13-103875City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
40 -McGhanical
Permit #: 13 -103875 -00 -ME
Inspection Request Line: (253) 835,3050
Project Name: VALLEY HARVEST MARKET
Project Address: 28855 MILITARY RD S Parcel Number. 042104 9037
Project Description: Installing a new Type I hood with make up air units and new exhaust fan on roof.
Owner
AuRIicant
Contractor
EXECUTIVE HOUSE INC
MUTUAL INDUSTRIES INC
MUTUAL INDUSTRIES INC
7517 GREENWOOD AVE
1605 S 93RD ST SUITE E-5
MUTUAH041D5 (2/25/15)
SEATTLE WA 98103
SEATTLE WA 98108
1605 S 93RD ST SUITE E-5
SEATTLE WA 98108
Additional Permit Information
Is this an Online or O.T.C. application?.................No
Mechanical Fixtures
Ducting........................................... 1 Fans................................................ 1 Hoods............................................. 1
PERMIT EXPIRES Monday, April 21, 2014
Permit Issued on Wednesday, October 23, 2013
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:/� LA Date: 1 o Z�
r THIS CARD IS TO MAIN ON-SITE
CITY" " Construction In ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 13 -103875 -00 -ME Address: 28855 MILITARY RD S
Project: EXECUTIVE HOUSE INC FEDERAL WAY, WA 98003-7912
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
0
Mechanical Rough -in (4165)Gas
Piping (4125)
Final - Mechanical (4065)
Approved
Right of Way
Approved to release test
Approved
By
Date
By
Date
< 11��Date _?_ �--1
Rough Electrical
Approved
Final Electrical
Approved
1:1Approved
Right of Way
By
Date
By
Date
By
Date
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Federal Way
REC§VED
SEP 0 3 2013
PERM IT'*APPLICATION
A CITY OF FEDERAL WAY
NUMBER (� _ VCS 6 � - M— C TARGET DATE
/DW,05
SITE ADDRESS �� �, � r � �
SUITE/UNIT •
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL #
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING 'K MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
va l 14a"We-et MGt-� / 3 L b/ '1/
LIAL r ", 7-/
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
N
PRIMARY PHONE
PROPERTY OWNER
VIC_ l Kt,
MAILING App ( l �Q �
E-MAIL
CITY
STATE IZR72/
NAME l
t
PH'O 7 "l- 6-'
i�
MAILING ADDRESS
�+
E-MAILE-MA
CONTRACTOR
CITYSTATE
ZIP
FAX
S
WA STATE CONTRACTOR'S LICENSE Y
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE N
is 4A Dr
RAMS DW
PRIMARY PHONE
MADJN Z DRESS � � -�
APPLICANT
J
CITY
STATE
ZIP
FAX
NAMEPRIMARY
��jj��
PHONE
PROJECT CONTACT
•l/WI
MAHJNG ADDRESS
E-MAIL
The individual to receive and
respond to all correspondence
063m,I�V
CITY STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5,000 Or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
I certify 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 certify 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 city as a part of this application.
SIGNATURE: �'-t-�-� / DATE d
/
PRINT NAME: / �di►Ii G�Q�Q�.
Bulletin #100 - January 1, 2013 Page] of 3 k.\Handouts\Permit Application
.eon,
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
Indic&e
how maly of each type of fixture
to be installed or relocated as part of this project. Do not include existing res to remain
Indicate how many of each type 006ture
R U
FANS
GAS PIPE OUTLETS OTHER (Describe) ►
LAVS (Hand Sink*
-L
AIR C' V111
FIREPLACE INSERTS
_� HOODS (c --64a..
RAINWATER SYSTEMS
BOI
FURNACES
HOT WATER TANKS (G—)C,�MPRESS
SHOWERS
S,
GAS LOG SETS
REFRIGERATION SYST
SINKS (Kitchen/utaity)
AJCTING
GAS PIPING
WOODSTOVES
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING PERMIT
EXISTING/PREVIOUS USE
LOT SIZE )In Square Feet)
$
Indicate how many of each type 006ture
to be installed or relocated as part
o this project. Do not include existin res to'remain.
BATHTUBS (-T b/She—C—bo)
LAVS (Hand Sink*
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Kitchen/utaity)
'WATER HEATERS (electric)
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE
LOT SIZE )In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No
❑ Yes ❑ No
Bulletin #100 — January 1, 2013 Page 2 of 3 kMandoutsTermit Application