09-100452 M€tha'ical
City of Way Permit #: 09-100452-00-M E
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: (253)835-3050
Ph (253)835-2607 Fax (253)835-2609
Project Name: C H ROBINSON
Project Address: 33400 9TH AVE S SUITE 210 Parcel Number: 926501 0060
Project Description: Relocation of existing grilles,diffusers and flexible ductwork to reflect new floor plan
Owner Applicant Contractor
GOLDEN STONE LLC UNIVERSAL REFRIGERATION INC UNIVERSAL REFRIGERATION INC
33400 9TH AVE S (GENERAL) (GENERAL)
FEDERAL WAY WA 98003 PO BOX 614 UNIVERI159RF(4/1/2010)
AUBURN WA 98071-0614 PO BOX 614
AUBURN WA 98071-0614
' i rAdditionalPermit formatio r r0g ,.
1,
Mechanical Valuation 1777 Is this an Online or O.T.C.application? Yes
`' '`,d" • '' s'' e�`r 'ani £' ,,,,,p',,/ - „;” , ,k,_ '4', 1') * -:, ,,* ' P , •,'@ s• x i k
Ducting 5
CONDITIONS:
Subject to field inspection without plans.
PERMIT EXPIRES Sunday, August 2, 2009
Permit Issued on Tuesday, February 3, 2009
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
-r.d the -it o(Federal Way.
Owner or agent: -- ,-, -' �� Date: 2 — o9
r Aihk
THIS CARD IS TfEMAIN ON-SITE "0 ~
CITY OF CommunityDevelopment Inspection Record
Federal
d
Federal ay IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 09-100452-00-ME
Owner: GOLDEN STONE LLC
Address: 33400 9TH AVE S SUITE 210
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.
•
0 Mechanical Rough-in (4165) 0 Gas Piping (4125) ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
By +_ , Date ' c-- `'� °.L—'mak•-�
G (4 Z• l3 09 By Date By, "' Date
For inspector reference only
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
Ai-e-
_.
, . . _
- , n 9
(..) 7 _ (to 0 zi--- 52___
..,..
Federal Way PERMIT — —
SF MF CO,
COMMUNITY DEVELOPMENT SERVICEFEB 0.3 7 � PL DE EN FP
33325E 8T"AVENUEWAY.
WA H9•PO BOX 9718 9718 I CATI O N
FEDERAL WAY.WA 98063-971841!1,,rw, T. / /
253-835-2607•FAX 253-835-2600F
FF 4>
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
• PROPERTY INFORMATION
SITE ADDRESS J 4(0 / 774-A / /4C — (5-ex-fill SUITE/UNIT# 2- (--)C
ASSESSOR'S TAX/PARCEL# 9z_ 6 ) ( - 0 6 0 LOT SIZE(4)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) plie 5 7 CCl vvt/,,,u 5 (Ge. �OVJ k Pry.* a.
(Attach.separate pagefar lengthy/eA description)
El PROJECT INFORMATION
TYPE/OF PERMIT 0 BUILDING 0 PLUMBING f (MECHANICAL
0 DEMOLITION 0 ELECTRICAL (❑ ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only) /Y� Q
/��/UGA f/o 0�2)C(. 7�+-r a N i 1 -5 ( df ,1 2 5 f Gfi�e,0
/Q (4/e G-fh�✓ i [JJ p e le c- f' vle I ( vv; 0 to,.24.
/
PROJECT NAME(Name of Business or Owner Last Name) _� 7tO,L�i 1.,--0li( '61,
• PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
�O(dew tet// --5/001e.- L-L G ( ) -
MAILING ADDRESS e_ CITY,STATE,ZIP W/t • E-MAIL ADDRESS
,jyao `4 7/� S 2-o( Fe�en►'4/ay qq�7
CONTRACTOR COMPANY NAME - APPLICANT NAME ( OFFICE PHONE
UPIirmac( re_f i fs R dro K- j ejt.fey
�e5 (t s.' e.-si . ( ) °7 T -TS-6Y
4CITYMAILING ADDRESS CELL PHONE
�` pc3 11307ce Cv/y f��c.CITY.ST t-i, 14/ `?507/ ( ) -
J
OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
/9_ q'9 -/o7o77-00 - z....- Iz - ( -a9 (2- ))-7, ----- 7Y.,Z.
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
£1N/V ?/ / M / i-''-(- (o
APPLICANT COMPANY NAME APPLICANT NAME f ( OFFFI/CSEPHO) NE
MAILING ADDRESS
'Ve.✓Woy A esc-txl lnafAA°lA CELL PHONE H - , --75-0(D(
p� (2O )5/O -/Y37
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect 0 Tenant >(Agent ❑ Other ( ) -
PROJECT NAME e PRIMARY PHONE r E-MAIL ADDRESS t
CONTACT Fv`yawl at voA (2.-r?) l' ,7 5�D
- ( �jry ,,a., Veti-t +re/�.c(r�✓4` .
LENDER NAME Per RCW 19.27.095: ✓ c...!0(..4
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( ) _
U DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE El TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER o LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)
II PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑COVERED OR El UNCOVERED?)
GARAGE ❑ CARPORT El
EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
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$ /7 7 7 (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS 2.. MISC(Describe)-
,,T—r_
BOILERS FIREPLACE INSERTS HOODS(commercial) 5tz1('4,..{{,5 eV-5
COMPRESSORS FURNACES RANGES
° DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/Shower Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(Toilet)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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 a..lication.
SIGNATURE` DATE Z
/ Property Owner and/or Authorized Agent
FOR OFFICE USE ONLY
o NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? ❑YES ❑NO
ZONING DESIGNATION CHANGE OF USE? o YES ❑NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? ❑YES o NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? ❑YES ❑NO
Bulletin#100—January 1,2009 Page 2 of 4 k\Handouts\Permit Application