08-105713 Mechanical
City of Federal Way Q
Community Development Services Permit #: 08-105713-00-M E
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: CHRISTIAN FAMILY CARELiges -CAM
Project Address: 33507 9TH AVE S Bldg A Parcel Number: 926500 0020
Project Description: Installation of(2) split-system gas furnace/AC units,including exterior condenser units, (4)
vent fans& ductwork,grilles& diffusers for tenant space. ***To include associated gas
piping
Owner Applicant Contractor
CHRISTIAN FAMILY CARE EVERGREEN REFRIGERATION LLC EVERGREEN REFRIGERATION LLC
8725 S TACOMA WAY (GENERAL) (GENERAL)
LAKEWOOD WA 98499 727 S KENYON ST EVERGRL954R2(1/6/10)
SEATTLE WA 98108 727 S KENYON ST
SEATTLE WA 98108
'74141ditional Permit I nformation
Mechanical Valuation 31500 Is this an Online or O.T.C.application? No
Air Handling Units 2 Ducting 1 Fans 4
Gas Piping 2
PERMIT EXPIRES Tuesday, June 2, 2009
Permit Issued on Thursday, December 4, 2008
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the u e will be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: Date: tL` U/
it
/3eSF --9()
DATE INSPECTOR AREA AND TYPE OF INSPECTION
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THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 08-1057.13-00-ME
Owner: CHRISTIAN FAMILY CARE
Address: 33507 9TH AVE S Bldg A •
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.
❑ Mechanical Rough-in (4165) ❑ Gas Piping(4125) ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
•
•
By ` Date 3 t -fir By� Date 1R —1 % Bydc4c�._� Date Z4,1•3-43 q
•
•
•
For inspector reference only j
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
-• • 'm. • I
CITT OP c / "'� 1 /,-.3.___
Federal Way DEC o l TO"' PERMIT
SF MF CO/ E ' PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES
33325 8TH AVENUE SOUTH•PO BOX 9718
FEDERAL WAY.WA 9718 ; FED�?PLICATION • / /S (g
253-835-2607•FAX 2#3-8051.21599 s,y 1"
www.rituatiede am' r-
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The ollowin• is re•uired in ormation-an incom.lete a••lication will not be acce.ted. Please •rint le•ibi (in ink)or
al PROPERTY INFORMATION
SITE ADDRESS tr% 5. - 5 71 i#+H }s- • 17«`J A SUITE/UNIT# 1-
ASSESSOR'S TAX/PARCEL# 1 Z) z- I 1 S- - 6 0 0 0 LOT SIZE(sf1
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page,/lengthy legal description)
® PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING II74(ECHANICAL
0 DEMOLITION 0 ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
-look II 4 . P14 IN yew r i 41104- ) r 41t ie.,el 4vl){irw t- i l i,1k) e H.4
PROJECT NAME(Name of Business or Owner Last Name) 011.1r 0.1 4,I't^ r 1 1 G oro
• PEOPLE INFORMATION
PROPERTY NAME f PRIMARY PHONE
OWNER (1flY' J4-l6'% .c•4r'v•. 19) C '1.4 ( ) -
MAILING ADDRESS ♦ CITY,STATE,ZIP
3 '-i rti'i IPI 4 � . j.e z fG 4 A "-1 I sk y i i^let
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
Evf1l'jViiv ('t gelf0n tLim V-e' 'tovv.._ ( i. ) 741,-I- % '-7 1
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
7Z? c 4,n— i f#. J-*C..cif-ISG, M1- '1) (ow ( ) -
CMI YOF FEDERAL WAY BUSIIN�ESS LICENSE N�U/MBER EXPIRATION DATE {� FAX NUMBER o,
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
V E., a- b e 1-- o' 5- Lk 12- Z / °r, / 10
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
CO G f c/(-- ( )
MAILING ADDRESS CITY.STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect 0 Tenant 0 Agent 0 Other(Describe) ( ) -
CONTACT NAME ,.,_ PRIMARY PHONE E-MAIL ADDRESS
y,,eo' loW -' (Zu(p+ )7 (13 - 1`11.((4 <Ufy W 1-Ale 11✓Vift.(b"
LENDER Per RCW 19.29.095: Lender information is NAME
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? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
• • r-_
0 II
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT❑
BXISTINO PROPOSED TOTAL TOTAL BXIBSTIPO 8T TOTAL PROPOSED SP TOTAL 8P
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.
MECHANICALalu Mechnical Work $ ��
i ' �� !i (A)/
/(t,k�i "' Q ( L r.
L AIR HANDLING UNITS EVAPORATIVE COOLERS 666 GAS LOGS REFRIG.SYSTEMS
BBgS 4-1 FANS HOODS(Commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES _ GAS WATER HEATERS
$ DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/shower Combo) SHOWERS WATER CLOSEib rroikt) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS _ RAINWATER SYST
WASHING MACHINES NALS HOSE BIBBS
LAVS)Bathroom sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK ,
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.
NAME/TITLE iDATE ) 2- / 1 / ')j1
nature) , (Title)
RELATIONSHIP TO PR CT o Owner ❑ Agent GYContractor ❑Architect 0 Other
is
FOR OFFICE USE ONLY 1P'\ El
o NEW o ADDITION ❑ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES p NO BASIC PLAN? ❑YES o NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? ❑YES o NO
PLATTED LOT? a YES n NO DEMO PERMIT REQUIRED? o YES SI NO
Bulletin#100—January 1,2006 Page 2 of 4 k\Handouts\Permit Application
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