11-103098City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609
FILE
9 Mechanical
Permit #: 11- 103098 -00 -ME
Inspection Request Line: (253) 835 -3050
Project Name: SAFEWAY STORE
Project Address: 1207 S 320TH ST Parcel Number: 150050 0020
Project Description: Installing a new rooftop, packaged unit with associated ducting and exhaust fans.
Owner
ADMican
Contractor
MGP IX SUNSET SQUARE LLC
REFRIGERATION UNLIMITED INC
REFRIGERATION UNLIMITED INC
425 CALIFORNIA ST FLOOR 11TH
5440 S PROCTOR
REFRAJIOI IKS (10/20/12)
SAN FRANCISCO CA 94104
TACOMA WA 98409
5440 S PROCTOR
TACOMA WA 98409
Mechanical Valuation .................. ..........................12500 Is this an Online or O.T.C. application? ................. No
Air Handling Units ......................... 1 Fans ............... ............................... 2
PERMIT EXPIRES Saturday, February 4,
Permit Issued on Monday, August 8, 2011
1 hereby certify that the above information is correct and that the construction on
the occupancy and the use will be in a dance with the taws, rules and regtala
a the City of Federal Way.
Owner or agent: �.
!012
he above described property and
ions of the State of Washington
Date. ZU L
-,
CITY OF 0 ,
Federal Way
PERMIT #:
THIS CARD IS T MAIN ON -SITE
4 Construction I itection Record
INSPECTION REQUTS: (253) 835 -3050
11- 103098 -00 -ME
Address: 1207 S 320TH ST
Project: 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)
Approved
Gas Piping (4125)
Approved to release test
Final - Mechanical (4065)
Approved
By _%> 6 � Date � ` 2 — 1
By Date
By Date � t
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF
Federal Way E C E j\ MIT
COMMUNITYDEVELOPMENT r SERVICES
253 -835 -2607, F A X 253-8 35- 2609
(P LI CAT I O N
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ROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ¢1 MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(TenantNamejHomeowner Last Name)
(�
S A C e �J Cil
PROJECT DESCRIPTION
Detailed description of work to
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be included on this permit only
PROPERTY OWNER
NAME
A W Cl- tAC-
PRIMARY PHONE
MAILING ADDRESS
«2� i2 .,e c
E'�L
C `
STATE
ZIP
NAME
PHONE
MAILING ADWRESS
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CONTRACTOR
CITY `°rACe>,M a
STATE
tAM
ZIP
, o
FAX
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COLR^ ACTOR'S LICENSES
WA STATE E I7LA
F LT �i « k- 5
EXPIRATION DATE
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FEDERAL WAY BUSINESS LICENSE #
NAME
PHONE
APPLICANT
ADD
E-MAEL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
n71e individual to receive and.
respond to all correspondence
concerning this application)
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NwME '°' N C P �t'C
PHONE
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DIALLING ADDRESS
E-MAIL
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CITY
STATE
ZIP
FAX
ALTERNATE CONTACT NAME:
PHONE
E -MAIL
PROJECT FINANCING
NAME
OWNER - FINANCED
Required value of $5,000 or more
(RCW 19.27.095)
DIALLING ADDRESS. CITY, STATE, ZIP
PHONE
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 irfarmation 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 laws regulating
construction or environmental laws.
[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 reliance of the city, including its officers and employees, upon the accuracy of the
information su lied to the city as apart application.
y
SIGNATURE: ~` ?�---- DATE ( 2 2j
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PRINT NAME: 13 G 9-J : A-V `'� l 1) f- & R- VE Pte.
Bulletin #100 - January 1, 2011
Page 1 of 3
k:\Handouts\Permit Application
VALUE OF MECHANICAL WORK
(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 project. Do not include existingfixtures
to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS
OTHER (Describe)
I AIR CONDITIONER
FIREPLACE INSERTS
HOODS (commerdal)
BOILERS
FURNACES
HOT WATER TANKS (Gas)
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING
GAS PIPING
WOODSTOVES
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS (or Tub /Shower Combo)
LAVS (tuna sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Kitchen /Utility)
WATER HEATERS W-ni )
HOSE BIBBS
SUMPS
WASHING MACHINES
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR V F EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE (In Square Feet) EXISTING FIRE SPRINKLER SYS PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No ❑ Yes ❑ No
TMAL
FOR OFFICE USE
TENANT AREA ONLY
Bulletin #100 - January 1, 2011 Page 2 of 3 k:\Handouts\Perniit Application