07-103442 \ 4
yyy� RECEIVED • 3 S( 7 aZ
CITY OF + p 7--_
Federal Way juN 2 5 2007 PERMI 0
COMMUNITY DEVELOPMENT SERVICES SF MF CO PL DE EN FP
33325 8Ta AVENUE SOUTH•PO BOX 9718 j/
FEDERAL WAY.IVA 9�/ 1' =EDERAL 1LY PPLI CAT • , 1 D � I
203 835-2607•FAX 25 0
leo aI cllal(ederahea,'AlUI ,DING DEPT,
1
The following is required information-an incomplete application will no b a accept•F. Please print legibly(in ink)or type.
/� • PROPERTY INFORMATION
SITE ADDRESS /p!O 5 3 /8Th 6 71e F e/ SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# D 9 (71-1 0 � - 9 A 0 W LOT SIZE(sj)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page/or lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu)
�JMol,AL ,4Nn .2NSTAL1.4Trc '�t/ Ot 4i.4c7 L.Jak14, 10x6-727x47- c.v -
'Nd NTT elLL4TSo�t1 m .FA-11.4 tu,�I F4-N.
PROJECT NAME(Name of Business or Owner Last Name) )- if F i"5 FOOL)
• PEOPLE INFORMATION
PROPERTY NAME ^ ,` PRIMARY PHONE
OWNER #4 0_5C/'i 1 ,vvRITAIE�v� P e i/p g /.r0s ( ) -
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
CONTRACTOR C MPANY NAME APPLICANT NAME OFFICE PHONE
1 p i1- cowl
/let
co. �a� (463)876 - 993-3
MAILING ADDRESS I C STATE,ZIP CELL PHONE
)14/) 67 NI) Aim' 4RNXtd4 o D ' (ao5) Seo - 76,8
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
as-e,6- /ol 9/9 - ao 8z- 1c3/3//07 (cS3)&7‘ -993y
COPY of card required CONTRACTOR'S REGISTRATION NUMBER EXP TION ATE rsitiv AIL ADD SS
with each application I � F' �', Q N
4M 3.l EGC o! A1.✓ 1m/o` / 7 aol;c, (.0,4 .cosy
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
54�U A5 Cel 124c-rolL . ( ) -
MAILING ADDRESS CITY,STATE.ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT � � FAX NUMBER
❑ Architect ❑ Tenant ❑Agent ''Other WV4 c �,44G7G ( ) -
PROJECT / PRIMARYPHONE
CONTACT okra. 4kEi44t/ GOO) S/0 - 76I0 NtA�DpD oSS 4,oe.0
o1^1
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( )
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER E LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
G ‘odc-1/1Y9
.
• L. ■ PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ FT. SQ.FT.
,
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑COVERED OR ❑UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
■ FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work$ 315-00.OO(A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS I FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(commercm])
COMPRESSORS FURNACES RANGES
IDUCTS 5Y5T6"1 GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(0)rub/Shower combo) LAVS(Bathoom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS umico
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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 ma,e 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,j a cit inc ding its of rs and employees,upon the accuracy of the information supplied to the city as a part of
this application.
I
NAME/TITLEI' ` DATE 6/" � O 1` 7
(Sign/ure) � (Title)
RELATIONSH l' 0 PROJECT a Owner ❑ gent d ‹-itractor a Architect a Other
FOR OFFICE USE ONLY
❑NEW ❑ADDITION ❑ALTERATION E REPAIR TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES NO BASIC PLAN? ❑YES ❑NO
ZONING DESIGNATION CHANGE OF USE? ❑YES ❑NO
NEW ADDRESS REQUIRED? E YES ❑NO UP/SEPA/SU? ❑YES ❑NO
PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? o YES ❑NO
Bulletin#100—April 2,2007 Page 2 of 4 k\Handouts\Permit Application
City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609
a
!I
Mechanical Perml #: 07- 103442- 00 -lME
Inspection Request Line: (253) 835 -3050
Project Name: HERFY'S BURGER
Project Address: 1640 S 318TH PL Suite A ' Parcel Number: 092104 9208
Project Description: Installation /reconfiguration of ductwork & diffusers for tenant space, including installation
of exhaust fan.
Owner
Applicant
Contractor
SEATAC VILLAGE SHOPPING C
AMBIENT CONTROL CO INC (GENERAL)
AMBIENT CONTROL CO INC (GENERAL)
1121 SW SALMON ST
1411 R ST
AMBIECC101PW (10/25/07)
PORTLAND OR
AUBURN WA 98001
1411 R ST
97205 -2000
AUBURN WA 98001
Additional Permit information
Mechanical Valuation ................. ...........................3500 Over the Counter Permit? ...................................... Yes
rep, - U1N
A
Mechanical Futures
Duc .
.............................
��il��an
M
......... ............................... 1
rep, - U1N
A
N'
a
d
OWN-
PERMIT EXPIRES Thursday, June 25, 2009
Permit Issued on Monday, June 25, 2007
I hereby certify that the above infoyMatiom is correct and that the construction on the above described property and
the occupancy and the usn'n4cordan9#pwi the laws, rules and regulations of the State of Washington
d of Federal Way.
Owner or agent Date: /i' //� 7
• THIS CARD IS TO MAIN ON -SITE .
CITY 'OF tommunity Develo m nt Ins ection Record
p p
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 103442 -00 -ME
Owner:
Address: 1640 S 318TH PL Suite .A
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 q -A - cj
For inspector reference only _
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date