16-101036MechRiVcal
City of Federal Way
Community & Econ. Dev. ServicesPermit #: 16 -101036 -00 -ME
33325 8th Ave S
Federal Way, WA 98003 6 1 " tion InS eC Request Ph: (253) 835-2607 Fax: (253) 835-2609 p Line: 253 835-3050
Project Name: ALEXIS SPA SKIN CARE
Project Address: 34428 PACIFIC HWY S Unit A Parcel Number: 889700 0010
Project Description: Replace (1) HVAC roofop unit - like for like
Owner
AoRlican
Contractor
VENIAMIN MIRONYUK
DAN HOGAN
LODESTAR REFRIGERATION CO INC
ALEXIS SPA SKIN CARE
LODESTAR REFRIGERATION CO INC
LODESRCI74KO (5/18/17)
PO BOX 4218
21431 72ND AVE W
6605 200TH SW
FEDERAL WAY WA 98063
EDMONDS WA 98026
LYNNWOOD WA 98036
Additional Permit Information
Mechanical Work Valuation?.................................10000 Is this an Online or O.T.C. application? ................. No
Mechanical Fixtures
Air Handling Units. ........................ 1 Roof Top Units.............................. 1
PERMIT EXPIRES Wednesday, September 14, 2016
Permit Issued on Friday, March 18, 2016
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
and the City of Federal Way.
Owner or agent Date: �6
THIS CARD IS TO REMAIN ON-SITE
CITY or.
Construction Inspection Record
Feaei-ai Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #:
16 -101036 -00 -ME Address: 34428 PACIFIC HWY S Unit A
Project: VENIAMIN MIRONYUK FEDERAL WAY, WA 98003
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)
0
Gas Piping (4125)
❑ Final - Mechanical (4065)
Approved
Final Electrical
Approved
Approved to release test
Approved
By
Date
By
Date
Date
❑
El
Right of Way
Final Electrical
Approved
❑
Rough Electrical
Approved
By
Date
By
Date
By
Date
4ik
CITY OF
Federal Way
PERMIT NUMBER f � _ 1
PjLlqm PERMIT APPLICATION
FEB 2 6 2016
COY?SW3 (x;, - tO i
F FEDERAL WAY
TARGET DATE
SITE ADDRESS
�3q �-I 21� ?Ac i w y 5
SUITE/UNIT M
PROJECT VALUATION
$ iD d oD
ZONING
ASSESSOR'S TAX/PARCEL #
9 GI o o - tv O
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBINGMECHANICAL I]DEMOLITION I]ENGINEERING FIRE PREVENTION
NAME OF PROJECT
, S
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME `
PRIMARY PHONE
PROPERTY OWNER
MAILINd ADDRESS
E-MAIL
CITY
STATE
ZIP
NAME dL
//
PHONE
MAILING ADDRESS
/(/3
E-MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA ST E NT TOWS LICENSE k
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE M
Dde D
iZk.1 I7
NAME
PRIMARY PHONE
APPLICANTMAILING
7
ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME
PRIMARY PHONE /
MAILING ADDRESS
�!/ GtJ •
�j M, AIL
L`r� 1 oh r N��C• ��'�
(The individual to receive and
respond to all correspondence
CITY /
M o17e4S I
STATE
Gt/A.
ZIP
1
FAX
concerning this application)
PROJECT FINANCING
NAME
OWNER -FINANCED
When value is $5,000 or more
(RCW ]9.27095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
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 sqh claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information suppli¢d the city as a part of this application.
t� r
SIGNATURE: '� �� DATE ZZ
PRINT NAME1i
Bulletin #100 — February 22, 2016 Page 1 of 2 k:\Handouts\Permit Application