10-104066Mechanical
City of Federal Way
Community Development Services Permit #: 10- 104066 -00 -ME
R o. Box 9718 > u
Federal Way, WA 98063 -9716 Inspection Request Line: 253 835 -3050
Ph: (253) 835 -2607 Fax: (253) 635- 2609 ac 4
` p
Project Name: POVERTY BAY COFFEE CO
Project Address: 1108 S 322ND PL Unit A Parcel Number: 150260 0040
Project Description: Installation of Class I hood and ductwork.
Owner
Applicant
Contractor
POVERTY BAY COFFEE CO
MECHANICAL & CONTROL SERVICES
MECHANICAL & CONTROL SERVICES
1108 SW 322ND PL
(GENERAL)
(GENERAL)
FEDERAL WAY WA 98003
301 PORTER WAY SUITE A
MECHACS962BT (02126112)
MILTON WA 98359
301 PORTER WAY SUITE A
MILTON WA 98359
Mechanical Valuation ................. ...........................8500
Is this an Online or O.T.C. application ? .................No
Ducting.......................................... 1 Fans............ .............................. 2 Hoods.............. ............................... 1
PERMIT EXPIRES Saturday, August 6, 2011
Permit Issued on Monday, February 7, 2011
I hereby certify that the above information is correct and that the construction on the above described propesrty 2B td
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of "Washington
and thePity of Federal Way.
Owner or agen --�` Date:
FrN/tu V /S% I
1
CITY DR
Federal Way
PERMIT #:
THIS CARD IS TO REMAIN ON -SITE r
Construction I>` )ection Record
INSPECTION REQUESTS: (253) 835 -3050
10- 104066 -00 -ME Address: 1108 S 322ND PL Unit A
Project: POVERTY BAY COFFEE CO FEDERAL WAY, WA 98003
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 ( 125)
Final Electrical
Approved
Final - Mechanical (4
Approved
1
Approved to release test
Approved
By
Date _.�
By
Date
By
Date 7 ,2:, _1,1
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
vRECEIV.-J
cNOP SEP L 4' 6 1 PERMIT Federal Way
CO 53M 8 D,LI 38 E °5 M I CATI O N
www.ciluofledera2wau . rom
/vJayaG6
SF MF CO Q EL PL DE EN FP
1-/V /
Bulletin #100 - fanuary 1, 2010 Pape 1 of 4 k• Nan in „+ pP ;r A,,,,1;,.�r —
XROVER V
SITE ADDRESS
►, a �r�
SUITE /UNIT # ZO G
ASSESSOR'6 TAA /PARCEL #
�5 o a a- -12v�
—
MMMM
P130E
NAME OF PROJECT
(Tenant or Homeowner Name)
ro -�
• BUILDING ❑ PLUMBING CHANICAL
TYPE OF PERMIT
• DEMOLITION ❑ ELECTRICAL 0 ENGINEERING ❑ F= PREVENTION
PROJECT DESCRIPTION
Detailed description of work to
'
- -
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Z' J v-r A r. . (as3) 9YS- b61 d'-
MAII3NG ADDRESS, CITY, STATE, ZIP E-MAD,
( sz".' 4-,
k 0 -,
OWNER IS ALSO: CONTRACTOR APPLICANT 'PROJECT CONTACT
PPMEARY PHONE
/
7 7
CONTRACTOR S, CITY, STATE, ZIP FAA
LAACTOKSL�
ENSE EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE
s q/, A P, V- io L162 2 -oo-
- NAME 11-- ,e C PRIMARY PHONE "
C vl..l� ✓1 J c-c_ ( `X 604 iCV( LeJ (0`133) d 6 - 5/ -7 7
APPLICANT Scull
MAH.ING ADDRESS, CITY, STATE, ZIP FAA
O
PROJECT CONTACT NAM�E PRnWARYPHONE
- 1
(The individual to receive and
respond to all correspondence MAILING ADDRESS, CITY, STATE, FAX
concerning this application) 3 u I d 4--P- v 675. ) 9a & - qjd a
ALTF -MIATE CONTACT NAME: PRIMARY PHONE E -MAIL
r V l s LS i"1 (0753) - 77 7 h ui cv • cs . o
PROJECT FINANCING NAME f
OWNER - FINANCED
Requiredfor Cv3
projects with \-�Cca l..-F
value of $5,000 or more MAILING ADDRESS, CftY. STATE, Z_ PRIMARY PHONE
(RCW19.27.095) 5.3) qy ce->)a
1 cert fy under penalty of pe7jury that I am the property owner or authorized agent of the property owner. I certify that to the best
of my knowledge, the information 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.
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 t reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the ci application. ,
S
SIGNATU '"< </' DATE
PRINT NAME: 10v n-}
Bulletin #100 - fanuary 1, 2010 Pape 1 of 4 k• Nan in „+ pP ;r A,,,,1;,.�r —
Value of Mechanical
Indicate number of each type off,
AIR HANDLING UNITS
AIR CONDITIONER
BOILERS
COMPRESSORS
DUCTING
i
re
1w
to be installed or relocated as part o
-;L FANS )
FIREPLACE INSERTS
FURNACES
GAS LOG SETS
GAS PIPING
ruxES :
�71BID oR ESTwATE MUST BE PRC
his project. Do not tnciude extsdr
GAS PIPE OUTLETS
HOODS comma tall
HOT WATER TANKS (G.i
REFRIGERATION SYST
WOODSTOVES
1n2ures to remain.
OTHER (Describe)
v i
�= ' , PIUIVIBING" FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing ftrtures to remain.
BATHTUBS *1 b /shower combo) LAVS (H.dslvlW TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Descn -be)
DRAINS SHOWERS VACUUM BRF 4JCERC
DRINKING FOUNTAINS SINKS rrck" .fu Lg9 WATER HEATERS (saecmrJ
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FI%TLJRFS
Area
.. GENERAL INFORIVIATIQN
PROJECT VALUATION
$ S/ Ste - UJ
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
g
EXISTING /PREVIOUS USE
LOT SIZE (In Square Feet(
EXISTING FIRE SPRINKLER SYSTEM?
❑ Yes ❑ No
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No
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AREA DESCRIPTION (in squaze feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
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FIRST FLOOR (or Mob17e Home)
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SECOND FLO9.Oa�R { �( ', u 141;-. I�t s M "i ( -
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COVERED ENTRY
AREA DESCRIPTION
Area
Occupancy Group(s)
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GARAGE ❑ CARPORT ❑
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PROPOSED
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* *NEW HOMES ONLY:*,
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ESTIMATED SELLING PRICE $
# OF BEDROOMS
Wy RCIAL
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` NEW /ADDITIQN'
AREA DESCRIPTION
Area
Occupancy Grou
Group(s)
Construction
# of
Additional Information
in Square Feet
a
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AREA DESCRIPTION
Area
Occupancy Group(s)
Construction
# of
Additional Information
In Square Feet
Type
Stones
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Bulletin #100 -January 1, 2010 Page 2 of 4 k:\Handouts\Permit Application