05-105762 City of Federal Way Mechanical Permit #: 05 - 105762 - 00 - ME
Community Development Services
P.O.Box 9718
"6 Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: REMAX
Project Address: 33915 1ST'S Suitell4 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 10470 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 agent: L � '� Date: 11i �'� .
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-105762-00-ME
Owner: ESM BUILDING, LLC
Address: 33915 1ST WAY S Suite 114
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.
II Mechanical Rough-in (4165) ❑ Gas Piping(4125) ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
/0 By,�,) Date f Itrk (:).5"-- By Date By Date /Z
�,�OF •
RECEIVED?5 - r a 7-Federal Way PERMIT - - - - -
COMMUNITY DEVELOPMENT SERVICES NOV 0 9 2005 SF MF CO a)EL PL DE EN FP
33325E -8 AL SOUTH•PO BOX 9718 A P P L I C A'� / // /
53-835IL WAY.WA 98063-9718 I i O s
.53-835-?607•eFAX dera53-835-2609 DERAL VW'�Y
'ww.cauof(ederalwau corn BUILDING DEPT.
The ollowin• is r-•wired in ormation-an incom•fete a.•lication will not be acce•ted. Please • 'nt le•ibl (in ink)or p .
• PROPERTY INFORMATION
SITE ADDRESS q 1 c- !/ � WGW/ .SO Gt YA . SUITE/ // 7.(
ASSESSOR'S TAX/PARCEL# r 1 Z %CC) y C) 7 5 •T SIZE(sj)
LEGAL DESCRIPTION(e.g.•icme Estates,Lot 1)
(Attach separate page for lengthy legal descrlptlon)
• PROJECT INFORMATION
TYPE OF PERMIT ❑BUILDING 0 PLUMBIN i ''MEC
0 DEMOLITION 0 ELECTRICAL ' ENG i ' . I G FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION/ (Provide detailed/description of work inc. -d on this •- r /
Al 5 7 (( a _.74(4/ K 4 y r'_ !H! i"- '. f. bt)-4((
(17 ft-vt a vL�rn C.. /ir l A, !ct4..• •
t:,
PROJECT NAME(Name of Busin- •e e.ame) f/`1 a +. i. — S Lf f f e //c(
PEOPLE INFORMATION
PROPERTY ' e • PRIMARY PHONE
OWNER Li 5L1//r/ Z-L C- ( ) -
MAILING •REBS CITY.STATE.ZIP
3- is t Wr s . -sem //y F I r(l l/a(p( r,,/(. 98003
CONT COMPANY NAME ` APPLICANT NAMEA OFFICE PHONE
664 7 ve4/ ( A2 ✓`(q/• eiv sI7 (vn v
� 'y 4 lv!r` (Z5 ) 937 -55-0 r
MAILING ADDRESS ! CITY.STATE.ZIP CELL PHONE
7 ) Sox &/y 6twh IVA `1867( ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
/ /- Fq- l czs 7 X 4 7-B L /z / 3/ / os ( zS>) 7 --3`f3Z
CON'TRACTORS REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
Li At / v .ER / / 5- q F y / ( / Oa,
APPLICANT COMPANY NAMEAPPLICANT NAME OFFICE PHONE
4//
5a~ tov►^( Fow-w ev- ( ) -
MAILING ADDRESS CITY.STATE.ZIP CELL PHONE
i y,%) /5 Cwt fit ( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant 'Agent 0 Other(Describe) ( ) -
CONTACT NAME ♦ PRIMARY PHONE E-MAIL ADDRESS
Frra"1 Cha 6/1-1".. (zf)) 93q - ASO / Bryaii1 t� u H Ive►-S•�(
LENDER . ._.Pe
rRCW-19.27.093. Under information is NAME ete f toy . COI+-,
required(fp%hact value exceeds$5.000 •
MAILING ADDRESS CITY.STATE.ZIP PHONE
( ) -
• DETAILED BUILDING INFORMATION
i
EXISTING USE C- i-7 Twit,e t/`r u� O1 tom'C C.P� PROPOSED USE Cei [f
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ /(/ 7?0
SPRINKLERED BUILDING? VYES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? eES ❑ NO
WATER SERVICE PROVIDER HAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER HAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
• •
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
BASEMENT SQ.FT. S9.FT.�SG.FT.
FIRST
SECOND
THIRD `
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS MOMS= 1OfAL- TorAcrow
ssass -Tarscrxrnos
vr - - - Torwsr
"NEW HOMES ONLY NUMBER OF BEDROOMS ESTIMATED SLLING PRICE $
FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project Do not in Lde existing fixtures to remain.
A ��
ValueecMECHA1VIchhanical Work $ I Q �7 r
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS _ FANS HOODS(Commerce) WOOD)VES
BOILERS FIREPLACE INSERTS RANGES a MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS l''
DUCTS GAS PIPE OUTLETS F
PLUMBING
AIP
BATHTUBS(or Tub/Shower Combol SHOWERS WATER CLOSETS(toile) MISC(D ebbe)
DISHWASHERS SINKS DRINKING FOUNTAINS f
GAS PIPE OUTLETS SUMPS RAINWATER SYST 0
WASHING MACHINES URINALS HOSE BIBBS
LAYS(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 RL- -b c vAvv`Q—X DATE /7— 6:7— 4:), ..--
(Signature)
,(Signature) (Title)
RELATIONSHIP TO PROJECT a Owner )Agent Contractor a Architect ❑ Other
:;FOR OFFICE USE ONLY.,-1:,-1: ::,'z'4
)(NEW ; •.-'t ADDITION a;ALTERATION _- a REPAIR.; ': - -c i TENANT IMPROVEMENT .-.•-. . -. ..:-- ..
R BUILDING SHELL ONLY? t�YES c 10 BASIC PLAN? _ , a YES NO'"
ZONING DESIGNATION - CHANGE OF USE? - a YES NO
NEW ADDRESS REQUIRED? ' a f- &NO , ..IIP/SEPA/SU? . -•.a YES O
6 PLATTED LOT? i•P'" •a NO '.' DEMO PERMIT REQUIRED? a TES NO '•.
Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application