06-102181 •
City of Federal Way
Community Development Services Mechanical Permit #. 06-102181 -00-ME
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: CIRCLE K CONVENIENCE STORE
Project Address: 2535 S 320TH ST Parcel Number: 599970 0010
Project Description: Relocate and reinstall HVAC grilles as necessary in new t-bar ceiling
Owner Applicant Contractor
KAYO OIL CO PACIFIC NORTHERN ENVIRONMENTAL PACIFIC NORTHERN ENVIRONMENTAL
315 S JOHNSTONE CORP CORP
BARTLESVILLE OK 1081 COLUMBIA BLVD PACIFNE022MH(7/1/06)
74004-0001 LONGVIEW WA 98632 1081 COLUMBIA BLVD
LONGVIEW WA 98632
Additional Permit Information
Mechanical Valuation 1200 Over the Counter Permit9 No
Mechanical Fixtures
Ducts 5
PERMIT EXPIRES Sunday, October 29, 2006
Permit Issued on Tuesday, May 2, 2006
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
nd the City o ederal Way.
Owner or agent:
T.:// A. Date: 5/0/Q
(4)4 c,c/ s13/06 GSC
• THIS CARD IS TO *MAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 06-102181-00-ME
Owner:
Address: 2535 S 320TH ST
FEDERAL WAY, WA 98003-5443
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) ❑ Gas Piping(4125) Final-Mechanical (4065)
Approved Approved to release test Approved
By Date By Date B h\t� Date ' t
5 ee, 0 .74"105-9 I
C
CITY of 4¢ C \LJ — 1 l I
Federalway ,� ,f 0 2 2006 PERMIT l 5— —1—
SF MF CO
COMMUN77YDEVELOPMENTSERVICES LPL DE EN FP
33325AVENUE SOUTH• BOX 9718 L I G A T I O N
FEDERAL WAY,WA 9806363-9718 OF FEp TD
253-835-2607•FAX 253.835-2609 441. ( / /
www cituoffedemhomt mm 9.114,.OIN
The following is required information-an inco •lete a••lication will not be acce•ted. Please •rint legibi in in or ty•e.
PROPERTY INFORMATION
SITE ADDRESS 2_45-35- 5
9 '-z'� /��j r SUITE/UNIT
_7
ASSESSOR'S TAX/PARCEL# _/ 91 (J - ® 0 J 0 LOT S E(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy regal description)
PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING . 0 PLUMBING /MECHANICAL
0 DEMOLITION ❑ ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlq)
LSC A.r ..S. ke-h--)5 Th'°rt-L. H v'✓j-c__ 1;2r U-ES A
fJel 5 A42-1-/ Ir- NEI 7-. &'NIL Cil ut./G
PROJECT NAME(Name of Business or Owner Last Name) CerJ C.2 C.C., C-i e iA5 K
PROPERTY NAME
Ce. ,,f1
�/ PRIMARY PHONE
OWNER l✓�f-1 oC.s C4 R_CR., i( ( ) -
(0LO A0DDRESSAl 2i" r��STATE,ZIP
CONTRACTOR COMPANY NAME + J I APPLICANT NAME OFFICE PHONE
Otl t ��'li�+"1 C1•1 V i4JAM6r44 ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
/06?1 G.�r.,,dvi ssJ. 1..1A 1 4sn1C-oc " 4 166.11. (360 ) ?5 7 -cc y 7
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
2 C? - U 5- / O i > Cl B L a I 31 /Tvc, . ( )
CONTRACTORS REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT NAME
OFFICE PHONE
N 5ktr 1410 '< 5'1kvC chRiAeC- ( ) z i -77i7
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
.5370 .4.1.--- !r►1cl,0CICJ1t(,%) Portrz,Ar"b . er9. 97Z,�z ( 3) 3Q -275
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant 0 Agent ❑ Other(Describe) (9%93) Z3c, - y s s e
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
Jtt Hou/L.,a. (5'03 ) _36,2 - /005LENDER `-sY * : •0A* 4/4 .N il 4e*, NAME
-1 are€ `,'
MAILING ADDRESS CITY,STATE,ZIP PHONE
( ) -
■. DETAILED BUILDING:INFORMATION , 1.`‘';' .' •a
EXISTING USE OW"MrPROPOSED USE 60_,14.--&...4.4/
EXISTING ASSESSED/APPRAISED VALUE $ A v /P1/4--- VALUE OF PROPOSED WORK $ /,
SPRINKLERED BUILDING? • YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? o YESNO
WATER SERVICE PROVIDER AO :KLHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDE• r. AKEHAVEN 0 HIGHLINE 0 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 0
NUMBER OF FLOORS EICESTINO PROPOSED TOTAL ,t,%1 .74„.0,/,
**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 $ (2 C
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(camm,rcia) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES K MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS =j.,Ji c , �
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(arTub/shower Combo) SHOWERS WATER CLOSETS(rode) MISC(Describe)
DISHWASHERS DRINKING FOUNTAINS
GAS PIPE OUTLETS 'UMPS RAINWATER SYST
WASHING MACHINES U'+ HOSE BIBBS
LAVS(Bathroom see) VACUUM BREAKERS ELECTRIC WATER HEATERS
.4_. ,.-;�.;.,_ , . `:c, :, ,. .,..,:: 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 E� t%J 2--?:.../...-1 DATE _ 51/ 0 6
(Si
m gnature) (Title)
RELATIONSHIP TO PROJECT ❑ Owner 0 Agent /Contractor 0 Architect ❑ Other
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