05-105763 4 'ft.
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• City of Federal Way Mechanical Permit #: 05 - 105763 - 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: MAPLEWOQD II SUITE 106
Project Address: 33915 1STIS Suite106 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 6011 Over the Counter Permit No
Mechanical Fixtures
[ Description Quantity Description Quantity Description Quantity
Ducts 1 Fans 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 with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agen ,C[�p��, g � Date: I 15/G-5—
THIS CARD IS TO REMAIN ON-SITE
CITY oF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-105763-00-ME
Owner: ESM BUILDING, LLC
Address: 33915 1ST WAY S Suite 106
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.
Z] Mechanical Rough-in(4165) ❑ Gas Piping(4125) ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
Date 1((17(0S-- By Date By OliDate /L//A
RECEIVEDc or 401614-* 0 - 1 0 �/y
Federal Way PERMIT NOV 0 9 2C
COMMUNITY DEVELOPMENT SERVICES MF C• � EL PL DE EN FP
33325 8aOU
(AVENUE STH•PO BOX 9718 I h
FEDERAL 07'FWAAX
53.83.9718 APPLI CATI FEDERAL`PIVAY f ( o� / C�5
253-835.3607•FAX253.835-2609 DING DEPT. `
www c¢uotfederaiwau.com
The ollowin• is r-•uired in ormation-an incom•lete a.•lication will not be acce•ted. Please • 'nt le•ibl (in ink)or • .
• PROPERTY INFORMATION
SITE ADDRESS f I r/ 1 .1-- Wc4./ s6(.t'� SUITE/UNIT# /0 C
y
ASSFSSOR'S TAX/PARCEL# l Z- C (4("- 2 / 0 LOT SIZE(4)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal descrlpn.N
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING XMECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on thispermit onlu)
/Hs // fe-t,ca.y t w%iforove_kp w.4.4 f nuc f wo1'ki "10 0 147s/ Sri/les
611- rejis fees . /L s7 // C, ) -e-x Gra-els f vei-1 f .s/cleWa//
io 1-4 e--, oC4 74,7S/Cie/ .
PROJECT NAME(Name of Business or Owner Last Name) Sloe a SI41 ca, - sc.(/5& #706,
• PEOPLE INFORMATION
PROPERTY NAMEC
OWNER - / j�Ll//mit r:(.i L L G PRIMARY;HONE
MAILLNG ADDRESS CITY.STATE,ZIP ( )
3115- (St �% s• -S e dry F (i £, 4. g80�3
CONTRACTOR COMPANY NAME ` APPLICANT NAME A OFFICE PHONE
Uvtiv�v-fa ( Ae ✓�t• Pir�l�w� z5ryOWN C7alvrr.. (zSj) 93 -5501
MAILING ADDRESS / crre.STATE,ZIP CELL PHONE
t� fox rv(y 4u6Lw i WA 9867( ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
/ q- yq- ( 07 ,P' q7- BL /z / 3( / oc ( 21') 7 -" 3Z
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
Li Ai / vA-R / / 5q c , '' / ( / °
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
fol( SawH e, Gots( FoW- 4 - ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
rYcr,�( l 5 Cei-ti"(u c--1" ( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect 0 Tenant SAgent 0 Other(Describe) ( ) -
CONTACT NAME / ♦ PRIMARY PHONE E-MAIL ADDRESS
v r ta...^ ( �t lvr",‘.. , (Z5)) 9 - �St / Br yai t1o�0 k NI V ,-.5,f(
LENDER ''.Per NMNM19.27.095i-lender btormatton is NAME refs i . CG wI
!eq Bred(fproject value exceeds$5.000 •,.
MAILING ADDRESS CITY.STATE,ZIP PHONE
( ) -
• DETAILED BUILDING INFORMATION
EXISTING USE C---C-1-74 f.L(e ACI.i�� a (C-e- PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ t740 It, 0•
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES o NO -
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
Sg-FT. SQ.FT. SQ.FT. I
BASEMENT
FIRST
1
SECOND
THIRD - i
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS mes ®e PROPOSTOTAL
TOTSLEErnITO
SPso naworaisor to ss•
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
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
Value of Mechanical Work $ 1 le 0 C)
/
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS I FANS HOODS(commetclm) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
I. DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS Toilet 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 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 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 OAL.- t A kV1/vziCr-- DATE f 1- d GI -- U s---
(Signature)
(Signature) (title)
RELATIONSHIP TO PROJECT 0 Owner 0 Agent o Contractor 0 Architect 0 Other
a NEW a ADDITION ','a ALTERATION "z.. ;'-a REPAIR ',•-` " ti TENANT IMPROVEMENT. '
•BUIY DING SHELL ONLY?",° "':,,-t-€.YES a NO , : 4,• 'BASICPLAN? - • , >'a YES a NO
ZONING DESIGNATION ' ', -:,:.43z CHANGE OF USE? "t a YES a NO
NEW ADDRESS REQUIRED'.;
? - YES :a NO ; . UP/SEPA/SU?" _ a YES :a NO '
PLATTED LOT? .- `d YES d NO • • •" • DEMO PERMIT REQUIRED? 0 YES a NO
Bulletin#100-January 7,2005 Page 2 of 4 k\fiandouts\Permit Application