05-102989 ,r
City of Federal Way
• Community Development Services Mechanical Permit #: 05 - 102989 - 00 - ME
PO.Box 9718
Federal Way,WA 98063-9718
Ph.(253)835-7000 Fax (253)835-2609 Inspection recpiest line: (253) 835-305C
Project Name: DASH POINT STATE PARK SHOP CONVERSION
Project Address: 5700 SW DASH POINT Rci Parcel Number: 102103 9002
Project Description: Install 2 gas furnaces and air conditioner. "415a5 ptpin3.22
Owner Applicant V Contractor
STATE OF WASHINGTON ADVANCED FILTER&MECH INC ADVANCED FILTER&MECH INC
PO Box 42668 418 VALLEY AVE NW UNIT B115 418 VALLEY AVE NW UNIT B115
PUYALLUP WA 98371 PUYALLUP WA 98371
PO Box 42668 !Olympia,WA 98504-2668 (253)770-2440
Mechanical Valuation.... .. 4500 Over the Counter Permit ................ Yes
Mechanical Fixtures
Description Quantity Description Quantity Description IQuantity
Air Handling Units 1 Furnaces 2
PERMIT EXPIRES December 20,2005.
Permit issued on June 23,2005
I hereby certify that the above information is correct and that the c truction on the above described property and
the occupancy and the use will .e in . cordance w1i the laws, es d regulations of the State of Washington and
the City of Federal Wa
/ � 'G/
Owner or agent: l/L�U Date:
THIS CARD IS TO REMAIN ON-SITE
CITY OF .r Community Development Inspection-Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-102989-00-ME
Owner:
Address: 5700 SW DASH POINT RD
FEDERAL WAY, WA 98023-2045
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.
•
11 Mechanical Rough-in (4165) •❑ Gas Piping(4125) �❑ Final-Mechanical(4065)
Approved Approved to release test Approve
By.; L� Date G ice_ By 5 Date 61-,- --k)---015:, By ��ba e pA.)
. REcEivEn
Fede Way JUN 2 �o ,r �- 8' Z-
COMMUNITY DEVELOPMENT SBRVICBS PERMIT CITY OF FE F MF CO L PL DE EN FP
�3?FtD"RLWAY,VENUE WA AI 80639718 APPLICATIC� FERAL ,�Y
' 253435-2607.FAX 253435-2609
iNG DEpT // I
w nw.dtwfedemlway.cc, —1
The ollowl • is re• ired i ormation-an inco •lete a••lication will not be acce•ted. Please •rint le•ibi i or 11
■ PROPERTY INFORMATION
SITE ADDRESS .57 c17 1\—Rt,..4, C`• SUITE/UNIT I
ASSESSOR'S TAX/PARCEL I ( C'7_ ( O 3- / Q d LOT SIZE(sJJ
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Aaaah&W.W.I~for Mpav legaidesaiPtion)
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide det ed des ' tion of worked onpermit onlu)
Q LL �` -4- � ,�,c Q
PROJECT NAME(Name of Business or Owner Last Name)
al PEOPLE INFORMATION
PROPERTY NAME c_Rj...._
PRIMARY PHONE p/
OWNER t
1���- ) C g( - .4T�q -�O
MAILING ADDRESS STA Z
CONTRACTOR COMPANY NAME \ \^ APPLICANT NAME OFFICE
OFFICE PHO–N�Er�
MAILINGADDRESS .\kms D r ‘--4.,S n+� <! -2-L( 0
(� 1 ,r CELL PHONE v
CITY OF FEDERAL W SINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
ER _
CONTRACTOR'S REGISTRATION REGISTRATION NUMBER(copy of carequited with each application( / EXPIRATION DATE �
AD ')) !fir LJ r .tst
_4_ _ -Z / /
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP - CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
❑Architect ❑Tenant 0 Agent 0 Other(Describe) ( ) -
CONTACT (� PRIMARY PHONE E-MAIL ADDRESS
cM /�CiZ V`- \ (ZS;)77 -9•y gra
LENDER > ;•l•, ..:z , ,,,•r_, ,i 417,;10„.,,r i,l; ,; NAME
5•:r.'_ fI^;1C •i, ,P,- -.d.r. r.1-;-i"-- .res
MAILING ADDRESS CITY,Y,STATE,ZIP
• ■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ 16;5/721 VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? a YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES ❑ NO
WATER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER o LAKEHAVEN a HIGHLINE ❑PRIVATE(SEPTIC)
•
- PROJECT FLOOR AREAS
r
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
'
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
LXISTOIOPROPOLLD TOTAL
NUMBER OF FLOORS
I
- r
"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.
MECHANICAL ,
Value of Mechanical Work $ � )
252)
•
AIR HANDLING UNITS EVAPORATIVE COOLERS OAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(Gmmerota4 WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS / '- I FURNACES OILS WATER HEATERS
DUCTS d GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Combo} SHOWERS WATER CLOSETS(roues MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom ink 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 gbovinpremises to perform the rk for which the permit application is made. I further agree to hold
harmless the City of Federal W 6ts to any claim(i co�eases, and attorneys'fees incurred in the investigation and defense of
such claim),which may be mjzd by any person,Inc ing'the ung signed,and filed against the City of Federal Way,but only where such claim
arises out of the reliance o the city,instuding i,, ofjice�ts and"nip gees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE - �4 2"//7/ / DATE f? -Zz--
Signature) (Title)
RELATIONSHIP TO PROJECT ❑ Owner 0 Agent "contractor 0 Architect 0 Other
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Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application