05-105764 City of Federal Way Mechanical Permit #: 05 - 105764 - 00 - ME
Community Development Services
P.O Box 9718
Ph.eral(25 Way,WA 98063-(253 Inspection request line: (253) 835-3050
Ph.(253)835-7000 Fax.(253)835-2609 P 9
Project Name: MAPLEWOOD II SUITE 108
v
Project Address: 339151ST�S Sul e108 Parcel Number: 926504 0150
Project Description: Installation of(1)exhaust fan with ductwork runouts,grilles and registers.
Owner Applicant Contractor
ESM BUILDING,LLC UNIVERSAL REFRIGERATION INC. UNIVERSAL REFRIGERATION INC.
320 106TH AVE NE SUITE 100 PO BOX 614 PO BOX 614
BELLEVUE WA 98004 AUBURN WA 98071-0614 AUBURN WA 98071-0614
(253)939-5501
Mechanical Valuation 4521.00 Over the Counter Permit No
Mechanical Fixtures
j Description Quantity Description Quantity L Description IQuantity
Ducts 1 Fans P 1
PERMIT EXPIRES May 14,2006.
Permit issued on November 15,2005
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 the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent.* _ _ _ �� Date: 6S
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-105764-00-ME
Owner: ESM BUILDING, LLC
Address: 33915 1ST WAY S Suite 108
FEDERAL WAY, WA 98003
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.
IA Mechanical Rough-in (4165) ❑ Gas Piping(4125) ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
/z of
By ,��('�- Date �( ("I �j� By Date By Date /y
anOF RECEIVED 0 5 - I Q 5 4_
Federal Way PERMIT
COMMUNITY DEVELOPMENT SERVICES 1V 0 V Q 9 2005 SF MF C•a EL PL DE EN FP
333258T"AVENUE SOUTH•POBOX 9718 APPLI C Nh
iti FEDERAL WAY.WA 98063-9718 T�
253-835-2607•FAX 253-835-2609 ERAL WA; ll l / av,3 / 05 uww.cauof'(ederalwao.com BUILDING DEPT.
The ollowin• is r:-•uired in ormation-an incom•fete a••lication will not be acce•ted. Please 'tint le•ibl (in ink)or • .
• PROPERTY INFORMATION Q
i SITE ADDRESS ,, 7/ I�j* �✓GNJ ASO t�t'tGt SUITE/UNIT# /DCS
ASSESSOR'S TAX/PARCEL# 1 z O 47i ---- Q /--5- 0 -- -- - LOT SIZE(4)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot I)
(Attach separate page for lengthy legal descnptton1 i—
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING >t MECHANICAL
t 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu) /
/51$74// --/e, .t47 //44,0r0 ye-144e-v,f ra°# 7'i o..,,k /'uvr 01475 9r•/(.S
a..c1/ i^e..j iS 71e.r74- • //KS-V l/ (/ ) 42-KG1w,`c 71' ,- ve•i I- Se.;;(e_c4.a((
1-Ca_V o(...f side- .
Ir///;'/ i4 o'-o!'
PROJECT NAME(Name of Business or Owner Last Name) 4.'MI- – - — sed /08
• PEOPLE INFORMATION
PROPERTY NAME -5'./11 6u//d L..L G PRIMARY PHONE
OWNER -
l�t.1d ( )
MAILING ADDRESS CITY.STATE.ZIP
3775 is f 4✓/, s• -sem //y F� (i'v&p G1/4. g8ao3
CONTRACTOR COMPANY NAME ` APPLICANT NAME A OFFICE PHONE
ter
6 1 via l l�e ✓�i• ,- �,�y.,A C7a lvf"- (ZS,) 937 -55-01
MAILING ADDRESS / CITY.STATE.ZIP CELL PHONE
n o) lv(y 4u49(MA lel 4/674 T86 7( ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
/ ce- yq- ( 07 iP47-B L /Z / 3( / oS ( Zf>) 7 - 3Z-
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
Li /v / v E'R. / 1 5-2. 1P E '7' / / / Ca„
APPLICANT COMPANY NAME // APPLICANT NAME OFFICE PHONE
/I S001.1.1^e— C..;:441,l FaWlelelcv- ( )
MAILING ADDRESS CITY.STATE.ZIP CELL PHONE
iA 2t4-1 15 Coll 1-et e-14- ( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
❑Architect 0 Tenant VAgent 0 Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAILADDRESS
�r�y�'� ( (L/L1"_ (�)) 9 c - �So / By y ct,rt 0 Lt H/verger(
LENDER ... -PerRCW 19.27.095:-Zander lrlfbnetition is; _ NAME refoff/ e c.40,.....- - requite(fproice value exceeds$5.000 '
MAILING ADDRESS CITY,STATE,ZIP PHONE
( )
■ DETAILED BUILDING INFORMATION
EXISTING USE C-45-1-74 144 e./`r i1( dar;Chi PROPOSED USE %'GP �j
EXISTING ASSESSED/APPRAISED VALUE $ l I VALUE OF PROPOSED WORK $ / -5CO /' 0 0
SPRINKLERED BUILDING? ; ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? (YES ❑ NO
WATER SERVICE PROVIDER ' HAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER �� "HAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. _ sq.FT. sg.FT. j
BASEMENT
FIRST
SECOND -- " _ -- - ---
THIRD (
FOURTH - '- - I
a
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
i
NUMBER OF FLOORS EXISTING PROPOSEDTOTAL , , TOTAtumTaro se TOTAL PERPOSED SE'.- TOPER RP,
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
1
FIXTURES
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 L��(• ap
Vol,re of Mechanical Work,
,T
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS 1
BBgS I FANS HOODS(commerct ll WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
I DUCTS GAS PIPE OUTLP.lb
PLUMBING
BATHTUBS(or Tub/Shower combo) SHOWERS WATER CLOSETS(Tide[) 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
DISCLAIMER/SIGNATURE BLOCK
I cert�fy 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 authorizdU 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 ( ILL.._ r A MA_ f . DATE I I-0 9 - !>
(Signature) (Title)
RELATIONSHIP TO PROJECT 0 Owner 0 Agent X Contractor 0 Architect ❑ Other
'POR OFFICE VSE ONLY-:;*4P'-":: ',
' NEQr o ADDITION-. cl ALTERATION. a REPAIR. • a TENANT IMPROVEMENT - , .
BUILDING SHELL ONLY? ---:'-•,'• .a YES JO ' "" . T BASIC PLAN? .-'• ❑YES w +% ' ' ,
ZONING DESIGNATION '` ' . - CHANGE OF USE?-. - a YES O .
NEW ADDRESS REQUIRED? 'a YES .4440 - - .,UP/SEPA/SU?,'' . .- , La YES ! 0 ,
iiif PLATTED LOT? - ' • ES la NO _ ' DEMO PERMIT REQUIRED? - o YES NO
Bulletin#100-January 7,2005 Page 2 of 4 k\I-Iandouts\Permit Application