12-104580 • III Meolancal
City of FederalWay Permit #: 12-104580-00-M E
Community&Econ.
Dev.Services
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 '• L It-,........ '.-�; P q
Project Name: FARMERS INSURANCE
Project Address: 33650 6TH AVE S Unit 110 Parcel Number: 926480 0210
Project Description: Modifications to existing low pressure supply and return distribution system
Owner Applicant Contractor
SUNLIFE ASSURANCE CO CANADA PUGET SOUND REFRIGERATION HVAC& PUGET SOUND REFRIGERATION HVAC&
600 UNIVERSITY ST SUITE 503 MECHANICAL SERVICES(GENERAL) MECHANICAL SERVICES(GENERAL)
SEATTLE WA 98101 PO BOX 27073 PSRHVMS924JT(4/30/14)
SEATTLE WA 98125-1473 PO BOX 27073
SEATTLE WA 98125-1473
Additional Permit Information
Mechanical Valuation 20225 Is this an Online or O.T.C.application Yes
mechanical Fixtures
Air Handling Units. 1 Ducting 1
CONDITIONS:
Subject to field inspection without plans.
PERMIT EXPIRES Saturday, April 6, 2013
Permit Issued on Monday, October 8, 2012
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: l,,, Date: 1 d- `12-
-.0
fixe„:
to,4o4z
• THIS CARD IS TO IN ON-SITE
CITY OF Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 12-104580-00-ME Address: 33650 6TH AVE S Unit 110
Project: SUNLIFE ASSURANCE CO CANAD 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.
0 Mechanical Rough-in(4165) El Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By ftc Date ''2"7 --/z By Date , 'By-3"C S Date I('-3Q---/
❑ Rough ElectricalEl Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
•
CITY OF F� I�/ED PERMIT SF MF CO PL UE EN FI'
Federal
coonr�NIT1'DEVEwpMc ICl0 8 2012 APPLICATION
'k. 253 835-2607•FAX 253 -2609
tc,riv.,11110//ecicruitnili.com
om
CITY OF FDERAL WAY
SITE ADDRESS cosc
SUITE/UNIT#
33650 6th Ave. S Federal Way WA 98148 104
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 20,225 9 2 6 4 8 0 0 2 1 0
TYPE OF PERMIT ❑BUILDING ❑ PLUMBING .J MECHANICAL
E DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT Farmers Insurance Ridgewood Center
('Tenant Na, e/llomeowner Last Name)
Make HVAC modifications to the existing low pressure supply and return distribution
PROJECT DESCRIPTION
Detailed description of work to system
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Norris, Beggs&Simpson
MAILING ADDRESS E-MAIL
600 University St. Suite 102
CITY STATE ZIP
Seattle WA 98101
NAME PSR Mechanical PHONE 206-367-2500
MAILING ADDRESS 3132 NE 133rd Street E-MAIL
CONTRACTOR jason.jensen@psrmechanical.com
CITY Seattle STATE ZIP FAX
WA 98125 206-368-6856
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
PSRHVMS924JT 4 20 14 20-04-101543-00-BL
NAME PHONE 206-255-3809
Jason Jensen
APPLICANT MAILING ADDRESS E-MAIL
3132 NE 133rd Street jason.jensen@psrmechanical.com
CITY STATE ZIP FAX
Seattle WA 98125 206-368-6856
PROJECT CONTACT NAME Jason Jensen PHONE
206-255-3809
(The individual to receive and
respond to all correspondence MAILING ADDRESS 3132 NE 133rd Street E-MAIL
jason.jensen@psrmechanica.com
concerning this application)
CITY Seattle STATE ZIP 98125 FAX206-368-6856
ALTERNATE CONTACT NAME: PHONE E-MAIL
Haul Goto 206-367-2500 paul.goto@psrmechanical.com
PROJECT FINANCING NAME Norris, Beggs& Simpson iC OWNER-FINANCED
Required slue of$5.000 or more p
(0l"11-/0.27.00.0 MAILING ADDRESS,CITY,STATE,ZIP PHONE
600 University St. Suite 102
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: _ IV ' DATE 1 6A/7
Jas•-'ensen
PRINT ' E:
Iiullclin 0101/ I,IIttIJry I. 'III I P;i_c I of K II:ni:I:sti, l'crni:i -Ahhlic;iti:m
• •
ME( FINTPRES
_
VALUE OF MECHANICAL WORK 20,225.00
$ (a copy of bid or estimate must be provided)
Indicate how many of each type o//ixture to be installed or relocated as part o/this pr'oject. Do not include existing fivtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS X OTHER(Describr)
AIR CONDITIONER FIREPLACE INSERTS I IOODS rc,n„norriatl VAV Box
BOILERS FURNACES 11OT VNATER TANKS(Gas(
COMPRESSORS GAS LOG SETS REFRIGERAITON SYS('
X DUCTING GAS PIPING WOODSTOVES
PLUMBING FIXTURES
Indicate how many(death type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower combo) LAVS Oland Sulks) TOILETS WATER PIPING
DISIMASHERS RAINWATER SYSTEMS URINALS O'IIIER(llrs(ribe)
DRAINS SIIOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER I(EATERS(i ire ro)
HOSE BIBBS SUMPS WASIIING MAOI LINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
S_20,225
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
)(Yes I= No Yes - 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 E CARPORT E
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE S_ #OF BEDROOMS
VO_1119E;RCIAI_— NEW/ADDITION
AREA DESCRIPTION Area Occupancy Construction #of
in Square Feet p y Grou p(s) Type Stories Additional Information
NEW BUILDING
ADDITION
COMMERCIAL — RE:NIODEt,/TTN ANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction #of
in Square Feet p y Type Stories Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
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