04-105217 •
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City of Federal Way Mechanical Permit#: 04 - 105217 - 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) 835-3050
Project Name: BROADCOM it
Project Address: 32001 32ND bit
Parcel Number: 162104 9001
Project Description: Install(3)VAV boxes with distribution fron 2 existing AC units
Owner Applicant Contractor
FOSS REDEVELOPMENT AMBIENT CONTROL CO INC AMBIENT CONTROL CO INC
PO BOX 94449 1411 R ST 1411 R ST
SEATTLE WA 98124 AUBURN WA 98001 AUBURN WA 98001
(253)876-9933
Mechanical Valuation 13985 Over the Counter Permit No
PERMIT EXPIRES July 12,2005.
Permit issued on January 13,2005
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. c,
Owner or ag 0 — Date: / / J
•0,
A .
THIS CARD IS TO REMAIN ON-SITE
CI Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-105217-00-ME
Owner: FOSS REDEVELOPMENT
Address: 32001 32ND AVE S Suite 410
FEDERAL WAY, WA
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) �❑ Gas Piping(4125) vi Final-Mechanical (4065)
pproved Approved to release test
,
By ' Dater ..1� Q,
( i By Date B • `1 Date I b�
Of.411 . RECEIV
4.
Federal Way EEI /E / S!
�C 2 $ NO4 PERM F MF CO �L PL DE EN FP
COMMUNr1Y DEVELOPMENT SERVIC
33325 8Th SOUTH•Po BO9 p L I C A T I( N 8 20� . TD j
FEDERAL WAY,WA 98063-9718 / -Zi y U
253-835-2607-FAX 253-835-2609 j/7 / ) /
AP
unww.aluonederalwaucofCfTY OF FEDER AI_
DEPT. �G% �
The followingis required information-an incompleteCOY or' FE• RAL W/y
4 f a••licatio ,.,: .I.,a..,;_y d. Please •rent legibly(in ink)or type.
s-.J
IN PROPERTY INFORMATION
SITE ADDRESS .'j2 LJI 5. J Z. -L3- ASUITE/UNIT N Jo
ASSESSOR'S TAX/PARCEL# I 2 I o (4 - 9 0 0 1 LOT SIZE(sJ)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
■ PROJECT INFORMATION -/
TYPE OF PERMIT 0 BUILDING 0 PLUMBING O ECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work indu ed this permit onlq)
.1....1.- QTc . Ael. ' ( V Pc\) e-, -c c.J. ‘--D-It
IN. %--- s 11 :::.c 21 ':_ _ 0'" - fan
y*-- - S .
PROJECT NAME(Name of Business or Owner Last Name) • Ukr)6044
- . . - - NI PEOPLE INFORMATION
PROPERTY NAME / � �1n�l,, PRIMARY PHONE
OWNER ITL^J3 1�L• � i 7 ( ) -
MAILING ADDRESSCITY STATE,ZIP
,111 'Me u l 2 - C_ LSA. 9�S((9
CONTRACTOR COMPANY NAME A(P(�ICANT NAME OFFICE PHONE
IA"Mbie. C.- C- .&. - u aU(' ,.)5 (2-S7€ -933
MAILING ADDRESS CITY,STATE,ZIP �'�y CELL ONE
I c-c( Sr. K • v.) (.,,y _ w (104:,)9z: -7E:,Yy
OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
i /-19 -1Q G .CS! 0-B L IZ /51 /of `�7.5) 1... -9q3y
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application( EXPIRATION DATE
a.m 1 c c 1 01 P (.)_ l'z . / ZS /o)--
APPLICANT MPANY,44AMEthtPLICANT NAME OFFICE PHONE
key NI-t'RJL •) (2 g-7 -933
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
14-11/ 4 57- /LLLA) At _,J ctn-j►rSocff CZx.I 5-10 -7L'r%
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant 1Agent ❑ Other(Describe) ( ) -
CONTACT E PRIMARY PHONE E-MAIL ADDRESS
�v(a r 4 (Z).51 ti -762W'
LENDER Per RCW19.27.095::Lenderinformationis' NAME
required if project value exceeds$5,000 P, (,
MAILING ADDRESS CITY,STATE,ZIP /'4
.■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
i WATER SERVICE PROVIDER a LAKEHAVEN 0 RIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑HIGHLINE ❑ PRIVATE(SEPTIC)
10-79.796688
C,
PROJECT FLOOR AREAS -
• AREA DESCRIPTION EXISTING SQ.FT. PR* - ED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EXISTING TOTAL.PROPOSED TOTAL sLaSTLe°AND ntOPOSED
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
. -
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
• MECHANICAL
Value of Mechanical Work $ '5,9 -r-3---
;
3 AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
. BBQS FANS HOODS(c........6.1) W OO DSTOV ES
' BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
<'5 DUCTS GAS PIPE OUTLETS
•
PLUMBING
BATHTUBS(or Tub/ShouerCombo) SHOWERS WATER CLOSETS(rode.) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE B1BBS
LAVS(Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
..----...--_;-:-.3;--.;-:•-_-_":::±:':-.:-.,''',*,-.1-:z -1 ._._. . 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/TIT -L/i-.de/l_ C y�l : ��fJ
DATE / L_—Z-7.c'(-/
(Signature) (Tule)
RELATIONS ' TO PROJECT 0 Owner ❑ Agent o Contractor 0 Architect 0 Other
I
i -
x ;
•
! FOR OFFICE USE ONLY
l •
a NEW a ADDITION a ALTERATION a REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES a NO BASIC PLAN? o YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES o NO
t NEW ADDRESS REQUIRED? o YES a NO UP/SEPA/SU? o YES o NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? o YES o NO
•
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Bulletin#100—March 30,2004 —
Page 2 of 4 k\Handouts—Revised\Permit Application
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