11-104104'Mechanical
` city of Federal Way Permit #: 11- 104104 -00 -M E
Community Development Services
P.O. Box 9718
Federal Way, F : (253 835- Inspection Request Line: 253 835 -3050
Ph: (253) 835 -2607 Fax: (253) 835 -2609 p q
Project Name: SAFEWAY FUEL CONVENIENCE STORE
Project Address: 1207 S 320TH ST Parcel Number: 150050 0020
Project Description: Installation of HVAC system for new convenience store.
Owner
Anulicant
Contractor
SAFEWAY INC
SAYBR CONTRACTORS INC
SAYBR CONTRACTORS INC
U S CORPORATE
3852 S 66TH ST
SAYBRCI033L7 (6/14/12)
5918 STONERIDGE MALL RD
TACOMA WA 98409
3852 S 66TH ST
PLEASANTON CA 94588
TACOMA WA 98409
Mechanical Valuation .................. ..........................12400
Is this an Online or O.T.C. application ? .................No
f
Air Handling Units ......................... 1 Ducting............ ............................... 1 Fans................. ............................... 1
PERMIT EXPIRES Tuesday, April 10, 2012
Permit Issued on Thursday, October 1.3, 2011
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent ` Date: tob3l
rl Io
QTY OF
Federal Way
PERMIT #:
11- 104104 -00 -ME
THIS CARD IS TO REMAIN ON -SITE
Construction I ection Record
Q ( )
INSPECTION RE UESTS: 253 835 -3050
Address: 1207 S 320TH ST
Project: SAFEWAY INC 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.
Mechanical Rough -in (4165)
Gas Piping (41 5)
Final - Mechanical (4065)
Approved
Approved to release test
Approved
BQ; S Date
By Date
By �GF Date /47 - - --
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
�.ff:�w.. C
Federal Way ERMIT
'n"PLICATION
sa3- assaeov F,vr xs�•aaaseom
' F FEDERAL WAY
l0 101
SF MF CO ME PL DE EN FP
/0 3l i/
WTZ Al it
GMTRI ONTR e
1207 South 320th Street, Federal Way, WA 98002
PIlOMM VALIIATWN
LONM
AGOMBOMS TA"ARCEL a
$ 12,400.00
CC -F
1 5 0 0 5 0_ 0 0 2 0
TYPE OF PER1wIIT
0 BtTt MMO 0 PLVMINO 471 AERCHliltilCAL
D DZUOLMZON 0 RNG UMNIKING ❑ FUM PRZirf;iMON
NAME OF PROJECT
p'enamtNamr /Homeoumerl�ostName/
Safeway Fuel Convenience Store
Mechanical work for a new convenience store.
PROJECT DESCRIPTION
Detailed desatption of utork to
be Included on this permit Only
MOPSRTY OWFER
MGP IX Sunset Square, LLC, Go Merlone Geier Management
Pwwx
8550 -1
'V8 el Mountain Road #260
d nterlonegeisr.tom
`man Diego
r'i� A 1
92130
Foam
G
�itrtiFt
COPITRACTOR
j
A ATi MA 't LICM
lZlDt�A/T.I�O� UP&
"ManAL '"27"u"
Bob Blair - Safeway Inc.
425- 201 -6401
APMICANT
O Box 85001
Bob.Blair safewa .coo
car Bellevue
WA
z>:98005
VAX 425 -637 -2267
PROJECT CONTACT
tMefndiuklualtorecelvand
Daryn Gilstrap
X
206- 730 -8305
WAUMMADDRUS
3852 So. 66th Street
dgilstrap@saybr.c
respond to all correspondence
conmmb,thts applIMSDW
Tacoma
��253- 531 -2144
Ei98409
COMACT KAM:
Jeremy Jenson
room
206- 423 -069
ZM AM
jjenson @saybr.c
PROJECT FINANCING
NAM
owa=- rsuuaaw
Re"bwd value gJ".000 or more
0XV 1"7.0")
MASMaAAMSq, Orr, WATWZO
8fttttRi
I ceft jt under penalty q/ped WV that I an the property ®caner or authorised agent qF Nee propertft avon r. I swift U&M to the beet
of my knowledge, the irt4wmaltmn aabmitt" In support of this permit application is true and correct. I thst ! artfi +amrepZ[/ whh
=.
an appttcabfe Clgt 4f Vederal May nWulutlens pertalabW to the work sathartsed by the issuance of a l wt4t and tfkst the
inewance of this permit dare not rename the sun girls reepencilAft . fir compliance with focal. state, or federal Sam resuk Eireg
construction or Nesirmunantat taws.
I amass to hod harmless tits City of rodsrai Kay as to any claim iinciu ding oasts, , and attoruW* jI " incurred In
the =sMan and 99%um grsua % cialsO. whIA may be roads 4r any person. dectnding Lhe wailereigrned, and,Jtted Valast dw amt,
but carts erUM such Claim aura out of the reunite aj the elet, including its aOKmrs and emptegars, ujwn the aacanwo d Me
b{pnaatlen to th ► as oft pkia apptteaden.
6Ni1!fATML* TZ O ZL(
PW—I NAM& �otlo 1,-- 1 n'r�Q& - sl Y_ _ kzI
Bulletin #100 -January 1. 2011 Page 1 of 3 k:Wandouts\permit Application
0
VALUE OF MECHANICAL WORK $ 12,400 (a copy of bid or estimate must be provided)
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existin fuchires to remain.
AIR HANDLING UNITS _� FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commeretaq
BOILERS FURNACES HOT WATER TANKS (G-)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
Indicate how many of each type of fixture to be installed or relocated as pct- af'this project. Do not include existing fixtures to remain.
BATHTUBS (or Tub /Shower Combo)
LAVS (nand Sink.)
TOILETS WATER PIPING
DISHWASHERS
RAINWATERS S
URINALS OTHER (Describe)
DRAINS
�SINKS
VACUUM BREAKERS
DRINKING FOUNTAINS
omtty)
WATER HEATERS (eteemd
HOSE BIBBS
SUMPS
WASHING MACHINES TOTAL FIXTURES
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
Lake Haven
Lake Haven
EXISTING /PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
Parking lot
29,500 SF
❑ Yes x No
❑ Yes x No
Bulletin #100 —January 1, 2011 Page 2 of 3 k:\Handouts\Permit Application