08-102614 Si,tilof federal Way liP Mechanical Permi••• 08-1 b2614-00-ME
m
Comonly�,hvelopment Services
• P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: PACIFIC RETAIL
Project Address: 31721 PACIFIC HWY S Suite 102 Parcel Number: 082104 9078
Project Description: Installation of ductwork,grills,registers,diffusers,(2)exhaust fans (restroom) and ducting.
Owner Applicant Contractor
DANIEL NIEDER UNIVERSAL REFRIGERATION INC UNIVERSAL REFRIGERATION INC
ELLAYENN'S LLC (GENERAL) (GENERAL)
5363 S KENYON SW PO BOX 614 UNIVERI159RF(4/1/2010)
SEATTLE WA 98118 AUBURN WA 98071-0614 PO BOX 614
AUBURN WA 98071-0614
Additional Permit Information
Mechanical Valuation 3646 Is this an Online or O.T.C.application? No
Mechanical Fixtures
Ducts 1 Fans 2
PERMIT EXPIRES Saturday, November 29, 2008
Permit Issued on Monday, June 2,2008
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
a d th iCity of Federal Way.
Owner or agent y Date: 6/t C8.
♦ ' f 4
DATE INSPECTOR AREA AND TYPE 01 INSPECTION
6 -6-08 C cJ 5e a IL 5 .►�v, 0.1�
�p
THIS CARD IS TO WAIN ON-SITE
CITY OF tommunit Develo mle t Inspection Record
A Y P p
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 08-102614-00-ME
Owner: DANIEL NIEDER
Address: 31721 PACIFIC HWY S Suite 102
FEDERAL WAY, WA 98003
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.
0 Mechanical Rough-in (4165) Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By 1�5 Date 7_z.._es&
For inspector reference only ___
❑ Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
.• /-- :::6 / (-)G/7Z ac_ tf /__
i R � /ra r ., ' 1Z-
�>r< o r - ( 0 2- to (. `f
iedera1Way MAY 28 2dit MIT
1 SF MF CO PEL PL DE EN FP
COMNLRP"Y DEVELOPIdENT SE 3�3iS _ O F F
333258r 1EA'UE SOLTH0PCrJ 881/ AL :��i,t�� A -�`.�._g ffiTI®N �'�
FEDERAL WAY.WA 9806,-9,. '(�
253-835 2607.�A};353 823-2609 r
1 1 /be
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
• PROPERTY INFORMATION
SITE ADDRESS 3/ 7 Z( P -c e, f I W y ,-(-4 SUITE/UNIT# /ol
ASSESSOR'S TAX/PARCEL# 0 8 z ( o4 - 9 0 7 P LOT SIZE (sf
LEGAL DESCRIPTION (e.g.Acme Estates.Lot 1), N 110 FT OF E 1/4 OF S 1/2 OF SE 1/4 OF SE 1/4 LY WLY OF PRIM ST HWY#1 LESS E 132.60 FT
(Attach separate page)Br lengthy legal descrption]
II PROJECT INFORMATION
TYPE OF PERMIT ❑ BUIL"ING ❑ PLUMBING k 1VIECIIANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only)
/qtr .e7( i`• /: iuctwoek'fo^1.l/eflee,is fcycs GA. ciuserc te-r sA(/ (a) es
Grius1 {MR 9f- e.)C/,cebu f' 614.4
4.
PROJECT NAME(Name of Business or Owner Last Name) ] GC - /c Pe r Y
U PEOPLE INFORMATION
PROPERTYPRIMARY PHONE
OWNER NAMEE�,1YA NN/5 LLC_ ( ) -
MAILING ADDRESS CITY.STATE.ZIP E-MAIL ADDRESS
v !
f S. KetA o... 51<. 5ec�ez k/4. G 8//8-iz
CONTRACTOR COMPANY NAME L • APPLICANT NAME OFFICE PHONE
Unt' r t( ? (s eli/tf ion- J�'rY 04e5cEn(1.:40.0“:1401". (2!j) `I?I'Y -1J S_6)]
MAILING ADDRESS / CITY.ST4PE.ZIP CELL PHONE
pc $0?‹ lv/y A146t4«€,1 WA. '7807/ ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
///�/// /9- 99 -/07097-00-f -Z-- /2 ' 3( - 78 (2'13)735- 7Y,Z
V CONTRACTOR'S REGISTRATION NUMBER
u,V/V 7?/ /S9,ff= EXPIRATION DATE
Y—/"-- (o M E- IL ADDRESS
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
'Je.✓v�
- ese-Ct(:,a.unat^ (?.j i) IP( - �S?.)(
MAILING ADDRESS CITY.ST[YIy'E,ZIP CELL PHONE
(2CXo)l`/D -/q5 7
RELATIONSHIP TO PROJECT FAX NUMBER
G Architect ❑ Tenant Q Agent D. Other ( ) -
NAME PRIMARY PHONE E-MAIL ADDRESS
PROJECT
T F7Qt .1 C-741/1/rk (2-9) ' - 5b( b Ya"1 JPU1rivavipt re.el.
LENDER NAME Per RCW 19.27.095: co4
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY.STATE.ZIP PHONE
( )
■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? rc YES 7 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ci YES 7 NO
WATER SERVICE PROW"ER =7 LAKEEAVEN EIIGEILINE tE TACOMA _- PRIVATE(WELL)
SEWER SERVICE PROVIDER C LAKEHAVEN ❑ EIIGHLINE PRIVATE(SEPTIC)
•M
• •
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
Q a SQ.FT. SQ.FT. SQ. FT.
BAMNT r r,
{ * '
FIRST
•
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑COVERED OR ❑ UNCOVERED?)
GARAGE ❑ CARPORT ❑
EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
NUMBER OF FLOORS
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL / / at.Value of Mechanical Work$ ?�tP�� (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS Z— FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(Como-lel-mai)
COMPRESSORS FURNACES RANGES
/ DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS or Tub/Shower Combo) LAVS(Bathroom Sulks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(Toilet)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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
/7
SIGNATURE: DATE
Property Owner and/or Authorized Agent
FOR OFFICE USE ONLY
❑NEW ❑ADDITION c ALTERATION ❑REPAIR c TENANT IMPROVEMENT
BUILDING SHELL ONLY? YES ❑NO BASIC PLAN? c YES c NO
ZONING DESIGNATION CHANGE OF USE? c YES NO
NEW ADDRESS REQUIRED? a YES NO UP/SEPA/SU? ❑YES u NO
PLATTED LOT? u YES a NO DEMO PERMIT REQUIRED? u YES .NO
Bulletin#100-January 1,2008 Page 2 of 4 k\Handouts\Permit Application