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07-105325City c4 Federal Way Coimnuhity Development Services P.O. -Box 9718 Federal Way, WA 98063 -9718 Ph: (253) 835 -2607 Fax: (253) 835 -2609 Mechanical Permit #: 07- 105325- 00 -,ME. Inspection Request Line: (253) 835 -3050 Project Name: FRED MEYER Project Address: 33702 21ST AVE SW Parcel Number: 930100 0010 Project Description: ALT - Install new gas line for Hobart bakery oven. Disconnect old electric ovens & reconnect to new gas oven. Replace exhaust fan. Owner Applicant Contractor FRED MEYER PORTLAND MECHANICAL CONTRS INC PORTLAND MECHANICAL CONTRS INC 3800 22ND AVE 2000 SE HANNA HARVESTER DR PORTLMCO24KA 2/27/08 PORTLAND OR 97202 MILWAUKIE OR 97222 2000 SE HANNA HARVESTER DR MILWAUKIE OR 97222 Addiit t :na i Permit information Mechanical Valuation ................. ...........................8000 Over the Counter Permit ? .......... ............................Yes Mechanical Fixtures Fans. ....... ................................. 1 Gas Pipe Outlets ............................. 1 PERMIT EXPIRES Friday, September 25, 2009 Permit Issued on Tuesday September 25, 2007 i hereby certify that. the above information iS correct and that the construction on the above desfted property and the occupancy and the use will be to accordance with the haws, rules and regulations of the State of Washington and the City of Federal Way. Owner or agent: i /7i� L t! %� Cam) L� C ze— Date: THIS CARD IS TO REMAIN ON -SITE CITY of Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050 PERMIT #: 07- 105325 -00 -ME Owner: FRED MEYER Address: 33702 21 STAVE SW FEDERAL WAY, WA 98023 -7762 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 L, � Dateq % By G Date �i-Z ..d For rector reference only ❑ Rough Electrical ❑ FINAL - Electrical Approved Approved By Date By Date ' CWT OF 1RECEIV E® ©� - Federal Way HERMIT COMMUNITY DEVELOPMENT SERVICES SEP 2 5 Zoo SF MF CO( IE EL PL DE EN FP 99925 FEDERAL A , WlTN • PO BOX 9718 L I CATI O N FEDERAL WAY, WA 98063 -9778 253- 835- 2607• PAX 253- 895 -2609 Cfi,`� 0 F� ww w. cituoffederWwau.com BUILDING DEPT. The following is required information - an incomplete application will not be accepted. Please print legibly (in ink) or type. SITE ADDRESS _S5 1 0,e-7 �f�C�t SUITE /UNIT # ASSESSOR'S TAX /PARCEL # q 3 � li C - 0 LOT SIZE (sl LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) (Attach separate pW for Wn9tJ L-g.1 d —HpH.W PROJECT • • TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING eMECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM PROJECT NAME (Name of Business or Owner Last Name) T %j -cy^ 11 1 PROPERTY OWNER �b CONTRACTOR APPLICANT NAM 1 � tl�t PRIMARY PHONE - MAILING ADDRESS I7 ,STA ZI '�P'�-y-I} Q E -MAIL ADJ` DRESS MPANY NAME APPLICANT NAME APPLICANT NAME rn OFFICE PHONE AACD MAILING ADDRESS ,')Dm se HannaAwyn4w CELL PHONE Dr CITY, STA W , ZIP ( ELL PH ON - C1 Le 9 CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATI N FAX N BER -I ._ UQ —6t— 19-/-::3 I ^l ZQ (�Cs) (06r -1)(0 2d CONTRACTOR'S REGISTRATION NUMBER E%PIRA ON DATE E -MAIL ADDRESS -PART W LO 2 K A amin' COMPANY NAME APPLICANT NAME OFFICE PHONE MAILING ADDRESS CITY, STATE, ZIP CELL PHONE RELAMONSHIP TO PROJECT ❑ Architect ❑ Tenant ❑ Agent O OtherJ.A FAX NUMBER PROJECT h PRIMARY PHONE E -MAIL ADDRESS CONTACT I n V LENDER EXISTING USE NAM UPS Per RCW 19.27.095: Lender information is required (f project value exceeds $5,000 MAILING DRESS CITY, STATE, ZIP PHONE ( PROPOSED USE EXISTING ASSESSED /APPRAISED VALUE $ VALUE OF PROPOSED WORK $ ,1t—D SPRINKLERED BUILDING? VYES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO WATER SERVICE PROVIDER LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) SEWER SERVICE PROVIDER HAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC) AREA DESCRIPTION EXISTING S . FT. PROPOSED S . FT. TOTAL S . FT. BASEMENT Value of Mechanical Work $ COPY OF B E TE MUST BE INCLUDED WITH APPLICATION) AIR HANDLING UNITS FIRST GAS PIPE OUTLETS WOODSTOVES BBQS FANS tli Y Yea"► { SECOND BOILERS FIREPLACE INSERTS HOODS (Commercial) THIRD FURNACES RANGES DUCTS ADDITIONAL FLOORS (DESCRIBE) REFRIG. SYSTEMS UP /SEPA /SU? DECK (❑ COVERED OR ❑ UNCOVERED ?) ❑ NO PLATTED LOT? GARAGE ❑ CARPORT ❑ DEMO PERMIT REQUIRED? ❑ YES NUMBER OF FLOORS "18MG ertoeoeao Torwt, rorwtMvefR"OSr TOTAL rxoPaesosr rorwar "NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ Indicate number of each type of fixture to be !led e t as part of is project. Do not include existing fixtures to remain. MECIi4MCAL ❑ TENANT IMPROVEMENT Value of Mechanical Work $ COPY OF B E TE MUST BE INCLUDED WITH APPLICATION) AIR HANDLING UNITS EV TIVE COOLERS GAS PIPE OUTLETS WOODSTOVES BBQS FANS tli Y Yea"► { GAS WATER HEATERS MISC (Describe) BOILERS FIREPLACE INSERTS HOODS (Commercial) COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS REFRIG. SYSTEMS BATHTUBS (or Tub /Shower Combo) DISHWASHERS DRINKING FOUNTAINS ELECTRIC WATER HEATERS HOSE BIBBS LAYS (Bathroom Sinks) RAINWATER SYST SHOWERS SINKS SUMPS URINALS VACUUM BREAKERS WATER CLOSETS (Toilet) WASHING MACHINES MISC (Describe) 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 mg 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. Ifurther 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 ut of the reliance o{ the city, including its officers and employees, upon the accuracy of the information supplied to the city as a part „ f,tb.(Japplication. / A and /or ❑ NEW o ADDITION ❑ ALTERATION o REPAIR ❑ TENANT IMPROVEMENT BUILDING SHELL ONLY? ❑ YES ❑ NO BASIC PLAN? ❑ YES ❑ NO ZONING DESIGNATION CHANGE OF USE? o YES o NO NEW ADDRESS REQUIRED? ❑ YES ❑ NO UP /SEPA /SU? o YES ❑ NO PLATTED LOT? ❑ YES ❑ NO DEMO PERMIT REQUIRED? ❑ YES ❑ NO Bulletin #100 — August 16, 2007 Page 2 of 4 k\Handouts\Permit Application