04-103142 •
City of Federal Way Mechanical Permit #:04 - 103142 - 00 - M
Community Development Services _
33530 Ist'way S
Federal Way,WA 98003-6210
Ph.253.661.4000 Fax 253.661.4129 Inspection request line: 253.835.3050
Project Name: COUNTRYYVIEE HOME LOANS
Project Address: 32001 32n S Suitell0 Parcel Number: 215465 0010
Project Description: Install 6 terminal boxes,1 ductless split system and 1 new ceiling fan.
Owner Applicant Contractor
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 30350 Over the Counter Permit No
Mechanical Fixtures
Description Quantity Description 'Quantity Description PQuantity]
r Air Handling Units V 6 Ducts r 1 Fans 11-1
PERMIT EXPIRES February 22,2005.
Permit issued on August 26,2004
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 W orfrk
Owner or agent: Date: g/ 26/1 ti
*
THIS CARD IS TO REMAIN ON SI'Er
. ...• f 441/4 I
arr ut4401 Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#:
Owner:
Address:
—,,._ . — .
-Thi;,card is part of you:iequired inspection documents. Scheduled inspections may h;, failed if this card is not on-site. DO NOT LOSE THIS CARD.
is ve,:ions are listed as close to s:,quentia1 araer as possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not
be.:o‘ered until i;is a?p:oved. Check with your inspector if you are unsure about ars of the inspections or the inspection sequence. On-going inspections
are logged on the bac.;of this card.
t NOTE: ?dor to seh:t:u•ing't Fr:.min„:•-t1.20) 0 • '
inspection;Electrical,numbing&Mechrnicsl
Rough-in aqd r`s:a Draft Stop in4ections twist be .
tii"sed-off and approved. /BC 10.3.4rt;iiC 198.5.4B' Date 6. ..
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REks ic+�I D .�,�yA` •'MMURnY DEVELOPMENT SERVICES
arr OF�/ • '`�• 33 WAY 98063-BOi8 711
Federal Way ERMIT APPLICATIO 53-661-4115.
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AUG 0 9 20 ww attml(edernlwa mm
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For Office Uae Only. L TD:
F�:max a -32- - Q 0 0 , a
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The ollowin• is re•tared in ormation-an inco •lete a.•lication will not be acce•ted. Please •rint le•ibi (in ink)or • .
• PROPERTY INFORMATION
SITE ADDRESS: a O ' , �_.j t _ SUITE/APT# imam
,.
ASSESSOR'S TAX/PARCEL#: Z 1 S 1. Q S - 6 0_ 1 a SQUARE FOOTAGE OF LOT:
LEGAL DESCRIPTION(e.g.:Acme Estates,Lot 1) qtaeh Pet•to1 S/(Wi (-IT sr
(Attach se rate page for le thy legal descript)n)
■ PROJECT INFORMATION
TYPE OF PERMIT(This application): o BUILDING 0 PLUMBING ,. ECHANICAL 0 DEMOLITION
0 ELECTRICAL 0 ENGINEERING 0 FIRE P• TION SYSTE,,
PR JECT DEF ON(Provide detailed d cription of work i r ded on this permit n1 . , 'Ai./ ii �-
/ ' j f I
6) i
PROJECT NAME(Name of Business/Owner Last Name): • _ •// ' kQ
• PEOPLE INFORMATION
POROPERTY WNER NAME: PRIMARY PHONE:
`_ M E u f L o Y_ 1 ! E- `i-r- (A6 )v6 C.
- 560AILING ADD• . STREET ADDRESS;): CITY,STATE,ZIP
Po 6-3, CiyyY1 Eget IJP) ` S a
CONTRACTOR NAME N rS 1 M e f N C ( )f� - y
MAIL�� ANN �
��� (STREET�AD ESS � � � CITY,STATE,ZIP ���V CELL PHONE: -
i � Gip, �t ( )
CITY OF FEDERAL WAY BUSINESS U ENE NUMBER: EXPIRATION DATE: . FAX NUMBER:
ZO_-oo-1n I_ . b% - 12./ 1 1 /o( (c6 ) 16Z_ - c)3a<
0 /-
CONTRACTORS REGISTRATION NUMBER: 4 /� EXPIRATION DATE:
F(copy of card required with each application) f 5 U ' L Q N_ 10 / 3 /G
LENDER NAME: DAYTIME PHONE:
)if Proposed Valuer.$5,000)
MAILING ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP
APPLICANT: NAME: COMPANY OFFICE PHONE:
My A N N T �//� t2 co. /V)F/al lob) 7611 -1 6^3
MAID G ADDRESS(STREET DDl(ESS): CITY,STATE,ZIP ` 1 O 8 EVENING PHONE:
9 322 1%i L RVQ s Sea LA* 8 ( )
RELATIONSHIP TO PROJECT: COFAX
0 Architect 0 Tenant Other(Describer w fs aAc(W ( Z5b b t - S58(
CONTACT PERSON FOR THIS PROJECT: 0 Property Owner )Contractor 0 Applicant E-MAIL @ fS f C�
M
■ DETAILED BUILDING INFORMATION
EXISTING USE: PROPOSED USE: D F/- 1 � 4,
/J
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK: $ .7CJ) 3 •d'3
SPRINKLERED BUILDING? O YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: 0 YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL k
BASEMENT
FIRST •
SECOND
THIRD
•
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
•
GARAGE/CARPORT
TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
HOW MANY FLOORS? OO
**NEW HOMES ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
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
Value of Mechanical Work $
--AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
FANS HOODS(commercl.l) WOODSTOVES i
BBQS �—BOILERS FIREPLACE INSERTS RANGES (cj MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS ir _, 1 D�
DUCTS GAS PIPE OUTLETS D�"
PLUMBING • . - '
BATHTUBS(or Tub/Sbowercomeo) SHOWERS • WATER CLOSETS(rose) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES - URINALS HOSE B1BBS
LAVS(Bathroom Sink 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 j
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,up n the accuracy of the information supplied to the city as a part of this application.1'?
/NAME TITLE: DATE:(Title( 10 y
( 'gnature)
RELATIONSHIP TO P O 0 Prop Owner 0 Applicant t'6Qtractor, ❑ Architect 0
iXPRAFF,.ICE USE,ONLY• - . -
U NEW - a ADDITION a ALTERATION a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES a NO BASIC-PLAN? o YES n NO
4 ZONING DESIGNATION: CHANGE OF USE? a YES a NO
_NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SII? a YES a NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? a YES a NO
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