07-104975w
r'
City of Federal Way
Community Development Services
P.@. Box 9718
Yedfbral Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609
i
.0,
Mechanical Permit #: 07- 104975 -00 -MF
Inspection Request Line: (253) 835 -3050
Project Name: WASHINGTON STATE LOTTERY OFFICE
Project Address: 33701 9TH AVE Sr r t Prel Number: 926480 0180
Project Description: Installation of (1) new 5 -ton rooftop unit and curb. This permit includes all supply air
ducts, new returns, air ducts and new diffusers associated with the RTU.
Owner
Applicant
Contractor
SIMON & JOHNSON
TEMP CONTROL MECH SERVICE CORP
TEMP CONTROL MECH SERVICE CORP
HERB SIMON & THEODORE JOHNSON
8310 30TH AVE NE
TEMPCMS065QP 10/23/09
1019 PACIFIC AVE S SUITE 1119
LACEY WA 98516
8310 30TH AVE NE
TACOMA WA 98402
LACEY WA 98516
Additional Permit infortr tlon
Mechanical Valuation .................. ..........................25374 Over the Counter Permit?....... ............................... No
Air HandWW Vnits ......................... 1 Ducts..... ...... ............................... 1
FIhALED
•Y
' THIS CARD IS TO REMAIN ON -SITE f ,
ClT,►OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 104975 -00 -ME
Owner: HERB SIMON & THEODORE JOHNSON
Address: 33701 9TH AVE S
FEDERAL WAY, WA 98003 -6762
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
G
By Date w_ 'p By Date Date // a
For inspector reference only _
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
CITY OF
Federal Way RECEIVED
PERMIT -�- �- - ��� �. q �
COMMUNNTYDEVELOPMENCSERVICES SF MF CO vp tr1) EL PL DE EN FP
33-325 FEDERAENUB SOUTH A 98063 97185 1 10 20 qk P P L I CA T I O N `/
FEDERAL WAY, FAX 98063 -2609 / 1 r TO
253 - 835• 2607• FAX 253- 835.2609
www. cif itaAetieralwat
1.t y OF FEDERAL WYAY
The following is re f *A0efbi'n —'an incomplete application will not be accepted. Please print legibly (in ink) or type..
—PROPERTY •. •
SITE ADDRESS 3S7r' 1 q /`iV� tS[� • �C�.` 4 ?��(� SUITE /UNIT #
ASSESSOR'S TAX /PARCEL # LOT SIZE (s]
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
TYPE OF PERMIT
(Attach aepam[e page for ferWthy IegW de - ipdonj - -
PROJECT • •
❑ BUILDING ❑ PLUMBING MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu)
PROJECT NAME (Name of Business or Owner Last Name) (Iv O 9! l
PROPERTY
OWNER
CONTRACTOR
COPY o[ uc regn
with .1 10 b
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAME
e.�rb
PRIMARY PHONE
(a53) a7a - L
MAILING ADDRESSp S4 fill
10 \ { a ^�.
CITY, STATE, ZIP
N1I�.
E -MAIL ADDRESS
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
a7
CITY,TATE, ZIP
CELL PHONE
o n 7 -et
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
OI
FAX NUMBER
(3(9 0) 491 -A9' ?5
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE
r` e_ o� tai�3 0
E -MAIL ADDRESS
COMPANY NAME
Tt,m-.5
APPLI A T NAME
1eb
OFFICE PHONE
(36o) IM3 - 89'70
MAILING ADDRESS,
831 v 30 mac.- ,u F,
CITY, SPATE, ZIP
q 95 l
CELL PHONE
o 50.7 - 0131
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent �tOther 1'��G- �i�"�•/+��"`�✓
FAX NUMBER
( %O) Y9,3 -40C ]CS
NAME
a
PRIMARY PHONE
36 0) S 0-7 - opt 3
E -MAIL ADDRESS
NAME
Per RCW 19.27.095•
Lender informatio is required if project value exceeds $5,000
MAILING ADDRESS
TY, STATE, ZIP
PHONE
EXISTING ASSESSED /APPRAISED VALUE $i
SPRINKLERED BUILDING? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHA
SEWER SERVICE PROVIDER ❑ LAKEHA
PROPOSED
VALUE OF PROPOSED WbIW $ .
,KRE SUPPRESSION SYSTEM PROPOSED /REQUIRED! I ,,❑ YES ❑ NO
❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
9
❑ PRIVATE
AREA DESCRIPTION
EXISTING
8 . FT.
PROPOSED.
S • . FT.
TOTAL
SO. FT.
BASEMENT
BASIC PLAN?
o YES
>60
FIRST
CHANGE OF .USE?
q YES
'SECND
NEW ADDRESS REQUIRED? D Y O
UP /SEPA /SU?
THIRD
YZO
PLATTED LOT? 0 YES kyo
ADDITIONAL FLOORS (DESCRIBE)
a YES
O
DECK (0 COVERED OR ❑ UNCOVERED ?)
GARAGE O CARPORT O
�.
NUMBER OF FLOORS
susnso
r rosao
Tor
"TAL E n=m sr
romz Pgaposw sr
TOTAL ar
*NEW HOMES ONLY" NUMBER OF BE OOMS ES TED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part'of this project: Do not include existing fixtures xtures to remain.
Value of Mechanical Work $ 37 yam_ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITHAPPLICATION)
_ AIR HANDLING UNITS EVAPORATIVE COOLERS OAS PIPE OUTLETS WOODSTOVE3
BBQS . FANS GAS WATER HEATERS MISC (Describe)
BOILERS FIREPLACE INSERTS HOODS (c..,dq .
COMPRESSORS FURNACES RANGES
_j_ DUCTS GAS LOG SETS REFRIO. SYSTEMS
BATHTUBS JwTub /show.rcombmj LAV.S (9.1..111.4 URINALS MISC (Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS tT.11.9
ELECTRIC WATER HEATER_ S SINKS WASHING MACHINES
HOSE BIBB$ 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 authorised by the owner of the above premises to perform the work for which the permit application is made. 1 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 ctai Q, which may be made by any person, including the undersigned, and /tied 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
TO PROJECT D Owner 17 Agent x Contractor
0 Architect o Other
0 NEW o ADDITION 0 ALTERATION
o REPAIR 7nENANT IMPROVEMENT
BUILDING SHELL ONLY? DYES kNO
BASIC PLAN?
o YES
>60
ZONING DESIGNATION
CHANGE OF .USE?
q YES
O
NEW ADDRESS REQUIRED? D Y O
UP /SEPA /SU?
o YES
YZO
PLATTED LOT? 0 YES kyo
DEMO PERMIT REQUIRED?
a YES
O
Bulletin #100 —April 2, 2007 . Page 2 of 4 k \Handouts\Permit Application