07-105806�• '
City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609
Mechanical Permit 007-105806-00-ME'
Inspection Request Line: (253) 835-3050
Project Name: LAKEHAVEN UTILITY DISTRICT
Project Address: 31627 1ST AVE S Parcel Number: 072104 9017
Project Description: Install (2) 2 -ton A/C units to servicer room an� replace 3 -ton system on rooftop.
Owner
Applicant
Contractor
LAKE HAVEN UTILITY DISTRI
T. I. NORTHWEST CORP.
T. L NORTHWEST CORP.
LAKEHAVEN UTILITY DISTRICT- WATER
121 23RD S7 SE
TINORC*044JK (8/1/09)
OPERATIONS
PUYALLUP WA 98372
121 23RD ST SE
iAVEN UTILITY DISTRICT- WATER OPERA
PUYALLUP WA 98372
PO BOX 4249
FEDERAL WAY WA 98063
Additional °PPermit 1itf6rmatian
Mechanical Valuation............................................35685 Over the Counter Permit? ...................................... No
I hereby certify that the above information its correct and that the construction on the above described property an
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 agen : Date: �d 2
THIS CARD IS TO#MAIN ON-SITE
CITY OF ` rte., tommunityDevelopment Inspection Record
rc
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 07 -105806 -00 -ME
Owner: LAKEHAVEN UTILITY DISTRICT- WATER OPERATIONS
Address: 31627 1 ST AVE S
FEDERAL WAY, WA 98003-5201
'I'!iis 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.
Mechanical Rough -in (4165)
0 Gas Piping (4125)
Final - Mechanical (4065)
Approved
Approved to release test
Approved
By
Date
By
Date
By
Date
For inspector reference only__ _
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
RECEIVED
QTY OF
0-7— I L
Federal Way PERMIT
COMMUNI7YDEVELOPMENT SERVICES OCT Y. 8 200 SF MF CO ®EL PL DE EN FP
33325 8m AVENUE SOUTH • PO BOX 9718 �PLICATIONTD
FEDERAL WAY, WA 98063-97j$l'T y �Aa HI
253-835-2607• FAX 253-835-26 B �OfWq
wwu�.cihiof(c�deralway.cotn UI NG DEPT, Y
The following is required irtformation - an incomplete application will not be accepted. Please print legibly (in ink) or type.
PROPERTY•. •
SITE ADDRESS 31627 1 st Ave South Federal Way, WA 98063 SUITE/UNIT #
ASSESSOR'S TAR/PARCEL # 0721049017 _ _ _ _ _ _ _ LOT SIZE (sfl 524,026
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) PCL 1 Federal Way
(Attach separate pagefor lengttuj Legal descriptloW
PROJECT• ' •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING Rf MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT NAME (Name of Business or Owner Last Namd Lakehaven Utility District
PROPERTY
OWNER
CONTRACTOR
Y
COPY of card regai
with each applieatto
APPLICANT
PROJECT
CONTACT
LENDER
PEOPLE INFORMATION
NAME
PRIMARY PHONE
Lakehaven Utility District
( 253) 941-1516
MAILING ADDRESS
CITY, STATE, ZIP
E-MAIL ADDRESS
PO Box 4249
Federal Way, WA 98063
121 23rd Street SE
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
T. I. Northwest Corp.
Lindsay Zeth
( 253 ) 445-4104
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
121 23rd Street SE
Puyallup, WA 98372
( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
20 -02 -102036 -00 -BL
12/31/07
( 253 ) 445 -6684
CONTRACTOR'S REGISTRATION NUMBER
EXPIRATION DATE
E-MAIL ADDRESS
TINORC" 044JK
8/1/09
1indsay@tinorthwest.com
COMPANY NAME
T. I. Northwest Corp.
APPLICANT NAME
Lindsay Zeth
OFFICE PHONE
( 253) 445-4104
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
121 23rd Street SE
Puyallup, WA 98372
( ) -
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant 16 Agent ❑ Other
( 253) 445- 6684
NAME PRIMARY PHONE I E-MAIL ADDRESS
Sam Culp (253 ) 445 -4104 ext. 144 1 sam@tinorthwest.com
NAME
Per RCW 19.27.095:
Lakehaven Utility District
Lender irtformation is required (f project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
PO Box 4249
Federal Way, WA 98063
( 253 ) 941 - 1516
EXISTING USE Lakehaven Utility District
PROPOSED USE no chap
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ 35,685.00
SPRINKLERED BUILDING? ❑ YES t NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES NO
WATER SERVICE PROVIDER J6 LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER J6 LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
PROJECT ••• AREAS
GAS PIPE OUTLETS
AREA DESCRIPTION
EXISTING
SQ. FT.
PROPOSED
SQ. FT.
TOTAL
SQ. FT.
BASEMENT
HOODS (commercial)
BUILDING SHELL ONLY? ❑ YES ❑ NO
FURNACES
FIRST
ZONING DESIGNATION
GAS LOG SETS
3 RE MS
SECOND no change
LAVS (Hathroom Sinks)
URINALS
MISC (Describe)
THIRD
VACUUM BREAKERS
DEMO PERMIT REQUIRED? ❑ YES
SHOWERS
ADDITIONAL FLOORS (DESCRIBE)
SINKS
WASHING MACHINES
DECK (❑ COVERED OR ❑ UNCOVERED?)
SUMPS
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
ERIBTING
PROPOSED
TOTAL
TOTAL EIOSTIAO SF
TOTAL PROPOSED SP
TOTAL SF
"*NEW HOMES ONLY*" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
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
Value of Mechanical Work $_L5,685.00
3 AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
PLUMBING
BATHTUBS (nr Tub/Shower Combo)
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
(ACOP OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
EVAPORATIVE COOLERS
GAS PIPE OUTLETS
WOODSTOVES
FANS
GAS WATER HEATERS
MISC (Describe)
FIREPLACE INSERTS
HOODS (commercial)
BUILDING SHELL ONLY? ❑ YES ❑ NO
FURNACES
RANGES
ZONING DESIGNATION
GAS LOG SETS
3 RE MS
❑ NO
LAVS (Hathroom Sinks)
URINALS
MISC (Describe)
RAINWATER SYST
VACUUM BREAKERS
DEMO PERMIT REQUIRED? ❑ YES
SHOWERS
WATER CLOSETS (Toiietl
SINKS
WASHING MACHINES
SUMPS
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further, that I
am authorized by the owner of the above premises to perform the work for which the permit application is made. 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 of Federal Way, 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.
RELATIONSHIP TO PROJECT
❑ Other
1,0119167
FOR OFFICE USE ONLY
❑ NEW ❑ ADDITION
❑ ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑ YES ❑ NO
BASIC PLAN? :i YES
❑ NO
ZONING DESIGNATION
CHANGE OF USE? ❑ YES
❑ NO
NEW ADDRESS REQUIRED? ❑
YES ❑ NO
UP/SEPA/SU? ❑ YES
❑ NO
PLATTED LOT? ❑ YES ❑ NO
DEMO PERMIT REQUIRED? ❑ YES
❑ NO
Bulletin #100 - April 2, 2007
Page 2 of 4
MHandoutsTermit Application