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02-100749City of Federal Way Community Development Services Mechanical Permit #: 02 - 100749 - 00 - ME 33530 Is( Way S Federal Way, WA 98003-6210 Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050 Project Name: 7 ELEVEN STORE Project Address: 32935 1STXSfw & Parcel Number: 182104 9037 Project Description: MECH - Install refrigerent lines between new Slurpee macine and condenser fans on roof. Equipment provided by owner; approx 20 ft. Owner Applicant Contractor KORNBLAU & SON INC LOUIS PRO STAFF MECHANICAL PRO STAFF MECHANICAL 50 S GARFIELD AVE PRO STAFF MECHANICAL PRO STAFF MECHANICAL ALHAMBRA CA PO BOX 33370 PO BOX 33370 91801-3829 SEATTLE WA 98133 (206) 361-0071 Mechanical Valuation..........................................950 Over the Counter Perrnit...................................... Yes Mechanical Fixtures Permit issued on February 20, 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: Date: 2, ® D�— Me- C-- -k . T7, % L -n 0- ( <-- CJ p6ck �Of�_ RECEIVED CONSTRUCTION PERMIT APPLICATION ffx K F: n --APPLICATION NUMBER: .02 - L ff-074q- aa FEB 2 0 2002 APPLICATION NUMBER: - - CITY OF FEDERAL WAY APPLICATION NUMBER: - **The folloM4q-Q1NQJARTnformation — Please print (in ink) or type** Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application. ERTY MATION Q �+ O. O. SITE ADDRESS: Z /3 I _ , �D ASSESSOR'S TAX/PARCEL #: Ci� LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ;KM-ECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description): ' • ■ PEOPLE INFORMATION PROPERTY OWNER: CONTRACTOR: APPLICANT: NAME: DAYTIME PHONE: 7- � / �--✓c ( ) - MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): PD. Sox gm!!P? -7Z7KK/14-4, k1A gF13q NA 1 DAYTIME PHONE: ) 40% I MAILINGADDRESS(STREET ADDRESS; CRY, ATE, ZIP : EVENING PHONE: I f ©• .;90K O 3 / ) CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER: CONTRACTOR'S REGISTRATION NUMBER: G EXPIRATION DATE. (copy of card required) L 1 NAME, DAYTIME PHONE: MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE: RELATIONSHIP TO PROJECT: FAX NUMBER: ❑ ARCHITECT ❑ TENANT ❑ OTHER ( DESCRIBE): ) - E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR DETAILED BUILDING • • •EXISTING.USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ SPRINKLERED BUILDING? ❑ YES ❑ NO. FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC) **NEW RESIDENTIAL CONSTRUCTION ONLY" NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: ■ PROJECT FLOOR AREAS FLOOR EXISTING SQ. FT. PROPOSED SQ. FT. TOTAL BASEMENT FIRST AIR HANDLING UNIT(S) SECOND GAS LOG(S) REFRIG. SYSTEMeS) BBQ(S) THIRD HOOD(S) WOODSTOVE(S) BOILERS) FOURTH RANGE(S) MISC. ( ) COMPRESSOR(S) OTHER FLOORS (DESCRIBE) DUCT(S) DECK HEAT SOURCE: ❑ ELECTRIC ❑ GAS GARAGE HOW MANY FLOORS? BATHTUB(S) TOTAL' URINAL(S) WATER HEATER(S) DISHWASHERS) 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 4s a part of this application. NAME/TITLE: /fes—I i DATE: "o Z - e Z --- C1 _ ❑ PROPERTY OWNER APPLICANT ❑ CONTRACTOR COMMUNITY DEVELOPMENT SERVICES - 33530 FIRST WAY SOUTH - PO BOX 9718 - FEDERAL WAY, WA 98063-9718 - 253-661-4000 • FAX: 253-661-4129 www.citvoffederalway.com Indicate number of each type of fixture MECHANICAL AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEMeS) BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S) BOILERS) FIREPLACE INSERTS) RANGE(S) MISC. ( ) 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 OUTLETS) 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 4s a part of this application. NAME/TITLE: /fes—I i DATE: "o Z - e Z --- C1 _ ❑ PROPERTY OWNER APPLICANT ❑ CONTRACTOR COMMUNITY DEVELOPMENT SERVICES - 33530 FIRST WAY SOUTH - PO BOX 9718 - FEDERAL WAY, WA 98063-9718 - 253-661-4000 • FAX: 253-661-4129 www.citvoffederalway.com