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05-105761 9 , 4.141 City of Federal Way Mechanical Permit #: 05 - 105761 - 00 - ME Community Development Services P.O Box 9718 Federal Way,WA 98063-9718 Ph•(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-305C Project Name: TICOR yJP".4 Project Address: 33915 1ST1S Suite100 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 6680 Over the Counter Permit... No Mechanical Fixtures Description Quantity Description Quantity [ Description Quantityl 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 wit e laws,rules and regulations of the State of Washington and the City of Federal Way. Owner or agent. ___ _ A , ft & =, _ Date: f , __ A THIS CARD IS TO REMAIN ON-SITE CITY oF Community Development Inspection Record - Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT#: 05-105761-00-ME Owner: ESM BUILDING, LLC Address: 33915 1ST WAY S Suite 100 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. Igi Mechanical Rough-in (4165) 0 Gas Piping(4125) 0 Final-Mechanical(4065) Approved Approved to release test Approved By0E.,..1 Date (t,(Li 1,ya•-• By Date B •j Date I2--l C d RECEIVED . CITY CM � � - L �25 Federal Way PE RM ITNovaszo05 COMMUMTYDEVELOP.ME.NTSERVICES -(g / SF MF CO a EL PL DE EN FP 33325 ATM AVENUE SOUTH•PO BOX 9718 Y F D E RAL W Y • FEDERAL 0WAY,7•FAXI 98063-9718 APPLICA -NG T. '" 253-835-2607•FAX 253-835-2609 /0 www cauolfederaltvau corn o -ro(1898- 00 The ollowin• is r-•uired in ormation-an incom•lete a••lication will not be acce•ted. Please • 'nt le•ibl (in ink)or . C7 / NI PROPERTY INFORMATION SITE ADDRESS , l /5- !/ ,�j/ WC1 -5.6(47/(-1 SUITE/UNIT# /00 ASSESSOR'S TAX/PARCEL# i Z. aw 6 r4( - © / 0 LOT SIZE(sf) LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) !Attach separate page fee lengthy legal descrtptbN • PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING 0 PLUMBING )(MECHANICAL 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu) /L?4 (/ -f�Ji f m c v v� tfctG fwoa-Gtr v'Id IA©u74S' !^!L/le c 14,4 rq es fr's u .ee /,1571,,l/ (e ) e--1 c'Gr t,6►s71- v 1 9e- e i s fcee a 1- // a 11-4z_ 0147'co''fe� . PROJECT NAME(Name of Business or Owner Last Name) / /G©t/' T• /• . — s k/�� �Ov III PEOPLE INFORMATION PROPERTY NAME ��/� PRIMARY PHONE OWNER 5-c.,/7,1,44' q L L G ( ) _ MAILING ADDRESS / CITY.STATE.ZIP 3115- (5 t Vy 5. -sem fry F-ailzsi-il hrarti( A/4. 4800 CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE 664 i ve'- ( /�e_ ✓ft9' �'^Y�` G7.1lvrr` (Z53) 1'37 -55O/ MAILING ADDRESS ! CITY,STATE.ZIP CELL PHONE RD 30? 6'(Y 41.4 6 u.+^h VA g867( ( ) - CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER / c7- q- 1 07 <2) c77-B L /z / 3( / o5- ( z)-,) 7c-5f32- CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE unr 1 v4'R / / 5q il?' F-- y / / / oa, APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE "( .4 e, Cowes( For.✓`wiy- ( ) - MAILLNG ADDRESS CITY,STATE.ZIP CELL PHONE rY ( i 5 Cali 741 C-- - ( ) RELATIONSHIP TO PROJECT FAX NUMBER 0 Architect 0 Tenant cirrAgent ❑ Other(Describe) ( ) - CONTACT NAME 75 ♦ PRIMARY PHONE E-MAIL ADDRESS ( (Z-5)) ! -5-;C:) .31^70frei 9 o L(N/v erg.{( LENDER '- . PerRCW 19.27.098: Lender information is:., NAME re�r 7, . C•014"1ui�if project value exceeds$5.100'- l MAILING ADDRESS CITY.STATE,ZIP PHONE ( ) - • DETAILED BUILDING INFORMATION EXISTING USE ---.5-1-7--7 144 e.tc,-._4( d l CX- PROPOSED USEt - EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ K 0G•O.00 SPRINKLERED BUILDING? YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ NO WATER SERVICE PROVIDER LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER I LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ.FT. SQ.FT. sg.FT. BASEMENT FIRST SECOND THIRD FOURTH ADDITIONAL FLOORS(DESCRIBE) DECK(COVERED?) GARAGE 0 CARPORT 0 NUMBER OF FLOORS COMM mom= TOTAL TOTAL tmtteros[ TOTALR1g0�1D! moss "NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $_ FIXTURES Indicate number of each type/�offfudure to be installed or relocated as part of this project Do not include existing fixtures to remain. MECHANICAL Value of Mehe anical Work $ 6lU o AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS BBQS I FANS HOODS(Co }mmercialWOODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC(Describe) COMPRESSORS FURNACES GAS WATER HEATERS I DUCTS GAS PIPE OUTLETS PLUMBING BATHTUBS(or rub/Shower Combo) SHOWERS WATER CLOSETS(roto MISC(Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS LAVS(Bathroom Bioko( 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. atk„._ NAME/TITLE 1.--1A 14)1/4Q DATE I �— �� -0 (Signature) (Title) RELATIONSHIP TO PROJECT 0 Owner 0 Agent Contractor 0 Architect ❑ Other idea " :.o"ADDITION ,_•, a AL TION -4 t1 REPAIR a TENANT IMPROVEMENT. .•BIJILDING SHELL ONLY? , ;s;" ct YES ?Y BASIC PLAN? • H a YES NO ' . ZONING DESIGNATION - CHANGE OF USE? a YES • NO " NEW ADDRESS REQUIRED? "_.:a NO „ ,' • " UP/SEPA/SII? . . a YES. , O PLATTED LOT?''. F`, • 'YES b NO <. •. DEMO PERMIT REQUIRED? 'a YES '."` NO ` Bulletin#100-January 7,2005 Page 2 of 4 k\Handouts\Permit Application