07-103269a
u e decal Way
Community ity Dev elopment Services Mechanical Permit #: 07-103269-00-M8
Development
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609 Inspection Request Line: (253) 835 -3050
6
Project Name: TEAM HEALTH
Project Address: 505 S 336TH ST
Parcel Number: 926480 0270
Project Description: Install (1) new VAV box & relocate (1) double -duct VAV box; replace /relocate some
diffusers & ducting; install A/C for small equipment room.
Owner
Applicant
Contractor
TEAM HEALTH
PACIFIC AIR CONTROL INC
PACIFIC AIR CONTROL INC
3455 S 344TH WAY SUITE 210
11812 NORTH CREEK PKWY N
PACIFAC2301`8 (10/01/07)
FEDERAL WAY WA 98001
BOTHELL WA 98011
11812 NORTH CREEK PKWY N
BOTHELL WA 98011
Additional Permit Information
Mechanical Valuation .................. ..........................20300 Over the Counter Permit? ...................................... Yes
Mechanical fixtures
Air Units ........ ........." uc _.... ............... ......... 1 Fans...
- ......................... 2
I (P�.
�(o
__
r t THIS CARD IS TO REMAIN ON -SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 103269 -00 -ME
Owner: TEAM HEALTH
Address: 505 S 336TH ST
FEDERAL WAY, WA 98003 -6328
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)
Approved
Gas Piping (4125)
Approved to release test
Final - Mechanical (4065)
Approved
For inspector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
RECEIVED
v CITY OF 1J V !/ ZOOI V 3 �' ^
Federal Way /�
COMMUNITY DEVELOPMENTSElOy /CryOr FEDERAL WAPERMIT SF MF CO E L PL DE EN FP
33325 D AVENUE SOUTH • PO BOX 97�D)I,pING Dom, P L I C ATI O N
FEDERAL WAY, FAX 98063 260 O
253 - 835 -2607• FAX 253 - 835 -2609 -
www.cituo((edernlwau.com
Thefollowing is required information - an incomplete application will not be accepted. Please print legibly (in ink) or type.
M_ PROPERTY INFORMATION
SITE ADDRESS _ O So y� 3�0 f �1 ��t "�/ y SUITE /UNIT #
ASSESSOR'S TAIL /PARCEL # ) 2 0 H Q v - 0 2- `l 0 �, 0 �, LOT SIZE (Sf
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) P` r e s e 5 e- e- � +"c -
(A ttoch separate page for lengthy Vgd descripttoN
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING CHANICAL
❑ DEMOLITION O ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu)
T-eu a-, F = w-p rav -e� ') r ' tee 4 4Fo t 1F-I4 "
.T ,4 s47,(1 6) t?,ew yAy e e Ioc.LA _C() douWe- d.r-+yA,y Sax,
k e `e' -C e f ne (oav+e N1iSCF 0( iRy5 01 vc +way-
N 44 AC a o s 1. a (t g e�t'y er li oo YVl , �,, j j-��
PROJECT NAME (Name of Business or Owner Last Name) Ca w P V C e.��er • _ l �T �"""` 14 ' 1
PROPERTY
OWNER
CONTRACTOR
COPY of cud required
with each application
APPLICANT
PROJECT
CONTACT
LENDER
NAME ✓
�`
PRIMARY; HONE -
MAILING ADDRESS
t 1 ! 2 oreei� P �i
�jMAILING ADDRESS pj ��,q
401 1 / a �te 206
CrnY'. ;TIATE,ZZIP d1 /y�/� s}
Wall \ 1 e14 , AXA Q (�U
E -MAIL ADDRESS
FAX NUMBER
�) 317 Q Z Z -' 76
NAME
( v(Q
P -O& ) b 2— -
H (0
COMPANY NAME
fear -i �it' Cern b�
APPLICANT NAME
( drin La
OFFICE PHONE
pzxo) fag2-
0'393
MAILING ADDRESS
) it/artt► C ree1� � �� N� toy
CITY. STATE. ZIP
CELL PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
� 001 D / 2 g 600 h3 L
EXPIRATION DATE
%31/p 7
FAX NUMBER
(2 6) 3�/0 -
Z27 a
CONTRACTOR'S REGISTRATION NUMBER
FA C i AC 23 -D pg
EXPIRATION D TE
!O1017o -7
E -MAIL ADDRESS
ikee/1 Pa-i AM.A14
COMPANY NAME
Tai -C C t� �' Co,,-{ ra [
APPLICANT NAME
lG a �/ I>, Lo
OFFICE PHONE
(.2010) b Fs 2— 6 3ci`3
MAILING ADDRESS
t 1 ! 2 oreei� P �i
CITY, STATE. ZIP
ga FPS( WA e r1
CELL PHONE
(zoo) 3�(0 - 2a g9
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent >"Other (a
FAX NUMBER
�) 317 Q Z Z -' 76
NAME
( v(Q
P -O& ) b 2— -
H (0
D
T f r� &P'1& C Ql IY
NAME
Per RCW 19.27.095:
Lender information is required if project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
( )
EXISTING USE 0-f �-<« SCA e,,e- PROPOSED USE D 4"';7Ce SIf -4—
-�
EXISTING ASSESSED /APPRAISED VALUE $ VALUE OF PROPOSED WORK $ .1"nI �` 069
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)
N PROJECT ..• AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
S . FT. S . FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS (DESCRIBE)
DECK (D COVERED OR D UNCOVERED ?)
GARAGE O CARPORT D
NUMBER OF FLOORS F.7QSfI116 PROPOSED TOM TOTAL EXISTWO SF TOTAL PROPOSED SP TOTAL SF
•'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 $ ao 130D
(A COPY OF BID OR ESTIMATE MUST BE INCLUDED VMH APPLICATION)
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS PIPE OUTLETS
VACUUM BREAKERS
WOODSTOVES
BBQS
FANS
GAS WATER HEATERS
SINKS
MISC (Describe)
BOILERS
FIREPLACE INSERTS
HOODS)Commeroiai)
2
\lA\% PlOX2S
COMPRESSORS
FURNACES
RANGES
7
G�
DUCTS
GAS LOG SETS
_� REFRIG. SYSTEMS
DEMO PERMIT REQUIRED?
❑ YES
BATHTUBS (or Tub /shower Combo)
LAYS )Iialhmom Sinks)
URINALS MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS Toneq
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES
HOSE BIBBS
SUMPS
❑ 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 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 �0'l/SfT d%E7�"I sylo��t_DATE & // 9/0-7
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent Xcontractor
❑ Architect ❑ Other
❑ NEW ❑ ADDITION
❑ ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
BUILDING SHELL ONLY?
n YES n NO
BASIC PLAN?
❑ YES
n NO
ZONING DESIGNATION
CHANGE OF USE?
❑ YES
c NO
NEW ADDRESS REQUIRED?
❑ YES ❑ NO
UP /SEPA /SU?
❑ YES
c NO
PLATTED LOT?
o YES ❑ NO
DEMO PERMIT REQUIRED?
❑ YES
c NO
Bulletin #100 — April 2, 2007 Page 2 of 4 k\Handouts\Permit Application