09-102509 Mechanical
' city of Federal Way • •
Community Development Services
Permit #: 09-102509-00-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: 3 DOG DELI
Project Address: 35425 21ST AVE SW Suite A Parcel Number: 252103 9002
Project Description: Installation of(1) rooftop unit & associated ductwork.
Owner Applicant Contractor
DAVID HOEK AMERICAN ENERGY SYSTEMS AMERICAN ENERGY SYSTEMS
DAVID'S FEDERAL WAY LLC 2921 TALBOT RD S AMERIES147N1(8/28/10)
PO BOX 8164 RENTON WA 98055 2921 TALBOT RD S
TACOMA WA 98418 RENTON WA 98055
Additional Permit Information
Mechanical Valuation 1500 Is this an Online or O.T.C.application9 No
Mechanical Fixtures
Air Handling Units 1 Ducting 1
PERMIT EXPIRES Saturday, January 9, 2010
Permit Issued on Monday, July 13, 2009
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 i 'accordance with the laws, rules and regulations of the State of Washington
nd the City of Federal Way.
Owner or agent: Date: 7 / 3 _0 CI
FIN • !4/o
THIS CARD 1S TO MAIN ON-SITE
CITY°F " "" Construction In._ ection Record. -
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 09-102509-00-ME Address: 35425 21ST AVE SW Suite A
Owner: DAVID HOEK FEDERAL WAY, WA 98023
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.
E Mechanical Rough-in(4165) ❑ Gas Piping (4125) ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By Date
•
•
•
•
•
•
•
For inspector reference only
0 Rough Electrical ❑ FINAL-Electrical
Approved Approved
By Date By Date
,-7
• nn of • ir _ / VC
Way R EC , /
Federal PERMIT
COMMUNITY DEVELOPMENT SERVICES
SF MF CO LPL DE EN FP
33325 8*H AVENUfi SOUTB•PO BOX 9718 0 2 Zoari PP L I C AT I O N
FEDERAL WRY,WA 98063-9718 TD
253-835-2607•FAX 253-835-2609 / /C /
www.dhioffederahvau.com
Cl
The following is required FEDERAL
i inf on-an incomplete application will not be accepted. Please print legibly(in ink)or type.
PROPERTY INFORMATION
SITE ADDRESS -->5`)'2.- S Z I 4v-{ Ski
SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# EA 5 / 0 3 - 6 ® 0 - LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attar* p09t fr lengthy 1.901 dcxriptim/
I. PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING G MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION det,detailed description of work included on this permit mho
PROJECT NAME(Name of Business or Owner Last Name)
n1.4e..,-1i
• PEOPLE INFORMATION
PROPERTY NAME OWNER I ��jjA® �/ i 8-jey) (
/ PRIMARYP HONE -
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRF_4S
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
J}»°1 Edi'Ca �iu-723- f (t4 zs-)z5 s -)SS/7
dO' MAILING ADDRESS C[TY,STATE,ZIP CHONE ZaiZ 1 T�3�r3< ,(S el/i c1�o (75 )ELLPLtv1_cd r�t)
CITY OF FEDE WAY BUS FSS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
/ 7"--&//(
CO R'S=OF
% df97
ON NUMBER EXPIRATION DATE E-MAIL ADDRESS
C(c-00 Z-G f S G .z_ �'tel�-- l 7 iC' )
APPLICANT COMPANY IAMEAPPLICANT NAME OFFICE PHONE
1 .L A;� ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT ( )
FAX NUMBER
0 Architect 0 Tenant 0 Agent 0 Other ( ) -
PROJECT NAME PRIMARY PHONE VEMtL7)DR/E7r.if)CONTACT 0---E-4=--P -1'1v LTE:t_ S-') 24-'1 -�I S 6:4
r3 )XY1,P
LENDER NAME Per RCW 19.27.095: h-et
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE -
( ) -
U DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? o YES „t]-NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO -
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE o TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER o LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
.` PROJECT FLOOR AREAS.
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS mamma raoPOsm TOTAL TOTAL EsaN
f O sr TOTAL PROPOSED sr TOTAL sr
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ •
• FIXTURES
Indicate number of eacirtlfpSaf ftzhtt�to . gtalled or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work$ 500 (A PP OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLIN klyAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS Y ~FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(commeminq
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/shower Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS moo
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURR
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: DATE
Property Owner and/or Authorized Agent
)
f • "'
a NEW a ADDITION a ALTERATION ❑REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES o NO BASIC PLAN? ❑YES a NO
ZONING DESIGNATION CHANGE OF USE? o YES ❑NO
NEW ADDRESS REQUIRED? a YES ❑NO UP/SEPA/SU? ❑YES a NO
PLATTED LOT? a YES o NO DEMO PERMIT REQUIRED? a YES a NO
Bulletin#100—January 1,2009 Page 2 of 4 k\Handouts\Permit Application