10-103006dity of Federal Way •
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: JERSEY'S SPORTS BAR
Project Address: 35509 21ST AVE SW
• Mechanical
Permit #: 10 -103006 -00 -ME
Inspection Request Line: (253) 835-3050
Parcel Number: 252103 9002
Project Description: Gas piping from meter on exterior of building to inside the building; includes stub outs for
HVAC, fryer, range, and griddle. This permit is for stub out only, equipment installation to
be on separate permit.
Ownr
Annlicant
Contractor
DAVID HOEK
FRANK FIRE PROTECTION
FRANK FIRE PROTECTION
DAVID'S FEDERAL WAY LLC
15405 SE 310TH ST
FRANKFP928CO (2/20/12)
PO BOX 8164
KENT WA 98042
15405 SE 310TH ST
TACOMA WA 98418
KENT WA 98042
Mechanical Valuation............................................1800 Is this an Online or O.T.C. application? ................. Yes
qNklia, 1R/z//0
THIS CARD IS TO AIN ON-SITE
•
CrFY Construction Ins ction Record
Federal Way INSPECTION REQ TS: (253) 835-3050
PERMIT #: 10 -103006 -00 -ME - Address: 35509 21ST AVE SW
Owner: DAVID HOEK FEDERAL WAY, WA 98023
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.
Mechanical Rough -in (4165)Gas
Piping (4125)
Final Electrical
Approved
Final - Mechanical (4065)
Approved
By
Approved to release test
Approved
By
Date
By
Date
By
Date � 0
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
cffl OF
1\je�WERMIT
CO25-83.�oF7FA 09 APPLICATION
2.5.;-83.5-2607• FAX 253-R.',.5-2609 (�
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SP��IF C ME PL DE E
SITE ADDRESS /'!,
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SUITE/UNIT M
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
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- - - - - - - -
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING 4 MECHANICAL
❑ DEMOLITION 0 ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
-
C c Alm
PROJECT DESCRIPTION
f W11C'
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAM
CY 'V ,
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
NAME
PHONE
CONTRACTOR
MAILDI ADDRESS
d
E-MAIL
CITY 1
1STATE
ZIP
'?,roYZ
FAX
253
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NANE
PHONE
k SaU ,-K
2-e-6-- 222 zY--
MAILING ADDRESS
E-MAII
APPLICANT
CITY
Ti
STATE
ZIP h
�YL
FAX
PROJECT CONTACT
(The individual to receive and
NAME
S 1 �`S
PHONE
20 o — 2 L
MAILING ADDRESS
E-MAIL
respond to all correspondence
concerning this application)
CITY
STATE
ZIP
FAX
ALTERNATE CONTACT NAME:
PHONE
E -MAD.
PROJECT FINANCING
NAS
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 cert(y 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 apart of this application.
SIGNATURE: �p �/JC DATE` f�
PRINT NAME
Bulletin #100 — April 14, 2010 Page 1 of 3 k:\HandoutsTermit Application
VALVE of MECHANICAL WoRII $ (a copy of bid or estimate must be provided)
Indicate how many of each type of focture 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 (Gel)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING __,��GAS PIPING WOODSTOVES
..................................................................................... .
PROPOSED
TOTAL
.......:.:................:.........................................:...............:..:.............:..............................
CRITICAL AREAS ON PROPERTY? WATERPURVEYOR
SEWERPURVEYOR
VALUE OF EXISTING IMPROVEMENTS
FIRST FLOOR (or Mobile Home)
EXISTING/PREVIOUS USE
LOT SIZE Ila Square Feet)
EXISTING FIRE SPRMKLER SYSTEM?
PROPOSED PIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No
❑ Yes ❑ No
AREA DESCRIPTION (in square feet) EXISTING
PROPOSED
TOTAL
FIRST FLOOR (or Mobile Home)
COVERED ENTRY
GARAGE ❑ CARPORT ❑
OEM
PROPOWD ..
..;:TOTAL
Area Totals
. ..
ESTIMATED SELLING PRICE $
# OF BEDROOMS
FOR OFFICE USE
:..f: ..................:,.::::::: •:::::::::. .
Construction # of
AREA DESCRIPTION Area Occupancy Groups) Construction
Stories Additional Information
in Square Feet
ConstructionI # of I Additional Information
v
Tve Stories
Bulletin #100 — April 14, 2010 Page 2 of 3 Ul-landoutsTennit Application