10-103402City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609
` Mechanical
Permit #: 10 -103402 -00 -ME
k Inspection Request Line: (253) 835-3050
Project Name: JERSEY'S SPORTS BAR
Project Address: 35509 21ST AVE SW Parcel Number: 252103 9002
Project Description: New roof penetration, curb, ducting, for new RTU 3.5 ton gas package/AC unit to serve bar
area.
Owner
Aaalicant
Contractor
DAVID HOEK
BALANCE POINT COOLING & HEATING
BALANCE POINT COOLING & HEATING
DAVID'S FEDERAL WAY LLC
(ELECTRICAL)
(GENERAL)
PO BOX 8164
PO BOX 1455
BALANPS912DP (10/29/11)
TACOMA WA 98418
MARYSVILLE WA 98270
PO BOX 1455
MARYSVILLE WA 98270
Mechanical Valuation............................................3900
Is this an Online or O.T.C. application?.................No
Ducting........................................... ' 1 Fans............................................... 2 Roof Top Units.............................. 1
PERMIT EXPIRES Wednesday, February 9, 2011
Permit Issued on Friday, August 13 2010
1 hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and thea will be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: --??Date:
FiNMUbb s/to%o
• THIS CAIS TO AIN ON-SITE
My °F RD Construction Ins ction Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 10 -103402 -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 - Mechanical (4065)
Approved
By Date
Approved to release test
By Date
Approved
By Date
T
❑
Rough Electrical
Approved
E]Final
Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
OPERNHIE
Federal Way MF CO ME PL DE EN FP
V :.
DEVFL0PMENT 253-83-2609SERVICES APPLICA
253-R.',5-2607• FAX 253-R 35-2609
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SITE ADDRESS �V " I I yr r-C!A:KAL WAY
SUITE/UNIT #
` Is A,, ,c .S W CCAS
<.
PROJECT VALUATION
$
ZONING
ASSESSOR'S TAX/PARCEL #
�5 1 0-�L_- _!�b 0 -
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING <MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
,
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
r<7�Lt
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PROPERTY OWNER
NAME
QO.
PRIMARY PHONE
6 2" (,7q S-(. (p
MAILING ADDRESS
E -MAH.
CITY
STATE
ZIP
NAME
i.7A �AY�C i�
t7 . "T 1. 6f1 / 1 A A .n�•" {A7trl
PHONE t/
c �S sol oaq
I AILING ADD
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E-MAIL .
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RACTOR
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FAX
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EXPIRATION /z0%
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FEDERALio ov �,�s
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_
PHONE
APPLICANT
,MAH.nQaADDIW
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT -_b
(The individual to receive and
N
. INA ps. `_ "`
PHONE
112 SSG t U) 2 C
MAILING ADD S-
U
E-MAIL
respond to all correspondence
concerning this application)
CITY t (-t
ST_ ATEA-
ZIP^ G
FAX
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
PROJECT FINANCING
Required value of $5, 000 or more
Nom%
OWNER -FINANCED
MAIL[NG 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 properly 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 the city as apart of thisapplication.
SIGNATURE: DATE 7
PRINT NAME: S v<<SA4 0(w
v
Bulletin #100 -April 14, 2010
Page I of 3
k:\Handouts\Pelmit Application
Cc"L
reSw;
/brdoorUes'timate must be provided)
GAS PIPE OUTLETS OTHER (o"o,ib=)-
x0000(C~.~.*w
HOT WATER TANKS (Gw
nonnIaonxoomuruT
w0000rovmo
of this project. Do not include existingfixtures to remain.
URINALS OTHER (Describe)
vxonnM BooAomno
WATER HEATERS (oe~**
WASHING MACHINES
CRITICAL AREAS ON -PROPERTY? 'WATERFURVEYOR SXVJERPURVEYOR VALUE OF WaSTING IMPROVEMENTS
E2asTING/PREVIOUS USE LOT SEE (In Squa" Feet) EXISTING FIRE SPPJNMMZR SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
'
Bulletin #l00—April 14,2010 Page 2of 3 Application
PROPOSED
TOTAL
FOR OFFICE USE
AREA DESCREPTION (in square feet) EXISTING
FIRST FLOOR (or Mobile Home)
COVERED ENTRY
GARAGE 0 CARPORT 0
ESTIMATED SELLING PRICE $
1 #OF BEDROOMS
'
Bulletin #l00—April 14,2010 Page 2of 3 Application