06-104085City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) BM -2607 Fax: (253) 835-2609
Mechanical Permit #: 06 -104085 -00 -ME
Inspection Request Line: (253) 835-3050
Project Name: CINGULAR @ SAGHALIE PARK 1
Project Address: 33914 19TH AVE SW� _Parcel Number: 242103 9088
Project Description: Install HVAC systems in a cingular cellular site to support new telecommunications
equipment upgrade. Exterior mounted unit.
Owner
Applicant
Contractor
FEDERAL WAY CITY OF
SIEMENS BUILDING TECHNOLOGIES, INC.
SIEMENS BUILDING TECHNOLOGIES, INC.
CITY OF FEDERAL WAY
22010 SE 51ST ST
SIEMABTOI IDJ 10/17/2007
33325 8TH AVE S
ISSAQUAH WA 98029
22010 SE 51ST ST
FEDERAL WAY WA 98003
ISSAQUAH WA 98029
Additional Permit Information
Mechanical Valuation............................................22032.33 Over the Counter Permit?...................................... No
• THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record"
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 06 -104085 -00 -ME
Owner: CITY OF FEDERAL WAY
Address: 33914 19TH AVE SW
FEDERAL WAY, WA 98023
This card is part of your required inspection documents. 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 (4065)
Approved Approved to release test Approved
By Date By Date By Date XZ U
PW
RECEIVED t{' omX \✓
t• CITY` 1 W — 1L l D V "'
Federal Way {A�f I� PERMIT
COMMUNITY DEVELOPMENT SERVICEAU6 1 5 2O(' SF MF CO (N>EL PL DE EN FP
3332TD
8TX AVENUE SOUTH • PO BOX 9718 p L I C AT I O N
FEDERAL WAY, WA 98063--pffY OF FEDER
E
253-835.2607•FAX253-835ro- BUILDING
www.atiloffefli:ralwa'J.rn DEPT.
The oiiowin is re uired information - an Inco fete apolication will not be accepted. Please print le ribly in ink) or
PROPERTY•• •
SITE ADDRESS 33914 19th Avenue SW, Federal Way, WA SUITE/UNIT #
ASSESSOR'S TAX/PARCEL # 1 9 2 1 0 4 - 9 0 3 3 LOT SIZE (sj)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach sepmate page for lengthy legal description)
PROJECT• •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING e�MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu)
Install HVAC systems in a Cingular Cellular site to support new telecommunications
equipment upgrades.
PROJECT NAME (Name of Business or Owner Last Name) C
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
1
EXISTING USE
y Az4—'
NAME PRIMARY PHONE
MAILING A DRESS CITY, STATE, ZIP
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
Siemens Building Technologies
Ronald F. Diana
(425 ) 507 - 4364
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
22010 SE 51s' Street
Issaquah, WA 98029
(206) 718 - 1389
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
I ( ) -
12/31/06
(425) 507 - 4350
2 0-0 2-1 0 0 8 2 2-B L
CONTRACTOR'S REGISTRATION NUMBER copy of card required with each application)
EXPIRATION DATE
S I E M A B T 0 1 1 D
J
10/17/07
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
Siemens Building Technologies
Ronald F. Diana
(425 ) 507 - 4364
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
22010 SE 51s' Street
Issaquah, WA 98029
(206) 718 - 1389
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe)
I ( ) -
NAME PRIMARY PHONE E-MAIL ADDRESS
Ronald F. Diana 425 ) 507 - 4364 RON.DLANA(a�SIEMENS.COM
PerRCW 19.27.095. Lender information is
NAME
required if project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
( )
EXISTING ASSESSED/APPRAISED VALUE $
PROPOSED USE
VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
PF
'P '..
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ. FT. I SQ. FT. I SQ. FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS (DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT ❑
MUS TING PRO -911 TOTAL TOTAL.. 1XISTRIO ST TOTAL PBO-- SP . '.:, TOTAL Sr
NUMBER OF FLOORS
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL 0 /,, 1ti g
Al -0✓^ 0
o REPAIR o TENANT IMPROVEMENT
Value of Mechanical Work $ -;2:1 .4 CD3
3
Z . 3 V
o YES o NO
BASIC PLAN? o YES
Z AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS LOGS
Z REFRIG. SYSTEMS
BBQS
FANS
HOODS (co-o-mial)
WOODSTOVES
BOILERS
FIREPLACE INSERTS
RANGES
MISC (Describe)
L COMPRESSORS
FURNACES
GAS WATER HEATERS
DUCTS
GAS PIPE OUTLETS
PLUMBING
BATHTUBS (or Tub/shower combo)
SHOWERS
WATER CLOSETS (Toiiet)
MISC (Describe)
DISHWASHERS
SINKS
DRINKING FOUNTAINS
GAS PIPE OUTLETS
SUMPS
RAINWATER SYST
WASHING MACHINES
URINALS
HOSE BIBBS
LAVS (Bathroom sinks)
VACUUM BREAKERS
ELECTRIC WATER HEATERS
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 f led 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
(Signature) (Title)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent Contractor ❑ Architect ❑ Other
❑ NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY?
o YES o NO
BASIC PLAN? o YES
oNO
ZONING DESIGNATION
CHANGE OF USE? o YES
NEW ADDRESS REQUIRED?
o FES o' NO
UP/SEPA/SU? o YES
o NO
PLATTED LOT?
o YES o NO
DEMO PERMIT REQUIRED? o YES
❑' NO
Bulletin #100 - January 1, 2006 Page 2 of 4 k\Handouts\Permit Application