02-101315City of Federal Way
Community Development Services
33530 1 st Way S
Federal Way, WA 98003-6210
P1i:253.661.4000 Fax: 253.661.4129
Mechanical Permit #:02 -101315 - 00 - ME
Inspection request line: 253.835.3050
Project Name: VALLEY RADIOLOGIST
Project Address: 181 S 333RD�cS,uite210 Parcel Number: 926500 0258
Project Description: MECH - Replace fire dampered T -Bar diffuser with new smoke/fire damper hard lid diffuser
Owner
Applicant
Contractor
Josef & Alhadeff Jerry Diamond
HEATTRANSFER CO
HEATTRANSFER CO
515 116TH AVE NE #170
P.O. BOX 1268
P.O. BOX 1268
BELLEVUE WA
CARNATION WA 98014
CARNATION WA 98014
98004-5224
(000)885-3247
Mechanical Valuation..........................................500
Over the Counter Permit......................................Yes
Mechanical Fixtures
Description Quant` ` rlptlon`: _ , -. Quanfi Description x Quantity
Ducts
PERMIT EXPIRES September 25, 2002, IF NO WORK IS STARTED.
Permit issued on March 29, 2002
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.
Owner or agent: 7 Date: 'z" Z
CONSTRUCTION PERMIT APPLICATION
�—APPLICATION NUMBER: p z -
PPLICATION NUMBER:
PPLICATION NUMBER:
**The following is required information — Please print (k ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY INFOR14ATION
SITE ADDRESS: Z46 .S .sa• f� Zl0 ASSESSOR'S TAX/PARCEL #: 2 (o s
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PR03ECTINFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCCRRIPTION (Provide detailed description): f4�=-c i� �1• ��— % [�,�
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PROJECT NAME: Ile- Ar -1 /4&'I /D/oGi ,Is
PEOPLE. •
PROPERTY OWNER: NAME
JDAYTIME PHONE:
/T/�4aQe ' S��r AP -.#W 4k- JJQ
MAILING ADDRESS (STREET AgDRESS; CITY, STATE, ):
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CONTRACTOR:
APPLICANT:
NAME: /
DAYTIME PHONE: -
DAYTIME PHONE: i
MAI�LIING ADDRESS (STREET ADDR•E�SS;; CITY',
ITY, STATE,,
)S(
ZIP):
EVENING PHONE: I
ve
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
UMBER:
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EXPIRATION DATE:
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NAME: -
DAYTIME PHONE: -
MAILING ADDRESS (ST E DDR , STATE, ZIP):
EVENING PHONE:
RELATIONSHIP TO PROJECT:
❑ ARCHITECT ❑ TENANT ❑ OTHER ( DESCRIBE):
FAX NUMBER:
-
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
EXISTING USE:
PROPOSED USE:
SPRINKLERED BUILDING?
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
-■ - DETAILED BUILDING INFORMATION
EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED VALUATION FOR IMPROVEMENTS: $ S���i PIP
❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN ❑ HIGHLINE 11 PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE:
... : ■ PROJECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
AIR HANDLING UNIT(S)
FIRST
GAS LOG(S)
REFRIG. SYSTEM(S)
V BBQ(S)
SECOND
HOOD(S)
WOODSTOV�`E[ S)
BOILER(S)
THIRD
RANGE(S)
l MISC. ( bijkse-K)
COMPRESSOR(S)
FOURTH
DUCT(S)
OTHER FLOORS (DESCRIBE)
HEAT SOURCE:
❑ ELECTRIC ❑ GAS
DECK
BATHTUB(S)
GARAGE
HOW MANY FLOORS?
URINAL(S)
WATER HEATER(S)
DISHWASHERS)
TOTAL:
VACUUM BREAKER(S)
❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S)
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: DATE: Z
❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
FOR OFFICE .USE ONLY:
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 - 253-661-4000 • FAX: 253-661-4129
www. cityoftederalway.corn
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S)
EVAPORATIVE COOLER(S)
GAS LOG(S)
REFRIG. SYSTEM(S)
V BBQ(S)
FAN(S)
HOOD(S)
WOODSTOV�`E[ S)
BOILER(S)
FIREPLACE INSERT(S)
RANGE(S)
l MISC. ( bijkse-K)
COMPRESSOR(S)
FURNACE(S)
DUCT(S)
GAS PIPE OUTLET(S)
HEAT SOURCE:
❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S)
LAVATORY(S)
URINAL(S)
WATER HEATER(S)
DISHWASHERS)
RAIN WATER SYS.
VACUUM BREAKER(S)
❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S)
SHOWER(S)
WASH MACHINE OUTLET
GAS PIPE OUTLET(S)
SINK(S)
WATER CLOSET(S)
MISC. ( )
INTERCEPTOR(S)
SUMP(S)
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: DATE: Z
❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
FOR OFFICE .USE ONLY:
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 - 253-661-4000 • FAX: 253-661-4129
www. cityoftederalway.corn