05-101923 - 4 /
City of Federal Way Mechanical Permit #: 05 - 101923 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: STARBUCKS 1�
Project Address: 33702 21ST`S �. Parcel Number: 930100 0010
Project Description: Relocate(1)ceiling grid diffuser as part of tenant improvements.
Owner Applicant Contractor
STARBUCKS#3245 MERIT MECHANICAL INC MERIT MECHANICAL INC
33702 21ST AVE SW PO BOX 2109 PO BOX 2109
FEDERAL WAY WA REDMOND WA 98073-2109 REDMOND WA 98073-2109
(425)883-9224
Mechanical Valuation 300 Over the Counter Permit Yes
Mechanical Fixtures
Description Quantity j Description Quantity j Description Quantity
Ducts JI 1
PERMIT EXPIRES October 23,2005.
Permit issued on April 26,2005
I hereby certify that ,above information ise end-hat the construction on the fOove 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. -4111"4111° 4111P Date: G
SUBJECT TO HELD INSPECTION.
THIS CARD IS TO REMAIN ON-SITE
CITY OF A. Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-101923-00-ME
Owner: STARBUCKS #3245
Address: 33702 21ST AVE SW
FEDERAL WAY, WA 98023-7762
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) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By if Date Si
?
//1
SUBJECT TO FIELD IINSPECTICN.
, I
RECEIVED
.°1CITTOF Al R 2 6 Z005 V !0 5 - / , / F 3
Federal Way �,�, RM IT II
COMMUNITY DEVELOPMENT SERVICES CITY OF FEDERA SF MF CO 0 L PL DE EN FP
33325 8r,
FEDERAL
ESOA 98063 BOX 9718 BUILD 'LI CATI ON
FEDERAL WAY,WA 98063-9718 TD / /
253-835-2607•FAX 253-835-2609
:mu;.cityoflederalwau.com
Q CI ' uN.
The ollowin• is re•uired i ormation-an incom•late a••lication will not be acre•ted.KPlease 1,not ie • I T(in _P Zr , . Sn
• PROPERTY INFORMATION/ � ,�''
SITE ADDRESS 3370 2 21 S+ A'J S L) SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# _ - LOT SIZE(s,/)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT ❑BUILDING ❑ PLUMBING MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
-f ac.a1 I siche ‘,16► !I re ,urn e y-tJk -6
Ce4/,h5 yr4
PROJECT NAME(Name of Business or Owner Last Name) 7"(r/ohlel3Uct.cc
• PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER kV) Mtf E--.)e. (
MAILING ADDRESS _l CITY,STATE,ZIP
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
MERI f AA I/4 NI cid_ 3-err (42Aw1Gieb (4zs0 V4 3 -9224
MAILING ADDRESS COY,STATE.ZIP CELLPHONE
1 430 153rd Atie_l3t �Z�D�t�lo>tt� (4 ��2 - Z�Zg
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
lq-943 - 10540o - B L / ' Ras') g6-7 6762
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
IM le I- T itiLt & 1p 3 L NI 4 / o l /Loos
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
SAM e- AS il6auC ( )
-
MAILING ADDRESS COY,STATE,ZIP CELL PHONE
RELATIONSHIP TOPROJECT FAX NUMBER
❑ Architect 0 Tenant 0 Agent o Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
S—FF C P4h.J kC (UV/ 44Z- V ZC't
LENDER X'er; +G%V19.27 095 Leader tnforatattea ts NAME
required if project value exceeds$45,000
MAILING ADDRESS COY,STATE,ZIP
Cot-
• DETAILED BUILDING INFORMATION
Co
EXISTING USE F/ S tit k 1 PROPOSED USE S/411•1 C
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ .:.bC'
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑ NO
WATER SERVICE PROVIDER o LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER o LAKEHAVEN o HIGHLINE o PRIVATE(SEPTIC)
06 I. 6
t
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT El
NUMBER OF FLOORS EXISTING PROPOSED rarer raracaacnarnvo sf,.. wren�sctna ED er' T41r1T SF
**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 $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS)or7Lb/shower compo) SHOWERS WATER CLOSETS
(mile) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Ba hroom 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 •••e by any person,including the undersigned,and filed against the City of Federal Way,but only where such claim
arises out of the relianc city,including its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
e �J�
NAME/TITLE DATE ZIP(7-676)7.
(Signet e) (Title)
RELATIONSHIP TO PROJECT ❑ Owner ❑Agent Vntractor 0 Architect ❑ Other
a NEW 'a.P )DITLON a 41. ERATIOI a REPAIR c TENANT IMPROVIMMENT
'BUILDING SHELL ONLY'fi:.... ,4,t1 YES a NO 4
r)YES a NO
ZONINGDESIGNATIbN °:
,:::: r?TEs a*0..
NEW ADDRESS REQUIRED? a us a NO s uP/SE SU? a YES a N
,,�
PI.ATTE1 LOT7;'; a , .or
',a NO „DEMO I R1MY'IT•REQU1? a`YES a 140
Bulletin#100-January 7,2005 Page 2 of 4 k\Handouts\Permit Application