05-104619 s
City of Federal Way Mechanical Permit #: 05 - 104619 - 00 - ME
Community Development Servmes
P.O.Box 9718
Ph.(ral25 Way, 00A 98063-9718ax (23Inspection request line: (253)835-305C
Ph.(253)835-7000 Fax (253)835-2609 l� �l
Project Name: BROOKLAKE VILLAGE ADDITION PHASE II
Project Address: 1015 S 348TH St Parcel Number: 202104 9140
Project Description: Installation of gas piping for(6)new A/C rooftop units.
Owner Applicant Contractor
NWCH INVESTMENT PROPERTIE PRO STAFF MECHANICAL PRO STAFF MECHANICAL
5312 PACIFIC HWY E PRO STAFF MECHANICAL PRO STAFF MECHANICAL
TACOMA WA PO BOX 33370 PO BOX 33370
98424-2602 SEATTLE WA 98133 (206)361-0071
Mechanical Valuation. . 4650.00 Over the Counter Permit. .. .. Yes
Mechanical Fixtures
Description Quantity Description Quantity it Description Quantity
Gas Piping 6
PERMIT EXPIRES March 11,2006. .
Permit issued on September 12,2005
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 accorly ce with the laws,rules and regulations of the State of Washington and
the City of Federal Way. / )
Owner or agent: Date: I Z lt/
I
. THIS CARD IS TO REMAIN ON-SITE .
CITY OF Community Development Inspection Record
Federal Way WR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-104619-00-ME
Owner:
Address: 1015 S 348TH ST
FEDERAL WAY, WA 98003-7027
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.
0 Mechanical Rough-in(4165) .� Gas Piping(4125) 4.` .. . Final-Mechanical(4065)
Approved Approved to release test Appr ved
By Date B ki\ Date lAlt\tc By
cinoc "� r 65- l 0 W {L/ l q
Federal Way PERMIT ale
COMMuxnY DEVELOPMENTSERVICEs {hSF MF CC�/MA/EL PL DE EN FP
33325 D RALWE,WA 9•POB71 9718 APPLICATION t
FEDERAL WAY.WA 98063-9718 v / /
253-835-2607•FAX 253-835-2609
The ollotuin, is -, fired ' , ,tion-an ' •, , , , 1,Heat-ion will not be , .. , ,-, Please , ' t i L.,. Cin ink)or ._ .
MI PROPERTY�cINFORMATION
SITE ADDRESS l 015-- , _ -31'1- `3 a5
i ) SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - LOT SIZE(sj7
LEGAL DESCRIPTION(e.g.Acme Estates.Lot 1) 13L2I Pearn►i 0- 05-) 0ao3 c--00- GC,
(Attach separate pcgeJor lengthy legal description)
MI PROJECT INFORMATION
TYPE OF PERMIT ❑BUILDING G X I:' HANICAL
0 DEMOLITIO LECTRICAL ■ ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
0) 'S F)P)N1- TU ' X 1').F_W ,4-L UN)75 ON 9--0 F
PROJECT NAME(Name of Business or Owner Last Name) 0g-00K.L.14-KF Vi_t...4-(-- 1=
MI PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER C)TA) )ON MA"hi/1-L7).WI. ....-/-1 y GDR_P ( ) -
MAILING ADDRESS CrlY,STATE.ZIP
531-2- )?/ . liWy F F)Fr, 1.v,41,- i
CONTRACTOR COMPANY NAME n APPLICANT NAME OFFICE PHONE
P20— F" I'1 e:CH 4N i G,-t..- % E_ r�Z Ce_eu"ey (21° 3 Lr 49'7)
MAILING ADDRESS CITY.STATE.ZIP CELL PHONE
P 0-Tj>C>X 33`37 0 ,�AT'f(.s� 9 X133 ( ) NA--
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
20 - oz- 1 00 1 q -BL 17- /3/ / 0'7 I ( z ) 3Gr09-74-
CONTRACTOR'S REGISTRATION NUMBER(copy at cud required with each r ppleatioo) EXPIRATION DATE
7g. OsT IM I, 7ZN- G> & /-S% / Oj,
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
PR —*14- 1-- A1751-.u4/4-i,t/e.44-i.' PM12- GR?t_t.4)/ (Zoe,) 3 LJ - 0�7/
MAILING ADDRESS CriY,STATE.ZIP CELL PHONE
( ) NA--
RELATIONSHIP TO PROJECT / FAX NUMBER �/,..
0 Architect ❑Tenant 0 Agent )ther(Describe)MP,e.i- C�01&T• (70L) "514 - v-T2/-}'
CONTACT NAMEPRIMARY PHONE E-MAIL ADDRESS
rTCf? (2oa 314- 007/ QEtvzQ(l --5-1-Aft--vngz ffril(-ArL
LENDER Per RCW 19.27.095: Lender information is NAME `G✓ril
required if prqject value exceeds$5,000
MAILING ADDRESS CnY,STATE.ZIP PHONE
( ) -
• DETAILED BUILDING INFORMATION /
EXISTING USE Med(Re I-- PROPOSED USE Ii1�/t /Fel-
EXISTING
ASSESSED/APPRAISED VALUE $ 1V/f+l VALUE OF PROPOSED WORK $ 11; 50
o 'oO
SPRINKLERED BUILDING? YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES )(NO
WATER SERVICE PROVIDER VEN ❑ HIGHLINE 0 TACOMA n PRIVATE(WELL)
SEWER SERVICE PROVIDER LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
...443270te. 4e
•
A
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. Sg.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT❑
NUMBER OF FLOORS ^RO'OS= TOTAL ror2r.1111Ermc •mrwcrROPOS= iorwca
"NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL4:9 04"Value of Mechanical Work $ ,/ (fl t
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS Commend) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Comho) SHOWERS WATER CLOSETS nroaery MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS)nathroom 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,including its o vers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE DATE 9/2/,
5
(Signature) Mae)
RELATIONSHIP OJECT 0 Owner o Agent Contractor 0 Architect ❑ Other
FOR OFFICE USE ONLY
o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o TES o NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES o NO
Bulletin#100-January 7,2005 Page 2 of 4 k Handouts\Permit Application