17-102656 echanical
City of Federal Way
F I L Permit #:17-102M6
Community Development Dept Pel][Illi. 56-00-ME
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax (253)835-2609
Project Name: FEDERAL WAY GROCERY OUTLET
Project Address: 32945 PACIFIC HWY S Parcel Number: 172104 9068
Project Description: Remove&replace like for like self contained grocery store refrigerated cases.
Owner Applicant Contractor
R&R FEDERAL WAY LLC REBECCA HORTONSOURCE SOURCE REFRIGERATION/HVAC INC
5800 PRINCETON AVE REFRIGERATION&HVAC INC (GENERAL)
SEATTLE WA 98105 5506 SE INTERNATIONAL WAY SOURCRI995PE(12/13/17)
MILWAUKIE OR 97222 3902 W VALLEY HWY N
AUBURN WA 98001
Additional Permit Information
Mechanical Work Valuation9 46000 Is this an Online or O.T.C.application9 No
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Refrigeration Systems 1
CONDITIONS:
1. Separate plumbing permit required for all new plumbing fixtures.
PERMIT EXPIRES Monday,26 February,2018
Permit Issued on Friday,July 28,2017
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: ('t 11+-C� Date: q/(/l 7
THIS CARD IS TO REMAIN ON-SITE
"TvoF ` Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 17 102656 00 Address: 32945 PACIFIC HWY S
Project: R& R FEDERAL WAY LLC FEDERAL WAY WA 98003-6407
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.
El Mechanical Rough-in(4165) ,® Gas Piping(4125) ,
g p' g ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date _'c DatP \Z— (•
•
❑ Rough Electrical ❑ Final Electrical ❑ Right of Way
Approved Approved Approved
•
By Date By Date By Date
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I 47, 1 �
CITY OF PERMIT APPLICATION
Federal Way PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
253-835-2607+FAX 253-835-2609+permitcentel#cityoffederalway.com
,/n a I l 5s5-/
PERMIT NUMBER I 1 1 0 V
5 C., M_ 6TARGET DATE 1!3 0
1
SITE ADDRESS
SUITE/UNIT#
32945 Pacific HWY S Federal Way, WA 98003
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 46,000.00 1 7 2 1 0 4 - 9 0 6 8
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING a MECHANICAL ❑ DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT Grocery Outlet# 154
Remove & replace like for like self contained grocery store refrigerated cases
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
Grocery Outlet Store 253-835-9025
PROPERTY OWNER MAILING ADDRESS
32945 Pacific HWY S E-MAIL
CITY STATE ZIP
Way WA 98003
Federal Wa
NAME -- _. __ -. _ .. _
Source Refrigeration & HVAC PHONE888-473-3715
MAILING ADDRESS E-MAIL
CONTRACTOR 800 E Orangethorpe Ave
CITY STATE ZIP FAX
Anaheim CA -12801
WAST LICENSE# EXPIRATION DATE FEDERAL 6LICENSE
—
#3JI033V2-00oL
NAME PRIMARY PHONE
Rebecca Horton
APPLICANT MAILING ADDRESS E-MAIL
5506 SE International Way rhorton@sourcerefrigeration.com
CITY STATE ZIP FAX
Milwaukie OR 97222
NAME
PROJECT CONTACT Rebecca Horton PRIMARY PHONE
503-327-3266
MAILING ADDRESS
EMAIL
(The individual to receive and
respond to all correspondence 5506 SE International Way rhortonOsourcerefrigeration.com
concerning this application) CITY STATE ZIP FAX
Milwaukie OR 97222
NAME
PROJECT FINANCING El OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP
(RCW 19.27.095) 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 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.
SIGNATURE: DATE
PRINT NAME:_ 1• ,ea F. / I o r`7 o ISI
Bulletin#100—January 29,2016 Page 1 of 2 k:AHandouts\Permit Application