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06-1056644 • ty of ay Commun'ityDeveopmentServices Building - Commercial Permit #: 06 -105664 -00 -CO 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: DESERET CANOPY ADDITION Project Address: 2200 S 320TH ST Suite 1A rcel Number: 242320 0050 Project Description: ADD - Metal canopy to cover the front. Owner scan PARK BYUNG & YOUNG SU CHrATTER SUS C OF C & CHAN AY SAI CC 2200 S 320TH ST SUI lA FEDERAL WAY WA FAY WA gory: 9V Comm PO IEFDING LLC K 10/17/2008 'A �36 commercial store Lender Includes: 1 #2 #3 #4 Occupancy Class: OOF Construction Type: Ty III --B Occupancy Load: Floor Areas . ft. 540 0 0 0 Additional Permit Information Existing Sprinkler System in Building?.................YesMechanical to be Included?................................... No Number of Stories..................................................1 Permit for Building Shell Only?............................ No Plumbing to be Included?......................................No Special Inspection(s) Required?............................ Yes New / Additional Sq. Feet - Total .......................... 0 Occupancy # 1 - Use ............................................... Carport S, sitive Areas? (Wetlands/Slopes, etc)................No Zoning Designation ................................................ CC -C No Fixtursi s to This 40_0:_0_40� n 000*"- CONDITIONS: Sprinkler coverage is required for the canopy. PERMIT EXPIRES Sunday, April 19, 2009 Permit Issued on Thursday, April 19, 2007 I hereby certify that the above information is correct and that the construction on the above described property and the occupancy and the usp will be in accordance with the laws, rules and regulations of the State of Washington Yand t e Ci y of Federal Way. Owner or agent: Date: GI THIS CARD IS TO REMAIN ON-SITk- ` CITY OF . Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT #: 06 -105664 -00 -CO Owner: PARK BYUNG & YOUNG SU CHAN Address: 2200 S 320TH ST Suite 1A 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. ❑ Footings/Setback (4110) ❑ Foundation Wall (4115) ❑ Drainage/Downspout (4040) Approved to place concrete Approved to place concrete Approved to backfill By Date By Date By Date ❑ Re -steel (4215) ❑ Slab/Concrete Floor (4255) ❑ Underfloor Framing (4285) Approved to place concrete or grout Approved to place concrete Approved to sheath floor By Date By Date By Date ❑ Shear Walls (4245) ❑ Roof Sheathing (4220) ❑ Floor Sheathing (4105) Approved to install flooring Approved to install siding Approved to install roofing By Date By Date By Date NOTE: Prior to schedu=Framing120) ❑ Framing (4120) ❑ Fire/Draft Stops (4095) Approved inspection; Electrical, Plnical Approved to insulate Rough -in and Fire/Draft ust beBy Date igned-off and approved. 108.5.4 By Date ❑ Insulation (4150) ❑ Gypsum Wallboard Nailing (4130) ❑ Suspended Ceiling Grid (4265) Approved to install wallboard Approved to install mud & tape Approved to drop tile By Date By Date By Date ❑ Final - Fire Department (4060) ❑ Final - Planning (4070) ❑ Final - Public Works (4080) Approved Approved Approved By Date By Date By Date ❑ Final - Building (4050) Approved By Date I • I • CITY OF ' ` . .Buil8irig Division 33325 Eighth Avenue South Federal Way • Fe Box 9718 Federal Way 98063-9718 vz:*�L Phone 253-835-2607 Fax 253-835-2609 INSPECTION NOTICE ADDRESS: `-D0 �p rte—' Sj �- #: 90 6 Z — e,&- 2-169-7 ,&- 2i/D7 /li4) A i .r/i1 dlAll lei IF YOU HAVE ANY QUESTIONS CALL Call for reinspection before cover (253) 835 - WHEN CORRECTIONS HAVE BEEN MADE CALL (253) 835-3050 FOR RE -INSPECTION. SEE BACK OF CARD FOR DETAILS. DATE SPECTOR DO NOT REMOVE THIS NOTICE Page of F__ INSPECTION NOTICE ADDRESS: Z�c7 5. 3 S IX #: =�G7 J�•� tr�� '®� � o �"/��'C ,�U�L�7�NC-�/U.3�i���s✓ ,�C'�sT?c./��T� ��i' �d�` �'c�7L.�/�� . 10 q&Z,9V A-69 4,011-41Wk- Ave - 4 0A /?0101 �i0�%t� �v/L 'ii+�r.S /p/�.�L,Z-� ` W�/Z�� /�%'L•/�ty �SIJ/�'�/'f�/7'�s ; 2,0, / of rJee 1490mym) s j /; Mdvorlzap. �N ,�-Uf1i /%�✓ Tb 7Z±g- Z N -Z77�rs-r A 4«T�r h-- F-&kt ger%d/ V fp"I ok- same p/e 14t, .S,•C�fi'f2 .,- ,� r!d (ems/NG�o`tl�/��T`�vi✓ /.S �.+�J�C �J�ca/Z itrf�i�lJ .4-� }�o7Z/ `Z d� IF YOU HAVE ANY QUESTIONS CALL g� ,"/,,Ot 6°N�i ay 2_{253) 835- ; Z? -3 Call for reinspection before cover WHEN CORRECTIONS HAVE BEEN MADE, CALL (253) 835-3050 FOR RE -INSPECTION. SEE BACK OF CARD FOR DETAILS. DATE INSPECTOR DO NOT REMOVE THIS NOTICE j I Page C of / 'BuilaiMg Division CITY OF 33325 Eighth Avenue South Federal Way Fe Box 9718 Federal Way 98063-9718 V::A�L Phone 253-835-2607 Fax 253-835-2609 INSPECTION NOTICE ADDRESS: Z�c7 5. 3 S IX #: =�G7 J�•� tr�� '®� � o �"/��'C ,�U�L�7�NC-�/U.3�i���s✓ ,�C'�sT?c./��T� ��i' �d�` �'c�7L.�/�� . 10 q&Z,9V A-69 4,011-41Wk- Ave - 4 0A /?0101 �i0�%t� �v/L 'ii+�r.S /p/�.�L,Z-� ` W�/Z�� /�%'L•/�ty �SIJ/�'�/'f�/7'�s ; 2,0, / of rJee 1490mym) s j /; Mdvorlzap. �N ,�-Uf1i /%�✓ Tb 7Z±g- Z N -Z77�rs-r A 4«T�r h-- F-&kt ger%d/ V fp"I ok- same p/e 14t, .S,•C�fi'f2 .,- ,� r!d (ems/NG�o`tl�/��T`�vi✓ /.S �.+�J�C �J�ca/Z itrf�i�lJ .4-� }�o7Z/ `Z d� IF YOU HAVE ANY QUESTIONS CALL g� ,"/,,Ot 6°N�i ay 2_{253) 835- ; Z? -3 Call for reinspection before cover WHEN CORRECTIONS HAVE BEEN MADE, CALL (253) 835-3050 FOR RE -INSPECTION. SEE BACK OF CARD FOR DETAILS. DATE INSPECTOR DO NOT REMOVE THIS NOTICE j I Page C of / COMMUNITYDEVELOPMENT TDEPARTMENT & ASSOCIATES, INC. MAY 312007 GEOTECHNICAL ENGINEERING • ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING & INSPECTION May 30, 2007 City of Federal Way Building Department PO Box 9718 Federal Way, WA 98063-9718 RE: Final Letter Regarding: Federal Way Deserett Industries Federal Way, WA To Whom It May Concern: Project No. 066-07055 Pmt No. 06 -105664 -00 -CO In accordance with your, request and authorization, we have performed special testing and inspection services for the above referenced project. The special inspections for this project were: • Reinforced Concrete • Proprietary Anchors • Structural Steel To the best of our knowledge, all work which has been tested and/or inspected has been found to be in general accordance with the approved plans and specifications, engineering revisions, and Chapter 17 of the 2006 International Building Code. If you have any questions or if we can be of further assistance, please do not hesitate to contact our office at (253) 939-2500. Respectfully submitted, KRAZAN & ASSOCIATES, INC. Kathryn E. Gordon Project Manager Puyallup Division Cc: C&C Mobile Welding, LLC, Attn: Chris Campbell With Offices Serving The Western United States 922 — Valley Avenue NW Suite 101 • Puyallup, WA 98371 9 (253) 939-2500 11 Fax: (253) 939-2556 65/1812067 16:10, 3668795624 CK MOBILE WELDING PAGE 01 V*JrUZan & Associates, Inc. GEOTECHNICAL ENClNEERNG - ENVIRONMENTAL ENGINeIAING CONS'rkucTION TESTING AND INSPECTION )ATE: 3"14, "0�1 �'ROJE;CT #: DSS ` "ROJECT ��J.S�(�esere_ L _OCATION: ajim S. — <RAZAN PROJECT MANAGER: ­ FIELD REPORT NO: CONTRACTOR: ( -c L ,ob;(C 66242 JURISDICTION:_ f y E�e,�l &Vic•/ " PERMIT7 INSPECTOR; WEATHER' A tZIM i + its i . i� 4G* ' «'i _ .r,� l �Lr 11 irnIGSC DrWSi1 l ily �qn4 n V Equipment/Asset Number(s): (o the best of my knowledge, the obov/171�111A / WAS NOT performed In accordance with the approved pl(Dns, specificatlans, and regulatory requirements, 5ugerin tandent/Representative: Serving the 14 15w Ffe/d Aejwrr.&,(- 7toykioo I Effccalve Dila5)25M)5 �+.. ..�..__....._ .....,.n.., .n i., ........ 1.. ....,...,...i .�,. ,f....., i�,..,,..,�., ,.1'.1.. .•I l.,,r '�',.....,.w ...�.� ,..n N• . n...l,w.n 1�� 1nv fl -1,11 wlrk n.....r„ n nvr ii i, ­if tAc viicn[ and Krurttn & A.zmiatw. QUANTUM I CONSULTING ENGINEERS PROJECT MEMORANDUM TO: DATE: Chris Campbell 5/01/2007 C&C Mobile Welding, LLC BY: PROJECT: John Riley, PE DONATION CENTER CANOPY PROJECT NUMBER: 5178.01 RE-. Wind Screen Wall Framing — Donation Center Canopy, Federal Way, WA The wind screen wall is constructed with 4" by 20 GA horizontal light -gauge steel girts spanning between columns and located on top of the concrete curb and at 4' on center maximum vertical spacing up to the top girt located along the underside of the canopy roof support edge beam. The girt flanges are shot pinned to each steel tube column and the screen wall metal decking is screwed to each girt flange to complete the assembly. This framing support for the wind screen wall is acceptable as constructed. Please feel free to give me a call if you have any questions at my direct line 206-957-3906. Sincerely, Quantum Consulting Engineers C. jolZRiley, , P.E. Principal y+ 1 1511 THIRD AVENUE SUITE 323 SEATTLE, WA 98101 TEL 206.957.3900 FAX 206.957.3901 www.quantumce.com PV 05/02/2007 12:48 FAX 10 004. r44 & ASSOCIATES, INC. GEOTECHNICAL ENGINEERING • ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING & INSPECTION April 20, 2007 KA No. 066-07055 i Mr. Chris Campbell Q p .Z , C & C MOBILE WELowci, LLC PO Boz 1422 Graham, WA 98338 --- i i RE: In Process Inspection Report Federal Way Deserett Industries FEDERAL WAY, WASHINGTON Dear Mr. Campbell, ! Enclosed are copies of the compressive strength test results regarding the above referenced project. If you have any questions or if we can be of further assistance, please do not hesitate to contact our �ffice. i Respectfully submitted, KRAZAN & ASSOCIATES, INC. Thomas L. Watson Project Manager Puyallup Division iLW/pm Cc City of Federal Way Attn: Fernando Femandez(fernando.famandea@cityo$ederalway.com) Offices Serving The Western United States ! 922 Vallcy Avenue NW Suite 101 • Puyallup, Washington 98371 • (253) 939-2500 • Fax: (253) 939-2556 07055 Meek 05/02/2007 12:48 FAX 10005 Icrazan Associates, Incr 1501 -15th Street NW Suite 106, Aubum, WA 96002, (253) 939-2500 Project No. 066-07055 i. Code 070065 Pour Date 311 )07 1 Report No. 18716 Weather Partly Cloudy Jurisdiction City of Federal Way Permit No. Not on site Project Federal Way Deserett Industries Engineer Location 2200 320th Street Architect Client CSC Mobile Welding, LLC contractor C & C Mobile Field Data CYLINDER REPORT Reported Batch i Data Concrete X Other Date Specimens Read. 3/19/2007 Cyt. i Design Actual Field Weights Weights Supplier COrIISS Plant No. 2 Site Mix Comp. Mix No. C1600A C1 600A i Date Cern. lbs. ! No informatio Mix Air Unit C.F. F. Ash lbs. Provided by Slump Temp, Temp. WL Set # By Type C. agg. lbs. r )supplier Time Truck# Ticket # % Air (in.) (F) (F) (pef) 3/23/2007 C. -egg. lbs. 2 10:20 74 29331 4° 55 58 12.56 C. agg. tbs. 3 40304 3,200 Sand lbs. X ASTM C39 070065 Water lbs. Placement Area 4x8 Air Ent. (oz) Location Placed for truck pad and loading dock at rear of Thrift 55179 Other (oz) Store ASTM Clog other (oz) 4/130007 128 Other (oz) 12.56 0.0 Other (oz) 4,350 JS NNA Water Added oilp Job als. 13 I i I Field Test Methods Remarks Placed via truck chute and consolidated by H/F vibrator x ASTM C143 x ASTM C138 I x ASTM C106 ASTM C173 x ASTM C31 X ASTM 0172 Please refer to Field Report No. 66242 OTHER ASTM 0231 Inspector S. Hyatt, Jr. Laboratory Data Design Strength 3,000 @ 28 days Date Specimens Read. 3/19/2007 Cyt. Test Field Max. Comp. Tested Br*ak Laboratory Code Date Cure Wkge Dim. Area C.F. Load Str. (psi) Set # By Type Test Methods 070065 3/23/2007 17 4x8 12.56 0.0 40304 3,200 BH NyA X ASTM C39 070065 4/13/2007 128 4x8 12.56 0.0 55179 4,390 JS NIA ASTM Clog 070065 4/130007 128 4x8 12.56 0.0 54613 4,350 JS NNA ASTM C617 070065 H 4x8 070065 070065 070065 070065 Remarks Results Reviewed By� Date Reviewed I Codes for Break Types: 1 Cone 2: Cone & Split 3: Cone & Shear 4: Shear Measurement Uncertainties: ASTM C-39 +/- 8% Fm 031cm FaMw_ 3 Eff**" MD S41M TM MKvmo.4on pv klwl"ft­ n t popaee for r. uaM.�ir w+As efniK TW resort me, rOt be MWWUne In ons roma WKPW rw Wd%n pdnetrbn of f e dM .b 02M a AypC6 X ASTM C1231 ASTM C780 Other Test Results X Conforming i Non -Conforming 5: Columnar (Split) WELDING INSPECTION =KraZan & Associates, Inc. REPORT NO.: 4561 GEOTECHNICAL ENGINEERING • ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE:❑�`% CONTRACTOR: C �eW''�'�`'",/ -- PROJECT#:PERMIT NO: PROJECT: t r%l{i'c %tt.�' .r�'✓Pl- a�11� Jr /t,.t, INSPECTOR: lrr:r✓irac' LOCATION: ' = 12 r` JURISDICTION: 0 Y a / rc'! KRAZAN PROJECT MANAGER: WEATHER: /r,F'G•'e%Gc`i`b�iN TEMP:r STRUCTURAL STEEL ❑ FIELD/ SHOP WELDING i4l- V.T. item(s) inspected: ❑ MATERIAL ID ❑ U.T. ❑ M.T. ❑ P.T. Location ❑ Welder qualification/certification verified for: a,,Z7 7J S- 5" !� Q Position: 164 Process: ® Weld Type: Weld Size ® Codes: ❑ NOTES - FLAT_ VERITCAL -$,MAIN FCAW F[L-L-ET C. P. 3/16" 1/4", HORIZONTAL OVERHEAD GMAW SAW P.P. PLUG 5/16" 3/8" AWS AfSG- TITLE 21 ❑ DISCREPANCIES IIIrrrIIIIIAN11 p Filler Metal: e 7C 16? /` ':f-;c7ee ❑ Other: R1 Other: Other:: f'7 RAJ UBC ASME ❑ r� % COMPLETE .moi /?.�"L�t�r �tff' C>f "3 „i'f -�P Ct'..� /!"'�i'Lf+�'J�I�CF , `t`.�'ir°.ai�v ✓ �/�3.r�f � ��t1�°e'.. ,�. "�'r� ,�r�> 5�?t', �r�`"��i r' h /Qt'cr°a."f,J +�i'rx t'�f✓ rt-'"t%'°�t,%( Q; e..r C-4 .�- To the best of my knowledge, the above'WAS / WAS Superintendent/Representative: 215 West Dakota Avenue, Clovis, Ca 93612 4231 Foster Ave., Bakersfield, CA 93308 1025 Lone Palm Ave. Ste. 2E, Modesto, CA 95351 545 Parrott St., San Jose, CA 95112 723 Commerce Circle, Sacramento, CA 95875 NOT performed in • (559) 348-2200 • (661) 633-2200 • (209) 572-2200 • (408) 271-2200 • (916) 564-2200 accordance with the approved plans, specifications, and regulatory requirements. Technician: 226 N. Sherman, Ste. A, Corona, CA 92880 • (909) 549-1188 1501 15th Street NW, #106, Auburn, WA 98002 • (253) 939-2500 20714 State Route 305 N.E., Ste. 3C, Poulsbo, WA 98370 • (360) 598-2126 13434 N. E. 177th Place, Woodinville, WA 98072 • (425) 485-5519 11913 N. E. 103rd Avenue, Vancouver, WA 98662 o (360) 254-3200 ,-.1(raZan & Associates, Inc. GEOTECHNICAL ENGINEERING • ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: PROJECT #: PROJECT: LOCATION: KRAZAN PROJECT MANAGER: Equipment/Asset Number(s): CONTRACTOR: JURISDICTION: PERMIT #: INSPECTOR: WEATHER: FIELD REPORT NO: 83503 TEMP: To the best of my knowledge, the above WAS / WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician: Serving the Western United States 1501 Field Report.doc Revision 1 Effective Date: 5/25/05 The information provided on this report is prepared for the exclusive use of the client. This report may not be reproduced in any format without the written permission of the client and Krazan & Associates. =,--.Krazarz & Associates, Inc. GEOTECHNICAL ENGINEERING • ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: PROJ ECT #: 00,015-20"75 PROJECT: LOCATION:' KRAZAN PROJECT MANAGER: Equipment/Asset Number(s): CONTRACTOR: JURISDICTION: PERMIT #: INSPECTOR:_ WEATHER: FIELD REPORT NO: 83502 TEMP: To the best of my knowledge, the above WAS / WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician: Serving the Western United States Meld Report.doc Revision 1 Effective Date: 5/25/05 ^mation provided on this report is prepared for the exclusive use of the client. This report may not be reproduced in any format without the written percussion of the client and Krazan & Associates. cm or Federal Way z000 PERMIT COMMUNITYDEVELOPMENT SERVICESt4ov O 33325 87H AVENUE SOUTH • 63 BOX 9718 e�pc^ , L I C AT I O N FEDERAL WAY, WA 98063-9718 � f GVV 253-835-2607• FAX 253-835-26 '�'Y www.at federalwau.com SUILD�NG 0- &- - 10 -'ff -�Q & --�/ SF MF CO ME EL PL DE EN FP TD/J M n ,,.fin The olloudn is re uired in ormation - an incom lete a lication will not be acce ted. Please rint le ibl in ink or PROPERTY INFORMATION SITE ADDRESS _2200 South 320th Street, Federal Way, WA SUITE/UNIT # ASSESSOR'S TAX/PARCEL # _2423200050_ _ - LOT SIZE (sj) _N/A/_ LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) _ 6 EVERGREEN PLAZA AS AMENDED PER REC 20030909000708 LESS W 30 FT FOR RD PROJECT INFORMATION TYPE OF PERMIT )(BUILDING ❑ PLUMBING ❑ MECHANICAL (Attach separate page for lengthy legal description) ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this permit only) The addition of a metal canopy to cover the existing loading dock in the back of the Commercial store front. The back of the building is screened from normal public Viewing by being surrounded by other commercial building backs used for load. PROJECT NAME (Name of Business or Owner Last Name) Deseret Canopy Addition PROPERTY OWNER CONTRACTOR APPLICANT CONTACT LENDER E PEOPLE INFORMATION NAME PRIMARY PHONE Park Byung Chan and Young Su MAILING ADDRESS 2200 South 320th St CITY, STATE, ZIP Federal Way COMPANY NAME UL APPLICANT NAME dvrl. OFFICE PHONE (960 ) 8 5'6 MAILING ADDRESS P©. x �4� CITY, STATE, ZIP 14 11�1 CELL PHONE 000 6)0 11WL CITY OF FEDERAL 7WAY BUSINESS jLICENSE NUMBER EXPIR`AATION DATE 9--0L- iL 1 .0 7 .3 B_ L ),/J I /� FAX NUMBER �0)�` - I -,5,0A_ (CONTRACTS REGISTRATION N�BER (copy of car requiped with each application) EXPIRATION DATE COMPANY NAME The Church of Jesus Christ of Latter Day Saints APPLICANT NAME Tom Evens OFFICE PHONE ( 425) 392 - 1260 MAILING ADDRESS P.O. BOX 2328 CITY, STATE, ZIP Issaquah, WA 98027-0105 CELL PHONE RELATIONSHIP TO PROJECT ❑ Architect X Tenant ❑ Agent ❑ Other (Describe) FAX NUMBER NAME Brian Harron, P.E. PRIMARY PHONE ( 206 )674 - 4659 E-MAIL ADDRESS brian@patrickharron.com Per RCW 19.27.095: Lender information is required if project value exceeds ,$5,000 NAME None MAILING ADDRESS CITY, STATE, ZIP (PHONE l ) EXISTING USE Thrift Store EXISTING ASSESSED/APPRAISED VALUE $ N/ SPRINKLERED BUILDING? X YES ❑ NO WATER SERVICE PROVIDER X LAKEHAVEN SEWER SERVICE PROVIDER X LAKEHAVEN PROPOSED USE Thrift Store VALUE OF PROPOSED WORK $ 40.000 FIRE SUPPRESSION SYSTEM PROPO=D/REQUIRE ❑YES X NO ❑ HIGHLINE iiTACOMA 11P(WELL) ❑ HIGHLINE 0 PRIVATE (SEPTIC) AREA DESCRIPTION EXISTING SQ. FT. PROPOSED SQ. FT. TOTAL SQ. FT. BASEMENT RAINWATER SYST URINALS HOSE BIBBS FIRST ECTRIC WATER HEATERS BASIC PLAN? ❑ YES SECOND ZONING DESIGNATION CHANGE OF USE? THIRD o NO NEW ADDRESS REQUIRED? o YES ❑ NO UP/SEPA/SU? FOURTH ❑ NO PLATTED LOT? ❑ YES ❑ NO ADDITIONAL FLOORS (DESCRIBE) ❑ YES o NO DECK(COVERED?) GARAGE ❑ CARPORT ❑ NUMBER OF FLOORS MUTING PROPOSED TOTAL TOTAL EX(9TII1 r TOTAL PROPORM 1W TOTAL OF **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRE $ Indicate number of each type of f lct 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 BBQS BOILERS COMPRESSORS DUCTS PLUMBING BATHTUBS (or Tub/shower combo( DISHWASHERS GAS PIPE OUTLETS WASHING MACHINES LAVS fRathrnnm Sinkcl J EVAPORA IVE COOLERS GAS LOGS FANS HOODS (commercial) FIREPLACE IN RTS RANGES FURNACES GAS WATER HEATERS GAS PIPE OU ETS ,;*riuwhxs WATER CLOSETS (Toitet) SINKS DRINKING FOUNTAINS SUMPS RAINWATER SYST URINALS HOSE BIBBS VACUUM BREAKERS ECTRIC WATER HEATERS REFRIG. SYSTEMS WOODSTOVES MISC (Describe) MISC (Describe) 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 (Signature) RELATIONSHIP TO PROJECT 7� ` (Title) ❑ Owner X Agent ❑ Contractor ❑ Architect ❑ FOR OFFICE USE ONLY ❑ NEW ❑ ADDITION ❑ ALTERATION o REPAIR ❑ TENANT IMPROVEMENT BUILDING SHELL ONLY? ❑ YES ❑ NO BASIC PLAN? ❑ YES ❑ NO ZONING DESIGNATION CHANGE OF USE? ❑ YES o NO NEW ADDRESS REQUIRED? o YES ❑ NO UP/SEPA/SU? ❑ YES ❑ NO PLATTED LOT? ❑ YES ❑ NO DEMO PERMIT REQUIRED? ❑ YES o NO Bulletin # 100 —January 1, 2006 Page 2 of 4 k\Handouts\Permit Application