03-1030914
City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: EVERGREEN BANK
Mechanical Permit #:03 -103091 - 00 - ME
Inspection request line: 253.835.3050
Project Address: 1300 S 320TH 5rt Parcel Number: 082104 9241
Project Description: Add new diffusers and associated ductwork to existing mechanical system, (2) bathroom exhaust fans,
and install (1) 9,000 BTU A/C unit, 400 CFM for cooling only to computer server room, subject to field
inspection.
Owner
Applicant
Contractor
Derald E Martin & Margaret A Martin
ELECTROMATIC SALES & SERVICE INC *D
ELECTROMATIC SALES & SERVICE INC *D
2791 152ND AVE NE BLDG 7E
2791 152ND AVE NE BLDG 7E
REDMOND WA 98052
REDMOND WA 98052
(425) 216-1601
PERMIT EXPIRES January 24, 2004.
Permit issued on July 28, 2003
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 Wa
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Owner or agent: Date:
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Ne c...(A . l�o��� � Sn, 4914
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®�,� CONSTRUCTION PERMIT APPLICATION
CITY OF y +v`t
I �..i✓ PPLICATION NUMBER: U 3 - ( a 3 cV �� (_ ce
Federal Way APPLICATION NUMBER:
j` `iL G 'iiiAPPLICATION NUMBER: - — — — — — — - — —I
**The follovy`r��s;r�tg�cigtprn — Please print (in ink) or type**
Please note: Electrical Fire Preven `'
ys emss aand Engineering permits may require a separate application.
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PROPERTYINFORMATION
SITE ADDRESS: fto S• ��ff,0-�=' JT ASSESSOR'S TAX/ PARCEL #: D 5 7, ` Q Z l�. _t
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROJECT• •
TYPE OF PROJECT (This application): o BUILDING o PLUMBING MECHANICAL o DEMOLITION
❑ ELECTRICAL o ENGINEERING ❑ RE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
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PROJECT NAME:��CG�rQL'il((\k
v
PEOPLE• •
PROPERTY OWNER: I NAME: DAYTIME PHONE: -
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MAILING ADDRESS (STREET ADDRESS, CITY, STATE, ZIP).
CONTRACTOR:
NAME:
DAYTIME ONE:
AMPH(ZOO
) 6Z4 - 33-70
i MAILING ADDRESS (STREET ADDRESS; CITY, STATEZIP):
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EVENING PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER.
_0Q-�c�_3__®�_�-
FAX NUMBER: 1
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CONTRACTORS REGISTRATION NUMBER:
card of d required>
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2 'S 3
I EXPIRATION DATE:
N F be) -Z3
APPLICANT: NAME: DAYTIME PHONE:
(Wb) - 337D
MAILING ADDRESS (STREET AAD RESS; CITY, STATE.
ZIP): t 7 EVENING PHONE:
2111 M!i ' Ay/Pk� L�•C Ji�EYYIIL� �A.)ii � L
LRELATIONSHIP TO PROJECT. FAX NUMBER: '
oARCHITECT ❑ TENANT *OTHER ( DESCRIBE):=C� �— j
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER o APPLICANT CONTRACTOR I
DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: o YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE 0 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
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING UNIT(S)
BBQ(S)
BOILERS)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S)
T FAN(S) HOOD(S)
FIREPLACE INSERTS) RANGE(S)
FURNACE(S)
GAS PIPE OUTLET(S)
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINKS)
SUMP(S)
REFRIG.SYSTEM(S)
WOODSTOVE(S)
MISC. ( )
HEAT SOURCE: 0 ELECTRIC 0 GAS
URINAL(S) WATER HEATER(S)
VACUUM BREAKER(S) 0 ELECTRIC 0 GAS
WASH MACHINE OUTLET
WATER CLOSET(S) MISC. ( )
]TSCLATMFR/STGNATURF RLC
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: I� �pc�d� ��` DATE: -7 -03-C)3
0 PROPERTY OWNER O 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