11-102922 • Mechanical
Cof Way
Communityity DevelopmentFederal Services Permit #: 11 -102922-00-ME
P.O.Box 9718
Federal'Way,WA 98063-9718 Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax (253)835-2609 p Q
Project Name: ST PAUL TRAVELERS
Project Address: 33650 6TH AVE S Suite 200 Parcel Number: 926480 0210
Project Description: Relocate(4)supply diffusers,(8) return grilles,and install(4)new return air grilles.
Owner Applicant Contractor
SUN LIFE ASSURANCE COMPANY OF PUGET SOUND REFRIGERATION HVAC& PUGET SOUND REFRIGERATION HVAC&
CANADA MECHANICAL SERVICES(GENERAL) MECHANICAL SERVICES(GENERAL)
777 108TH AVE SUITE 103 PO BOX 27073 PSRHVMS924JT(4/30/12)
BELLEVUE WA 98004 SEATTLE WA 98125-1473 PO BOX 27073
SEATTLE WA 98125-1473
Mechanical Valuation 7861 Is this an Online or O.T.C.application? Yes
Mechanic,
Ducting...... 11
PERMIT EXPIRES Monday, January 16, 2012
Permit issued on Wednesday, July" 20, 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 be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: Date: 7/till /`.
Fiu/w%
0 THIS CARD IS T MAIN ON-SITE
CITY°F Construction I ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 11-102922-00-ME Address: 33650 6TH AVE S Suite 200
Project: SUN LIFE ASSURANCE COMPANY FEDERAL WAY, WA 98003-6754
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) 0 Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By /` Date P.-17-#
•
❑ Rough Electrical Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIV D - ( 7 Z C 27
PERMIT
ERMIT
SF MF CO PL DE EN FP
Federal 2 Q st�
COMMUNITY DEVEIAPMENT SERVICES �PPL CATION
253-835-2607•FAX 253-835-2609
••11 ifteI
OF FEDERAL WA
CDS
SITE ADDRESS SUITE/UNIT#
33650 6=` Ave S ZK) C402..
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
06 2. 6 4 8' 0 - 0 2 I 0
TYPE OF PERMIT ❑BUILDING ❑ PLUMBING KMECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT G
(Tenant Name/Homeowner Last Name) 'CftA�/'E LE(ZS ��T I �j_J�1�✓' ,1��r��f/�./
PROJECT DESCRIPTION (ZkicAt6 C.4) SvPP1v P•ccv$G/5, C3) rze*v 4. G2tttc5, ,9rtrJ lln5r*l1 (K)
Detailed description of work to I`'Owl (L001111W AhR 6v-itt"S
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER SUN I fE ASSVPJ 'CE CO „„f cow tie WORILtS 4660 I SIMPSar`)
MAILING ADDRESS E-MAIL
600 votve�czzstcy sf SIE 1024
CITY STATE ZIP
St,ATI‘G c agte!
NAME 1 PHONE
pst tAEctlAmc/rt.. (206) 367 - zs�o
MAILING ADDRESS E-MAIL Mgt*•G ow
CONTRACTOR 3!32 NE 13317D STcow
CITY STATE ZIP FAX
SesttRG trA ars (Z06) 36k- CTS-6
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
1.252kfivtAS'2.4 JT 4 /30 /2 'l . 20-09-rois'13-00-f3L
NAME PHONE
?AUL Gatb (20c) 367-14vv
APPLICANT MAILING ADDRESS E-MAIL
32.32 Nt t33¢P Sr Prwt.• 600 a Psa.#Acd,a.tiem.„Cowl
CITY STATE ZIP FAX
Se/rtT4C wA cans" 600 36fc-eta
PROJECT CONTACT NAME PHONE
(The individual to receive and p L Gan, (ZOC) 367- SSW)
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application) 3132. N3; 13-5120 ST 1:WL.6070 o YSLIIAed,A'NICnL-Com,
CITY STATE ZIP FAX
.54cA fi a '2..4 qv 12 Czd) 368''6 erg
ALTERNATE CONTACT NAME: PHONE E-MAIL
'ital. So.) Ecz- (244)367- Zsdv via •Srnyc,t.B P5Lwt&ch wic..tt..Com
PROJECT FINANCING NAME
OWNER-FINANCED
Required value of$5,000 or more
(RCW 19,27.095) MAILING 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 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 the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of this application.
SIGNATURE:>9'7DATE
PRINT NAME: ! rVL 6:' '
Bulletin#100-January 1,2011 Page 1 of 3 k:Aflandouts\Permit Application
• •
r
MECHANICAL FIXTURES
VALUE OF MECHANICAL WORK $ $',0 I (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 existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLEIb OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(Commercia() W Ri4•0*G Supply P(MJ C/4
BOILERS FURNACES HOT WATER TANKS(Gas) 3 gOlotore tZGtVWJ Games
COMPRESSORS GAS LOG SETS REFRIGERATION SYST 14 'Jew itULIJ LQ.1N/tj
DUCTING GAS PIPING WOODSTOVES
PLUMBING FIXTURES
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 nub/Shower Combo) LAYS(nand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/amity) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes ❑ No ❑Yes n No
RESIDENTIAL _ NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
"NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
In Square Feet Type Stones
NEW BUILDING
ADDITION
COMMERCIAL- EMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
In Square Feet Type Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100-January 1,2011 Page 2 of 3 k:\Handouts\Permit Appli