05-100867f N
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City uf Federal Way Mechanical Permit #: 05 - 100867 - 00 - ME
Community Development Services
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -7000 Fax: (253) 835 -2609 T Inspection request line: (253) 835 -305a
Project Name: MEAT FOR THE SOUL
Project Address: 34024 HOYT SW SuiteF Parcel Number: 308900 0320
Project Description: Install gas piping for range, hood heater and grill.
Owner
Applicant
Contractor
HOTIE TOYTIE, LLC C/O NICHOLSON INVE
D &M PLUMBING INC *DONALD DRAVIS *
D &M PLUMBING INC *DONALD DRAVIS
2333 CARILLON PT
3211 CENTER ST
3211 CENTER ST
KIRKLAND WA
TACOMA WA 98409
TACOMA WA 98409
98033 -7353
(253) 627 -3300
f \WkIle"
THIS CARD IS TO REIN ON -SITE
- CITY of Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 05- 100867 -00 -ME
Owner: Owne . BRENT NICHOLSO N
Address: 34024 HOYT RD SW Suite F
FEDERAL WAY, WA 98023
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 j - - O y Date - /� %p
...,A RF(*&D
Federal Way PERMIT
COMM1W AVENUE SOUTH SERVICES Z X�PLICATION
33325 8TM AVENUE SOLTN • PO BOX 9718
FEDERAL WAY, WA 98063 -9718
253-835-2607- www. it!m FAX 253-835-26 111-Y OF FEDERAL WAY
www.cituofl'ederalway.com !l,,��
BUILDING DEPT.
The following is reauired information - an incomplete anolication will not be
SITE ADDRESS C 7 A U "C) Y I t< o
ASSESSOR'S TAX /PARCEL # _ _ —
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach separate page for le Wft legal d- -Wt. —)
SF MF CO ME EL ODE EN FP
Please
S UNIT # _
LOT SIZE (sj)
TYPE OF PERMIT ❑ 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) IA-9 4 f}' 77 1Li2/P 7�457 S 01/
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
EXISTING USE
NAME a PRIMARY PHONE
140LA L C -
MAILING ADDRE CITY, STATE, ZIP
COMPANY NAME
D �- jM OblLfIveigo o L
/ .NQi
APPLICANT NAME
C lW
OFFICE PHONE
U-53) boa? - 330 0
MAILING ADDRESS
/ �IV73 —: '
sT.
CITY, STATE, ZIP
(' 4M 9
CELL PHONE
(53 } a---0 - :5475;
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBE -EXPIRATION DATE
-L/ �- L 0 1- B L r� ` ;31 d .S
FAX NUMBER
t 1
CONTRACTORS REGISTRATION NUMBER (copy of card required with each application)
EXPIRATION DATE
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP -
CELL PHONE
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe)
FAX NUMBER
( -
I ctrxjy I
NAME I PRIMARY PHONE E -MAIL ADDRESS
iueax eesis �$�000
NAME
MAILING ADDRESS
CITY, STATE, ZIP
EXISTING ASSESSED /APPRAISED VALUE $_
SPRINKLERED BUILDING? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN
LSEWER SERVICE PROVIDER a LAKEHAVEN
PROPOSED USE
VALUE OF PROPOSED WORK $
FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? O YES
❑ HIGHLINE o TACOMA o PRIVATE (WELL)
a HIGHLINE o PRIVATE (SEPTIC)
o NO
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECU4NICAL
Value of Mechanical Work $ 1
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
BATHTUBS tor—rub/Shower Combo)
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINES
LAVS (B.Oaoom Sinks)
EVAPORATIVE COOLERS
GAS LOGS
REFRIG. SYSTEMS
FANS
eHOODS )co—rdal)
WOODSTOVES
FIREPLACE INSERTS
RANGES
MISC (Describe)
FURNACES
GAS WATER HEATERS
GAS PIPE OUTLETS
ftbd, j — C6JU,,
SHOWERS
WATER CLOSETS (roilet)
MISC (Describe)
SINKS
DRINKING FOUNTAINS
SUMPS
RAINWATER SYST
URINALS
HOSE BIBBS
VACUUM BREAKERS
ELECTRIC WATER HEATERS
I certify under penalty of per, jury 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
tNS application. —/`) , /7
NAME/TITLE 40'!// z4 r ( di i% g= DATE �;:.2
(Signature) — (Title)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent ❑ Contractor ❑ Architect ❑ Other
Bulletin #100 — January 7, 2005 Page 2 of 4 kWandoutsTermit Application