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15-104387do City of Federal Way Community & Econ. Dev. Services 33325 8th Ave S Federal Way, WA 98003 Ph: (253) 835-2607 Fax: (253) 835-2609 Project Name: FRED MEYER Project Address: 33702 21ST AVE SW Media meal FILL Permit #: 15 -104387 -00 -ME Inspection Request Line: (253) 835-3050 Project Description: Remove and replace Type I kitchen hood Parcel Number: 930100 0010 Owner ARolicant Contractor FRED MEYER INC COMPLETE RESTAURANT REPAIR COMPLETE RESTAURANT REPAIR PO BOX 42121 PO BOX 203 COMPLRR893D9 (3/29/17) PORTLAND OR 97242 KENT WA 98035 PO X 203 KENT 98035 V Additional Permit Informatic�,rk Is this an Online or O.T.C. application?.................No ,,' 101 Mechanical Fixtures Hoods............................................. 1 Separate Fire Suppression and Subject to field inspection with t I hereby certify tff* the occupancy and 40 -., C K EXPIRES Wednesday, February 24, 2016 Permit Issued on Friday, August 28, 2015 e information is correct and that the construction on the above described property and will be in accordance with the laws, rules and regulations of the State of Washington ' of Federal Way. Dater, ^ Z g - % Cl" -4& OF Federal Way THIS CARD IS TO REMAIN ON-SITE Construction Inspection Record INSPECTION REQUESTS: (253) 835-3050 PERMIT #: 15 -104387 -00 -ME Address: 33702 21ST AVE SW Project: FRED MEYER INC FEDERAL WAY, WA 98023-7762 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 ( 065) Approved Approved to release test Approved By (My Date 11 I 1 1 I (S By Date By Date U4 l+r ttr-S T- o K. . Rough Electrical Approved 1:1Approved Final Electrical Right of Way Approved By Date By Date By Date A ROU"ED0 Federal WRG 2 8 Z015 PERMIT COMMUNITY DEVELOPMENT SERVICES ,� P LI CAT I O N 253-835-2607• FAX 253-835-2609 mm,c.,UU01/edPrQHL'fiLrdii�lF FEDERAL CDS 4V - 10 i3e'T SF MF CO ME L DE EN FP � ze f SITE ADDRESS S SUITE/UNIT Fred Meyer Store 111 33702 21 Avenue SW, Federal Way, WA 98023 PROJECT` VALUATION ZONING ASSESSOR'S TAX/PARCEL S W �/ OOO .. %� % ,/ �/ / � / S� ✓ - - TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING El MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT (Tenant Name/Homeowner Last Name) Fred Meyer Store 111 PROJECT DESCRIPTION Remove one (1) hood. Replace with one (1) new similar updated hood. Detailed description of work to be included on this permit only �. PRIMARY PHONE PROPERTY OWNER MAIIdNG ADD E.MAH, / a V N -k1 • ©TE ZIP 6 Z NAME CRR, Inc. PHONE 253.852.0624 wrAELING ADDRESS E-MAIL CONTRACTOR PO Box 203 mark@completerestaurantrepair.com CITY STATE ZIP FAX Kent WA 98035 253.852.0623 WA STATE CONTRACTOR'S LICENSE # COMPLRR893D9 EXPIRATION DATE FEDERAL A l,j *NSE # NAME PHONE APPLICANT MAHAVG ADDRESS E -MAD. CITY STATE ZIP FAX PROJECT CONTACT NAME PHONE (The individual to receive and Mark Templew 253.797.5008 MAILING ADDRESS E -MAD, respond to all correspondence concerning this application) PO Box 203 mark@ completerestaurantrepap CITY STATE ZIP FAX Kent WA 98035 253.852.0623 ALTERNATE CONTACT NAME: PHONE E-MAIL Michael Templeton 253.797.6589 mt@completerestaurantrepair.c PROJECT FINANCING NAME OWNER -FINANCED Required value of $5,000 or more 'AIZA MADdNG ADDRESS. ITT, STATE, ZIP PHONE IRCW 19.27.095) I cert(fy under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best of my knowledge, the information submitted in support of this permit application is true and correct. I cert(fy 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 to the ci s -a gt1PCaJ L cation. SIGNATURE: DATE 08/26/2015 PRINT NAME: Mark Templeton Bulletin #100 -January 1, 2011 Page 1 of 3 k:\Handouts\Pennit Application VALUE OF MECILAMCAL WORIC $ 35,000.00 (a copy of bid or estimate must be provided) Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe) AIR CONDITIONER FIREPLACE INSERTS L HOODS )commemisi) BOILERS FURNACES HOT WATER TANKS )Ga.) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES Indicate how many of each type offwture to be installed or relocated as part of this project. Do not include existing fixtures to remain. BATHTUBS )or 1Lb/shower combo) LAVS )Hand sinks) TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS (tmeben/Umuy) WATER HEATERS (E)eeme) HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES CRITICAL AREAS ON PROPERTY? I WATER PURVEYOR EXISTING/PREVIOUS USE I LOT SIZE (In Square Feet) SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS $3 ,UCU00 vov EXISTING FIRE SPRDVKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? V Yes ❑ No z Yes ❑ No Bulletin #100 — January 1, 2011 Page 2 of 3 k:\Handouts\Permit Application Iv Z , (RECO) WT FRONT 4 SUSHI 12 5 -DECK DELI D5DL12HX RCM NEW LSM SUSHI BAR T4D 11 (RELOC) RICE � COOKED25 R T6 D I 0 0 18,-o" -,FT ( N I ___._ ;Q D40A Z � � A I D rTi :x --4 C) m 28' SERVICE (RELOC) D200SC6 I UP WR IUI DI 79F-20 Iwl F- C 71 PL1 L-24 T4D 11 (RELOC) RICE � COOKED25 R T6 D I 0 0 18,-o" -,FT ( N I ___._ ;Q D40A Z � � A I D rTi :x --4 C) m 28' SERVICE (RELOC) D200SC6 I UP WR IUI DI 79F-20 Iwl