15-102993 • • MecharicAl
Ci i.'Econral Dev S Permit #: 15-102993-00-ME
Coinmuni &Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line:
Ph:(253)835-2607 Fax (253)835-2609 P q (253) 835-3050
Project Name: JACOBSON
Project Address: 1718 S 288TH ST Parcel Number: 332204 9109
Project Description: Installation of four exhaust fans,venting and grilles/diffusers.
•
Owner Applicant Contractor
JACOBSON LLC B EVERGREEN REFRIGERATION LLC EVERGREEN REFRIGERATION LLC
1718 S 288TH ST (GENERAL) (GENERAL)
FEDERAL WAY WA 727 S KENYON ST EVERGRL954R2(1/6/16)
98003 SEATTLE WA 98108 727 S KENYON ST
SEATTLE WA 98108
Additional Permit Information
Is this an Online or O.T.C.application? Yes
Mechanical Fixtures
Ducting 4 Fans 4
PERMIT EXPIRES Wednesday, December 16, 2015
Permit Issued on Friday, June 19, 2015
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.
! (if
Owner or agent: rDate: ��
THIS CARD IS T EMAIN ON-SITE
Federal WayConstruction I 3 ection Record
INSPECTION REQUE TS: (253) 835-3050
PERMIT#: 15-102993-00-ME Address: 1718 S 288TH ST
Project: JACOBSON LLC B FEDERAL WAY, WA 98003-3260
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.
o Mechanical Rough-in(4165) CI Gas Piping(4125) El Final-Mechanical(4065)
Approved Approved to release test Approved
By p.),,,,t Date —1 16 H 5- By Date By PA-L_ Date '7—it -IS
❑ Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF • PERMI'�APPLICATION
Federal Way RECEIVED
j �� JUN1'92415 i ,-
PERMIT NUMBER t $ - l V � 9 3 _ b 0 LDfp\6/1 —1,�
CIT( OF F'E
SITE ADDRESS CDS SUITE/UNIT#
i1 � 5 . VS c
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 2 ( �l UJ - i - Z ® ►-4 - `� t C� cl
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING IIMECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT Dr', Be�t 5ALv05art
PROJECT DESCRIPTION (
Detailed description of work to J-.► /trb'1 r f 0J\' (i ) u `e" 1 U �1
be included on this permit only �✓ 'I,,.,/ I`4rs
NAME r- ' r / PRIMARY PHONE
PROPERTY OWNER J1.{.,6LS,-, WC-
MAILING ADDRESS E-MAIL
t l t`� � U5S ' 5t ,
CITY F J • " STATE�/ ZIP tt�3
Il!C7/.
PHONE ! (-1(444
7 t ' j
NAME �.v'rvfittot 124-n,1(7,4 1 1-o G -IA 3- (`L"II-I-
MAILING ADDRESS 1 7 u� c E-MAIL,,()
CONTRACTOR L 1 UVC' 14"i/0 Jt. 4,\.t' "C e.,VC rtyll'1 Vae,tO,ti
CITY STATE ZIP FAX �.J
,�'�/ +Nle '[fi�t J x 20 C —1b 3 - 2-3`t`t
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
V a(At,5-12- �> V---2- k / 6 / 16
NAME PRIMARY PHONE e
X.
APPLICANT MAILING ADDRESS E-MAIL
1 271 SCS ke1tiAtL4-I 5A—, t,l, )L Gvir12o,l'1Va'e.u1"‘
CITY . STATE ZIP FAX
. :5r et%tb$ ;,,or_-143 -- 2-319
PRIMARY PHONE • e,
PROJECT CONTACT NAME �`K,^ (sjY� G�.U,} «A
2`I 1
(The individual to receive and MAILING ADDRESS 7 j�, a E-MAIL _
respond to all correspondence t Z-1 5c..%' ke"�1J 6`-, d�-�toLer 1"`tikt..iA., ,
concerning this application) CITY j 'tiff. 1 K- STATES ZIP FAX
T, ei,31 A eta -i ) 2,-W-1
NAME
PROJECT FINANCING El OWNER-FINANCED
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095/
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 tl}e city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy iof the
information supplied to the city as a part of this application.
SIGNATURE: A.).1.------- DATE 6 /11 A 5
PRINT NAME: A`br" EL" �
Bulletin#100-January 1,2013 Page 1 of 3 k:AHandouts\Permit Application
410
• VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $ 1- /(13(-)/(13
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS '°( FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial) _
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
6 DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT $
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or rib/Shower Combo) LAVS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
Yes - No Yes - No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT 0
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ _- # OF BEDROOMS
COMMERCIAL-NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet Type Stories
NEW BUILDING
ADDITION
COMMERCIAL- REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet Type Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin
#100-Januar I. 20 I3 Page 2 of 3 k:AHandouts\Permit Application