11-104024City of Federal Way • • Mechmical
community Development Services Permit #. 11 -1 04024 -00 -M E
P.O. Box 9718
Federal Way, WA 98063 -9718 Inspection Request Line: 253 835 -3050
Ph: (253) 835 -2607 Fax: (253) 835 -2609 p p
Project Name: SAFEWAY FUELING FACILITY - CONVENIENCE STORE
Project Address: 1207 S 320TH ST
Parcel Number: 150050 0020
Project Description: MEC - Install refrigerated cases and roof top refrigeration units to new convenience store
Owner
ARDlican
Contractor
MGP IX SUNSET SQUARE LLC
TRUETEMP NORTHWEST INC (GENERAL)
TRUETEMP NORTHWEST INC (GENERAL)
425 CALIFORNIA ST FLOOR 11TH
1627 45TH ST E SUITE 101
TRUETN1077KK (6/9/12)
SAN FRANCISCO CA 94104
SUMNER WA 98390
1627 45TH ST E SUITE 101
SUMMER WA 98390
Mechanical Valuation ..................... .......................11805.00 Is this an Online or O.T.C. application? ................. No
Compressors / Heat Pumps............ 2
PERMIT EXPIRES Wednesday, April 11, 2012
Permit Issued on Friday, October 14, 2011
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the us will be in ccorda a w' h the laws, rules and regulations of the State of Washington
a th ity of Federal Way.
Owner or agent: Date: /U �f / Y f/
FINWM I1/3 /II
CITY OF As�'
Federal ti'llay
PERMIT #:
Project:
• THIS CARD IS TO MAIN ON -SITE
Construction In ection Record
INSPECTION REQU TS: (253) 835 -3050
11- 104024 -00 -ME Address: 1207 S 320TH ST
MGP IX SUNSET SQUARE LLC FEDERAL WAY, WA 98003 -5339
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.
0 Mechanical Rough -in (4165)
Gas Piping (4125)
Final - Mechanical (4065)
Approved
Approved to release test
Approved
By Date
By Date
By Date ,�• -� �/
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
- F8F
e
P' L� PERMIT
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MF
COMMUNNYVI PMENTSERVICES
253u35 -2607• FX 253 -835- T AP P LI CATION
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SITE ADD R p�^
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SUITE /UNIT M
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PROJECT}
VALUATION
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ASSESSOR'S TAX/PARCEL *
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1 TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING >(MECH:ANICAL
❑ DEMOLITION ❑ ENGINNEEJRING/ ❑ FFIIR'jE PREVENTION
NAME OF PROJECT
(Tenant Name /Homeowner Last Name)
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PROJECT DESCRIPTION
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Detailed description of work to
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be included on this permit only
PROPERTY OWNER
NAME
PRIMARY PHONE
MAILING ADDRESS '
E-MAIL
-11 eN/ut-
STTE
Aw'r�-
ZIP
NAME
LAI MA M
PHONE
MADdNG ADDRESS
r �i. r l: l o l
E-MAIL
CONTRACTOR
C
STATE
ZIP
FAX
3
WA STATE CONTRACTOR'S LICENSE I
r� le LAJI 62-7
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE M
;20-0Y-/03_-5-,0 _-00 -84-
NAME -M G I.rJ .
PHONE 25-?– g2t. / 6 J 0
P
MAILING ADDRESS . �.
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E-MAIL
APPLICANT
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FAR
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PROJECT CONTACT
N
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(The individual to receive and
respond to all correspondence
MAILING ADDRESS
62 y 0' 6 '7 o
E -MAIL
concerning this application)
CI
STATE
ZIP
FAX
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
PROJECT FINANCING
NAW
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CNJ ZY
OWNER - FINANCED
Required value of $5, 000 or more
IRCW 19.27.095)
MAILING ADDRESS, CITY, STATE, Z
VDi
PHONE
yZ�' =4s S - 145-3 0
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best
of my knowledge, the h1formation submitted in support of this permit application is true and correct. I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal taws regulating
construction or environmental laws.
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,
but only where such claim arises out of the relia of the city, including its officers and employees, upon the accuracy of the
irtformation supplied to the city part this a ication.
SIGNATURE: r/ DATE
PRINT NAME: tt/H /� cJ� Li I I'L 4✓�`
Bulletin #100 —January 1, 2011 Page 1 of 3 k:\liandouts\Permit Application
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• s
VALUE OF MEcRAmcAL WORK $ 1 C! (a copy of bid or estimate must be provided)
Indicate how many of each type of fixture to be installed or relocated as part of this pM!ect. Do not include existin fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (Commercial)
BOILERS FURNACES HOT WATER TANKS (Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
Indicate how many of each typc
BATHTUBS (ornb /Shower Combo)
DISHWASHERS
_ DRAINS
DRINKING FOUNTAINS
HOSE BIBBS
to be installed or relocated as
LAVS (Hand Sinks) _
RAINWATER SYSTEMS _
SHOWERS _
SINKS (iatchen/Utmty)
SUMPS
f this project. Do not include
TOILETS _
URINALS _
VACUUM BREAKERS
WATER HEATERS (e)eowo)
WASHING MACHINES
rng fudures to remain.
WATER PIPING
OTHER (Describe)
CRITICAL AREAS ON PROPERTY? I WATER PURVEYOR I SEWER PURVEYOR ( VALUE OF EXISTING DIPROVEMENTS
EXISTING /PREVIOUS USE LOT SIZE (In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? I PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No ❑ Yes O No
Bulletin #100 —January 1, 2011 Page 2 of 3 k:\Handouts\Permit Application