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07-100309 1 Ir.* City of Federal Way • Community Development Services Mechanical Permit 107-100309-00-IVB 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: CAMILLE VANDEVANTER DENTAL OFFICE Project Address: 33507 9TH AVE S Bldg G Parcel Number: 926500 0020 Project Description: Installation of(2) split systems,duct work, GRDS,pumps,exhaust fans and gas piping in 4 locations Owner Applicant Contractor SOUTH THREE THIRTY SIXTH,LLC EVERGREEN REFRIGERATION INC EVERGREEN REFRIGERATION INC 1611 9TH AVE N 727 S KENYON EVERGRL954R2 01/06/2008 EDMONDS WA 98020 SEATTLE WA 98108 727 S KENYON SEATTLE WA 98108 Additional Permit Information Mechanical Valuation 25095 Over the Counter Permit? No Mechanical Fixtures Air Handling Units 2 Ducts 1 Fans 8 CONDITIONS: PERMIT EXPIRES Monday, January 26, 2009 Permit Issued on Friday, January 26, 2007 • I hereby certify that the above information is correct and that the construction on the above described property and the occupancy and th use wil be in accordance with the laws, rules and regulations of the State of Washington and the City of Federal Way. Owner or agent: Date: /2 47 16' -1 • DATIJINSPECTOR4 AREA AND TYPI'; OV INSPECTI®N //30/07. '. / --"/„,1:-.' .... 1,4„ )t, , Z--/ivi?' ,,;'(, ,4'-.7 --- el(e' . .. L THIS CARD IS TO&MAIN ON-SITE CITY OF rfr 4It ommunity Developnrint Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT #: 07-100309-00-ME Owner: SOUTH THREE THIRTY SIXTH, LLC Address: 33507 9TH AVE S Bldg G 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 c.3 Date 3,21-�7 By . w Dater-WC/ -o7 By Gc,/J Date 3-22 .07 Federal Way c� 01 PERMIT COMMUNITY DEVELOPMENT SERVICES % r°1 SF MF CO SIE EL PL DE EN FP 333258TH AVENUE SOUTH•PO BOX 9718 ��w\ �, ip ��ICATION FEDERAL WAY,WA 980 63-9 718. �`� To 253835-2607•FAX 253-8352609 / '2„..., / C74,,,,,„ uvciy. t,�inf;edemLnaii.coin The ollowingis re of'. QeP ©E,p �i Vat.-an incom.fete a..lication will not be acce.ted. Please .rint le.ibl (in ink)or .e. • PROPERTY INFORMATION � SITE ADDRESS .�. P FT-Th W 9 l "7 SUITE/UNIT#[v G i ASSESSOR'S TAX/PARCEL# 2 1 S 4 1 ` 0 - 0 1 ° LOT SIZE(sf) LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) /// /Attach separate page for lengthy Legal descrtptfoN / • PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING 0 PLUMBING MECHANICAL ❑ DEMOLITION j,;J::(7_+", 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROCT CT DESCRIPTION(Provide detailed description of work included on this permit only) 2) SPi + 5-y SdCi ► S +_ w pM� -t''w CrrlkkS 1 06,4444 CG,�ct�'h(�-�e pvr,r" '�) f 1()M S kof S eine) , r (L I L&C q ;411)" 1 PROJECT NAME(Name of Business or Owner Last Name) "4' (1 M J'I e V C1 ii rrlIAMAI DUAlgi Mme/ • PEOPLE INFORMATION PROPERTY NAME3� p E( PRIMARY PHONE OWNER k I l� FA/A)I1 `/C 1 ( ) - MAILING ADDRESS -4)IOC CITY,STATE,ZIP i 0 1$ 6 4h J B-eino-t , tom- , '17 00 '7 CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE 7 1rer4 (hen 4V) Q�'Y ►-fl6n - TovrC ("0b )'ter 17q4.4MAILING ADDRESS CITY,STATE,ZIP CELL PHONE CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER 2b - 0 - - 10 1 4 51 -B / / (1e0 )iC" - 2,-,1 CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE r V 'f a. 6 q .S' 4 0 2 C / c /) Z APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE ( ) - MAILING ADDRESS CITY,STATE,ZIP CELL PHONE ( ) - RELATIONSHIP TO PROJECT FAX NUMBER ❑Architect ❑ Tenant ❑Agent ❑ Other(Describe) ( ) - CONTACTPRIMARY PHONE E-MAIL ADDRESS N `ND 6 (vvrt (1407P 4 1774 II LENDERper RCW' 5122?095,�.Lender inforn NAME `i required- r41ect vva ue eds$ .,®!s ' MAILING ADDRESS CITY,STATE.ZIP PHONE ( ) - • DETAILED BUILDING INFORMATION EXISTING USE PROPOSED USE EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ SPRINKLERED BUILDING? o YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑ NO WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC) 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❑ EXISTING PROPOSED TOTAL TGTALHHISTINQ AP' i TOTALYROI Q&HD SF:- ` TpTAL St¢ 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 Value of Mechanical Work $ AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS BBQS FANS HOODS(commerota0 WOODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC(Describe) COMPRESSORS FURNACES GAS WATER HEATERS ' DUCTS GAS PIPE OUTLETS PLUMBING BATHTUBS(or rub/Shower Combo) SHOWERS WATER CLOSETS eraiot) MISC(Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS 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 e city,in ding its officers and employees,upon the accuracy of the information supplied to the city as a part of this application. NAME/TITLE DATE 1 /f q // 7 Signature) I (Title) RELATIONSHIP TO PROJECT ❑ Owner ❑Agent Contractor 0 Architect ❑ Other Elt UFkICiSE O ❑NEW F n ADDITION a AI;TERAT'IOI�i n REPAIR � rt SEPI SIT IMP12Q� NT i � BrnLthNG 40SHELL; NTNG1DESIc NATION NEW ADDRESS REQUIRED?� nYES ( NC t g I UP/SEI A/SU? a YES t O PLATTED.LOT? p YES ei,NO ,DEMO PERMIT REQIiIRED? ,` voi*frS Yi g Bulletin#100—January 1,2006 Page 2 of 4 k\Handouts\Permit Application