OFFICE PHONE (;ZS ) 5 3 I - 3-/�l RING ADDRESS O o CITY, STATE, ZIP M tN CELL PHONE ( ) oG -S 76 CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER 1 -130 2 "3 1 6 1 (2S3)53-? -a302 CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E -MAIL ADDRESS a- '.? l P IZ- �-- -)—` 0 1 m I cc,;- c- T t c> CO!r NAME Per RCW 19.27.095: Lender information is required if project value exceeds $5,000 APPLICANT NAME OFFICE PHONE ( ) - MAILING ADDRESS CITY, STATE, ZIP CELL PHONE RELATIONSHIP TO PROJECT ❑ Architect ❑ Tenant ❑ Agent ❑ Other FAX NUMBER ( ) - NAME PRIMARY PHONE E -MAIL ADDRESS NAME Per RCW 19.27.095: Lender information is required if project value exceeds $5,000 MAILING ADDRESS CITY, STATE, ZIP PHONE EXISTING ASSESSED /APPRAISED VALUE $ SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE PROPOSED USE PROPOSED WORK $ SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGNIINE ❑ OMA ❑ PRIVATE (WELL) SEWER SERVICE PROVIDER ❑ LAKEHAVEN 04UGHLINE ❑ PRIVAT SIC) ?jvG C-om PROJECT .•• AREA DESCRIPTION AREAS EXISTING S . FT. PROPOSED s . FT. TOTAL SQ.FT. BASEMENT AIR HANDLING UNITS EVAPORATIVE COOLERS ' GAS PIPE OUTLETS WOODSTOVES FIRST FANS 404 GAS WATER HEATERS MISC (Describe) BOILERS SECOND HOODS (commerctap COMPRESSORS FURNACES THIRD DUCTS GAS LOG SETS REFRIG. SYSTEMS .ADDITIONAL FLOORS (DESCRIBE) CHANGE OF USE? o YES DECK (❑ COVERED OR ❑ UNCOVERED ?) NEW ADDRESS REQUIRED? o YES ❑ NO GARAGE ❑ CARPORT ❑ ❑ NO PLATTED LOT? o YES ❑ NO NUMBER OF FLOORS ttxlsTnvO PROPOSED TOTAL TOTAL P"TMO Sr TOTAL PROPOSED SP TOTAL RP "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 3 (o-7 Uo ❑ Owner ❑ Agent Z Contractor ❑ Architect O Other Value of Mechanical Work $ o (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION) AIR HANDLING UNITS EVAPORATIVE COOLERS ' GAS PIPE OUTLETS WOODSTOVES BBQS FANS 404 GAS WATER HEATERS MISC (Describe) BOILERS FIREPLACE INSERTS HOODS (commerctap COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS REFRIG. SYSTEMS BATHTUBS (or Tub /shower combo) LAVS (Bathroom staks) URINALS MISC (Describe) DISHWASHERS RAINWATER SYST VACUUM BREAKERS DRINKING FOUNTAINS SHOWERS WATER CLOSETS rr tied 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 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 4f 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 DATE 7 MILInaturel Mtlel IRELATIONSHIP TO PROJECT ❑ Owner ❑ Agent Z Contractor ❑ Architect O Other o REPAIR o TENANT IMPROVEMENT ❑ ALTERATION ❑ NEW ❑ ADDITION BUILDING SHELL ONLY? o YES ❑ NO BASIC PLAN? ❑ YES ❑ NO ZONING DESIGNATION CHANGE OF USE? o YES o NO NEW ADDRESS REQUIRED? o YES ❑ NO UP /SEPA /SU? ❑ YES ❑ NO PLATTED LOT? o YES ❑ NO DEMO PERMIT REQUIRED? ❑ YES o NO 1 Bulletin #100 — April 2, 2007 Page 2 of 4 k\Handouts\Permit Application