09-102742 r •
City of FesFeral Way'- • F 1 LE n
Community Development Services r ermiMechanical
t #: 09-102742-00-M E
P.O.Box 9718
Federal Way,WA 98063-9718
IPh:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: LA INTERNACIONAL MINI SUPER
Project Address: 35425 21ST AVE SW SUITE C Parcel Number: 252103 9002
Project Description: Installation of class I hood.
Owner Applicant Contractor
DAVID HOEK J R S CONTRACTING SERVICES J R S CONTRACTING SERVICES
DAVID'S FEDERAL WAY LLC 15827 123RD AVE SE JRSCOCS913CK(2/12/11)
PO BOX 8164 RENTON WA 98058 15827 123RD AVE SE
TACOMA WA 98418 RENTON WA 98058
Additional Permit Igor : i
Mechanical Valuation 3000 Is this an Online or 0.T.C.application? No
Y
Fac EdMechanical Fixture,;s
ell»
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Floods 2
PERMIT EXPIRES Tuesday, April 6, 2010
Permit Issued on Thursday, October 8, 2003
I hereby certify that the above information is correct and that the construction,on the above described.property end
the occupancy and the uswill be in accordance with the laws, rules and regulations of the State of Washington
and City of Federal Way.
Owner or agent: `; Date: .;,...,,i
/0 ._aS_ 2oc
DATE ' INSPECTOR AREA AND TYPE Or YNSPECTION
10/07, ht b� odi 1,�4 f
9 �
•
THIS CARD IS TO R AIN ON-SITE
'..r.A.
CITY OF • Construction In ction Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT#: 09-102742-00-ME Address: 35425 21ST AVE SW SUITE C
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.
0 Mechanical Rough-in (4165) ❑ Gas Piping(4125) 0 Final-Mechanical(4065)
/Approved n ) / /� Approved to release test Approved
By �; '�/ Date ,5� / �J �!/1 By ct..., _ t Date
111•0114/t-0c> .By Date/4/0,y-
'
' ,
El Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
error MIT
Dag
47,
C•(11,7 EL PL DE EN FP
Federal Way � 2
COMMUNITY DEVELOPMENT SERVlCE0L 2 P L I CATI O�N ' l
253-8352607•FAX 253-8352609
www.dtwfederdwau.co cm ®F FEDERA
�s �., ...a .S.. .,....��,t.n ....E_.< ". . .
SITE ADDRESS
39125--6 �.l ,4v 5 h✓ ffdER*-I1 / WA' 93023
SUITE/UNIT C ZONING ASSESSOR'S TAX/PARCEL•
NAME OF PROJECT \
(Tenant or Homeowner Name) L A" �,N)`Er I ICM C 1aA.IA PA;t4 t S
0 BUILDING 0 PLUMBING 'MECHANICAL
TYPE OF PERMIT
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING �❑ FIRE PREVENTION
■ +_i O nI OOT
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
t f } 3rd € r 6""n >^rix" ' „ """ """"
NAME
PROPERTY OWNER 1>'Jjr) oe (2010 )PRi1MARTPHG- bb
MAILING ADDRESS,CITY,STATE,ZIP E-MAIL
o" 72 re)viev4/71. prfC
OWNER IS ALSO: o CONTRACTOR 0 APPLICANT 14 PROJECT CONTACT
NAME PRIMARY PHONE
'QRS CoN4tOCAit41' See J I'CE'S 2010 • 1 - o2 r,5'
CONTRACTOR • , FAX
sE r,, ► e (,o5S . .61120
WA STATE CONTRACTOR'S LICENSE 9 EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE N
Tr5CaG5913GK i 12•. Rem 2a •laobob-'ao
NAME PRIMARY PHONE
APPLICANT SCMeS S 2 CZE S N Zo- 3c11 - 02.67
MAILING ADDRESS,CITY,STATE,ZIP FAX
=Z. 2S ' 'J 5E $b(o J2- (472.
PROJECT CONTACT NAME PRIMARY PHONE
(The individual to receive and Z'A rhe S S z C.z E Sl\. 2°- 391 - 0 L''5"
respond to all correspondence MAILING ADDRESS,CITY,STATE,ZIP
concerning this application)
ALTERNATE CONTACT NAME: PRIMARY PHONE E-NAIL
PROJECT FINANCING NAME
OWNER-FMANCED
Required for projects with
value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE
(RCW 19.27.095)
I certify under penalty of perjury that I am the property owner or authorised agent of the property owner.I certify that to the
best of my knowledge,the information submitted in support of this permit application is true and correct.I certify that I will comply
with all applicable City of Federal Way regulations pertaining to the work authorised by the issuance of a permit.I understand that
the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred
in the investigation and defense of such claim), which may be made by any person,including the undersigned, and filed against the
city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the ci as a part of this application.
SIGNATURE: DATE 7/Z0/07
PRINT NAME: J .. -C-7..e5 N
Bulletin#100—4/17/2009 Page 1 o 4 k:\Handouts\Permit Application
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Value of Mechanical Work$ — (A COPY OF BID OR ESTIMATE MUST BE PROVIDED)
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS dip GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS APIssm, HOODS(commercial)
BOILERS FURNACES HOT WATER TANKS pee)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING ' • GAS PIPING WOODSTOVES
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Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo) LAYS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS . ' RAINWATER SYSTEMS, " URINALS OTHER(Describe)
DRAINS - SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS440414*-
SINKS(Kimbini/Utilky) WATER HEATERS(Electric)
HOSE BIBBS • SUMPS WASHING MACHINES •••14:"q"AkfrPF7WiT,";!--:-.'1:•-•H
• -
..76FeXEIZALINFORAMTION'il''
PROJECT VALUATION WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE lin Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
DYeso No DYes 0 No
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AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL
FORGrICE USE
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;
•
FIRST FLOOR(or Mobile Home)
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EINCIVOMIIMWSIMEMMIVAXIMNkItVAINNISi4NrgnMEMMINMENENEammadilus
COVERED ENTRY
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GARAGE D CARPORT El
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Miln :=1,111" ttimailsimpropg:
=WHIM PROPOSED TOTAL
Area Totals
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ESTIMATED SELLING PRICE$ #OF BEDROOMS
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— AREA DESCRIPTION Area Feet Construction #of
Occupancy Group(s) Additional Information
in Square _Type _Stories
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ADDITION
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AREA DESCRIPTION Area Construction #of
in SquareFeetOccupancy Group(s) Additional Information
,Stories,
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TENANT AREA ONLY
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Bulletin#100-4/17/2009 Page 2 of 4 k:\Handouts\Permit Application