03-101495i} ..
City of Federal Way
Community Development Services Mechanical Permit #: 03 -101495 - 00 - ME
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050
Project Name: EL MICHOACANO
Project Address: 29500 PACIFIC S SuiteJ Parcel Number: 304020 0093
Project Description: Installing new back shelf Type I hood with make-up air damper
Owner
Applicant
Contractor
DAVID RHODES
SKILFAB SHEET METAL CO
SKILFAB SHEET METAL CO
29500 PACIFIC HWY S
9826 14TH SW
9826 14TH SW
FEDERAL WAY WA 98003
SEATTLE WA 98106
SEATTLE WA 98106
(253) 333-0014
Mechanical Valuation..........................................6995.84 Over the Counter Permit ...................................... No
Mechanical Fixtures
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use willbe in accordaee "b t laws, rules and regulations of the State of Washington and
the City of Federal Wa _1
Owner or agent:
f
o r<"
Date: r' --Z- —Q 3
purr well,�
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�EC��VED CONSTRUCTION P RMIT APP ICATION
CITY OF �� PPUCATION NUMBER: -LO 1_
Federal Way APR 11 M3_ PPUCATION NUMBER:
Y OF FEIDERALWAY PLICATION NUMBER:
**The fo'10 1�iUq DredLormation - Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
SITE ADDRESS:
LEGAL DESC�2IF
�J sniff (uJy .JJ ASSESSOR'S TAX/PARCEL #:
N OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): o BUILDING o PLUMBING XMECHANICAL o DEMOLITION
o ELECTRICAL o ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT NAME: ! rf /TI v ( 0 20el '-1 Cy /.I"2 -5 / 9— NI (,C- 1 0ar), n
PROPERTY OWNER:
CONTRACTOR:
NA �—.OLaj .► \AYTIME d>7.7 ) PHONE, '
MAILING ADORE (STREET
(STR✓E✓ET ADORE , STATE, ZIP):
NAME:
DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS;
ST ZIP):
EVENING PHONE: I
CITY OF FEDERAL WAY BUSINESS LICE
NUMBER:��
FAX NUMBER: -
CONTRACTORS REGISTRATION NUMBER:
(�Yof�.��>
I EXPIRATION DATE:
/ /a
APPLICANT: I NAME:
0
MAILING ADDRESS (STREET ADDRESS STATE, ZIP):
RELATIONSHIP TO PROJECT: r�
o ARCHITECT o TENANT ❑ OTHER ( DESCRIBE):
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER ❑ APPLICANT o CONTRACTOR I
EXISTING USE:
PROPOSED USE:
SPRINKLERED BUILDING?
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
/DAYTIME PHONE:
)
/EVENING PHONE:
/FAX NUMBER:
E-MAIL ADDRESS:
EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED VALUATION FOR IMPROVEMENTS: ; co cl 6-1 F!q
o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: o YES o NO
o LAKEHAVEN o HIGHLINE o TACOMA o PRIVATE (WELL)
❑ LAKEHAVEN o HIGHLINE 0 PRIVATE (SEPTIC)
t
"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(SJ
BOILERS)
COMPRESSORS)
DUCE(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) REFRIG. SYSTEMS)
FAN(S) HOOD(S) WOOD VE(S
FIREPLACE INSERTS) RANGE(S) _� MISC. 0�
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: o ELECTRIC o GAS
PLUMBING
LAVATORY(S) URINAL(S)
RAIN WATER SYS.
SHOWER(S)
SINKS)
SUMP(S)
WATER HEATER(S)
VACUUM BREAKER(S) o ELECTRIC o GAS
WASH MACHINE OUTLET
WATER CLOSET(S) MISC. ( )
DISCLAIMER/SIGNATURE BLC
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 ch claim arises ou the reliance of the city, including its officers and employees, upon the accuracy
of the Information supe ' the city a art of th ppiicatio .
NAME/TITLE: I DATE:
o 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.dtyoffederalway.com