04-103604 A
Com ofFederalpay
men Mechanical Permit #:04 - 103604 - 00 - ME
Community Development Services
3530 1st Way S
Federal Way,WA 98003-6210
Ph:253.6o1 4000 Fax.253.661 4129 Inspection request line: 253.835.3050
Project Name: COUNTRYWIDE HOME LOANS
Project Address: 32001 32nd1S Suite110 Parcel Number: 215465 0010
Project Description: Install refrigeration piping for ductless split system.
Owner Applicant Contractor 410
FOSS DEVELOPMENT P S F MECHANICAL INC P S F MECHANICAL INC
FOSS DEVELOPMENT P S F MECHANICAL INC P S F MECHANICAL INC
1151 FAIRVIEW AVE N 9322 14TH AVE S 9322 14TH AVE S
SEATTLE WA 98109 SEATTLE WA 98108 (206)764-9663
Mechanical Valuation 300 Over the Counter Permit Yes
Mechanical Fixtures
i Description IQuantity Description jiQuantity L Description ,Quantity
refrigeration Systems 1
PERMIT EXPIRES March 7,2005.
Permit issued on September 8,2004
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 Wa .
Owner or agent: Date: 9 t
"'
(1(1
THIS CARD IS TO REMAIN ON-SAN!:
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-103604-00-ME
Owner: FOSS DEVELOPMENT
Address: 32001 32nd AVE S Suite 110
FEDERAL WAY, WA 98001-9625
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.
❑ Mechanical Rough-in(4165) 0 Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By Gtr Date 2 3.• � By Date By �Date//i/ ) +
f
.. a •• , .. -
530 FIRST WAY SOUTH•PO BOX 9718
Federal Way PERMIT APPLICATIO ►� M� FEDERAL
� .WAY,
ItP X53 1 9
orn
For Office Use Only TD
FW File Number: 0 - 1 1 (2 0 - C)0 /
The ollowin• is re.uired in ormation-an incom•lete a.•lication will not be acce'ted. Please •rint le•ibi (in in or .
■ PROPERTY INFORMATION
SITE ADDRESS: 0001 _S n U/-TK ' 2/U O k uSUITE/APT#
ASSESSOR'S TAX/PARCEL#: L L 5 ,'I b S - C O 1 0 SQUARE FOOTAGE OF LOT:
LEGAL DESCRIPTION(e.g.:Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
■ PROJECT INFORMATION
TYPE OF PERMIT(This application): ❑ BUILDING 0 PLUMBINGECHANICAL 0 DEMOLITION
0 ELECTRICAL 0 ENGINEERING❑ PREVENTION YS ,
PROJECT DESCRIPTIO (Provide etaile de 'ption of work in ude on this permit o ): _ 4 / . l l / /4
tt.ip.. _Z;$ 91-- ( I
II
PROJECT NAME(Name of Business/Owner Last Name):
• PEOPLE INFORMATION
OWNER:
PROPERTY NAME:Foss OE)/EL-of 1)1 g-11/41F PRIMARY HONE:
OWNER: _
MAILING ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP
I/ 51 rAi Q-urfw AVE' N se, T-c- 1 G .7 q6 to,
CONTRACTOR: NAME COMPANY OFFICE PHONE:
PsF meat 11t1 (mobinV -9663
MAILING ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP CELL PHONE:
9322 11% AVE -SE AkA_ 95108 ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: EXPIRATION DATE: FAX NUMBER:
- - - / / (sob )7bZ - 9381
CONTRACTORS REGISTRATION NUMBER: /✓ EXPIRATION DATE:
li (copy of card required with each application) _e5 FIT elk (� Iv} O / /
LENDER: NAME: DAYTIME PHONE: �wiii.+++
of Proposed Value'$5,000) ( ) -
MAILING ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP
APPLICANT: NAME: COMPANY OFFICE PHONE:
Mt/1\J
�N N /JE-(&. P-SF NEM 10 e . ( ) z6 -3,57
Mt/1\J AD RESS(STREET A DRESS): CITY,STATE, I EVENING PHONE:
g3Z2 )V A UE .S ��� Lo 93/oe ( )
RELATIONSHIP TO PROJECT: NUMBER: G /
0 Architect 0 Tenant .they(Describer (ZD6)76 Z -G,g/
CONTACT PERSON FOR THIS PROJECT: ❑ Property Ownerfontractor 0 Applicant rntyN P.Sr
I � GO
Ir ■ DETAILED BUILDING INFORMATION ki
EXISTING USE: PROPOSED USE: 4
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK: $
SPRINKLERED BUILDING? 0 YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: 0 YES 0 NO
WATER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE 0 TACOMA a PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE a PRIVATE(SEPTIC)
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. _ PROPOSED SQ.FT. TOTAL • •
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
**NEW HOMES ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• FIXTURES
Indicate number of each type of fixture that is to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL 36 d • (�J
Value of Mechanical Work $
--AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS t REFRIG.SYSTEMS
BBQS
FANS HOODS(commerciaQ WOODSTOVES 1
MISC
BOILERS FIREPLACE INSERTS RANGES (Describe)
COMPRESSORS FURNACES Gh..S WATER HEATERS - i
DUCTS GAS PIPE OUTLETS 1
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(roikt( MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES URINALS HOSE BIBBS
LAVS(aathroomsmk 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 Wit but only where such claim arises out of the reliance of the city,
including its officers and empl._` s,upo the accura of the information supplied to the city as a part of this application.
NAME/TITLE: DATE: q/cel 11
(Signature) (Title)
RELATIONSHIP TO PROJECT: ■ • operty Owner pplicant ❑ t]Qctor ❑ Architect ❑
FOR OFFICE USE ONLY:
n NEW a ADDITION ❑ALTERATION o REPAIR a TENANT IMPROVEMENT
f BUILDING SHELL ONLY? o YES a NO BASIC PLAN? a YES o NO 1
ZONING DESIGNATION: CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? o YES a NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? o YES o NO
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