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04-103494 st I! [City of Development Services Federal Way n,nmnflyMechanical Permit #:04 - 103494 - 00 - ME 33530 1st Way S Federal Way,WA 98003-6210 Ph.253 661.4000 Fax 253 661 4129 Inspection request line: 253.835.3050 Project Name: SAFEWAY#1555 Project Address: 1207 S 320TH 53 Parcel Number: 150050 0020 Project Description: Relocating and replacing refrigerated cases Owner Applicant Contractor 1560 INVESTORS LLC TRUETEMP NW TRUETEMP NW 200 S BROAD S t'#6 TRUETEMP NW TRUETEMP NW 1627 45TH ST E SUITE 101 . 1627 45TH ST E SUITE 101 SUMNER WA 98390 1 (253)826-9640 Mechanical Valuation 145000 Over the Counter Permit. No Mechanical Fixtures Descriptio n KQuanttj Description jouantit�; Description jjQuanty _ _ r Refrigeration Systems i�33 1 PERMIT EXPIRES March 14,2005. Permit issued on September 15,2004 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 Way. Owner or agent: ___ ��_ i Date: c/_ 7 ©� 3 - 6LE I Vii4 - I , • THIS CARD IS TO REMAIN ON-SITE ,• CITY OF Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT #: 04-103494-00-ME Owner: Address: 1207 S 320TH ST FEDERAL WAY, WA 98003-5339 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) ❑ Final-Mechanical(4065) Approved Approved to release test Approved By Date N _ 0 By Date By4 , Date ( Z... 3 "� ."41 t A ' 7 c O 1t A7 � c, O � I .t 33325 8`h Avenue South ' .," ,, 19, ! t ^' PO Box 9718 �'E� - _`� Federal Way WA 98063-9718 PERMIT SF MF CO 253-835-2607;Fax 253.835.2609 - . DE EN FP ' w` rcityoffederalway.com kPPLICAT q J (.744, • / / 0 The ollowin. is re.wired in ormation-an ifcco •lete a..lication will not be • ,, :tel#.l„Please •rint le•ibl (in ink)or L PROPERTY INFORMATION SITE ADDRESS/a v7 5o unlet 3 2 O FDei 4-L (,,,,q- Y. SUITE/UNIT# ASSESSOR'S TAX/PARCEL# - _ _ _ LOT SIZE(4) LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) (Attach separate page for lengthy legal desenptron) PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING 0 PLUMBING MECHANICAL ❑ DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this permit onit!) Re,1-0Cri,v & AA/6 RepLr9,u.✓6- R�ric(9 cifces PROJECT NAME(Name of Business or Owner Last Name) 5 f)-FFLAI KY #l5- PEOPLE INFORMATION PROPERTY NAM ,(�� PRIMARYrPHONE OWNER 1 cf jt1-(� (�/ 6 3 -),20.Z MAILING ADDRESS CITY,STATE,ZIP P,0. & k 8 sto 1 gelf ebur WA-. 9 8© /S-- 6s--e7j CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE 1524 er-eyk,p N w, et-itu67ri ,(/. J (25-3 )g,26 - ,4, 80 MAILING// ADDRESS p CITY,STATE,ZIP CELL PHONE 1e, 7 EL/$T 's. 5u Ere-/0/ .514 frn/veuthi 9g, o ( ) - CITY OF (Z EXIIRATION DATE FAX NUMBER 6 - df i e 3',4 I - B L Iz/ 2)( / Of (01S3 )$ -9-j CONTRACTOR'S REGISTRATION NUMBER(coPy of card required with each application) EXPIRATION DATE APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE -U TEA& /V uW, 77.2,4& p /� w. (i..2s3) 826 -96 S'© AILING ADDRESS CITY,STATE,ZIP CELL PHONE /10.27 grfri"' r.e S wre /0/ .cUir )E ) w >3 k q C1 ( ) - RELATIONSHIP TO PROJECT n FAX NUMBER 0 Architect El Tenant 0 Agent.Other(Describe) e,:EJV/1 2-4-C.�t (2 )gt - Q77 CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS $775-0 B 3 ;0(.1` we-(( (.S3 )926 - gbyo LENDER Per RCW 19.27.095: Lender information is NAME required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP n DETAILED BUILDING INFORMATION EXISTING USE L( S-b2€. PROPOSED USE 6.0 C-e- Y1 .57•T)lee_ / EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ 4 C 000 SPRINKLERED BUILDING? KYES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES 0 NO WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 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 offacture to be installed or relocated as part of this project. Do not include existing fixtures to remain. MECHANICAL Value of Mechanical Work $ 1514 5,000 AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS 33 REFRIG.SYSTEMS BBQS FANS HOODS(commercial) WOODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC(Describe) COMPRESSORS FURNACES GAS WATER HEATERS DUCTS GAS PIPE OUTLETS PLUMBING BATHTUBS(or T.b/showercombo SHOWERS WATER CLOSETS(rode) 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, 'nciudi g its o ficers and employees, upon the accuracy of the information supplied to the city as a part of this application. ��. NAME/TITLE ,, 40:2k/ DATE (Sig '!""u re) (Title) RELATIONSHIP TO PROJECT 0 Owner 0 Agent Contractor ❑ Architect ❑ Other FOR OFFICE USE ONLY ❑NEW a ADDITION o ALTERATION a REPAIR ❑TENANT IMPROVEMENT BUILDING SHELL ONLY? ❑YES o NO BASIC PLAN? o YES a NO ZONING DESIGNATION CHANGE OF USE? o YES a NO NEW ADDRESS REQUIRED? ❑YES o NO UP/SEPA/SU? o YES a NO PLATTED LOT? ❑YES o NO DEMO PERMIT REQUIRED? ❑YES ❑NO Bulletin#100—March 30,2004 Page 2 of 4 k\Handouts—Revised\Permit Application