05-101941 i M
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CCity of Federal WayDevelopment Services Mechanical Permit #: 05 - 101941 - 00 - ME
Community
P.O.Box 9718
Federal
25 Way,WA 9so63-(253 Inspection request line: (253) 835-3050
Ph:(253)83`-7000 Fax (253)835-2609 P 9
Project Name: GARLIC JIM'S FAMOUS GOURMET PIZZA
Project Address: 34024 HOYTW SuiteH Parcel Number: 308900 0320
Project Description: Install new duel'ork and supply and return diffusers with new bathroom exhaust fan
Owner Applicant Contractor
NICHOLSON INVESTMENT CORP AMBIENT CONTROL CO INC AMBIENT CONTROL CO INC
2333 CARILLON POINT 1411 R ST 1411 RST
AUBURN WA 98001 AUBURN WA 98001
\KIRKLAND WA 98033 (253)876-9933
Mechanical Valuation 6200 Over the Counter Permit No
Mechanical Fixtures
Description Quantity, Description Quantity [ Description Quantity
Ducts 2 Fans 1
PERMIT EXPIRES October 24,2005.
Pernth issued an April 27,2005
I hereby certify that the above information is correct an at the construction on the above described Ontierty 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: �t%1�
g/Gtda4 Date: 6-/- 2 7"05-
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KC 00405
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- • THIS CARD IS TO REMAIN ON-SITE
CITY OF Commune Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-101941-00-ME
Owner: NICHOLSON INVESTMENT CORP
Address: 34024 HOYT RD SW Suite H
FEDERAL WAY, WA 98023
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 /C Date J/ilo `' By Date <03 Date C'^..-l7-t,.r—
ary of l. R GE-1\1E41
a I (.(
Federal Way -+ l -_-
COMMUNITYDEVELOPMEM'SERVr�p ,} 1 2005 PERMIT SF MF A L PL DE EN FP
33325BatAVENUESWA9•63BOX9
FEDERAL WAY,WA 98063-9718 D
253-835-2607•FAX 253-835-2609 -J G„APPLICATION / /
www.cityolfederalway.cortn 1 A N' Of: F` n i_P'T
The ollowi • is re•uired in ormation-an inco •tete . ••lication will not be acce.ted. Please •rint le.ibt (in • or
• PROPERTY INFORMATION
SITE ADDRESS 54Q7-4 _ 101f+ Rod 1 SUITEJUNIT# i-4
ASSESSOR'S TAX/PARCEL# _ - LOT SIZE(sJ)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate pagef lengthy legal descriparay
• PROJECT INFORMATION -
TYPE OF PERMIT 0 BUILDING 0 PLUMBING titt MECHANICAL
0 DEMOLITION ELECTRICAL 0 ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
4�(/ new C6.-6041 le- aryl 5 (y aal ret-it)rn d eirl Lui amo ba-Nnroor,
.Qan
PROJECT NAME(Name of Business or Owner Last Name) 06( 1 C 111(1`5
• PEOPLE INFORMATION
PROPERTY NAME
PRIMARY PHONE
OWNER ( ) -
MAILING ADDRESS CITY,STATE,ZIP
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICEPHONE
Arn , k Coil-co\ Co, 5eJe v ice ie- (zip )(6/0 -Rq,3
MAILING ADDRESS CITY,STATE,ZP CELL PHONE
KW Z 1-'• Ami 4,1( f 1 (I A, 78C0) ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
I q -.1 t--J Q la 6 `L 0-B L / / t5 )874 - qFV
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
AMb .sECC 1 oI f w (0 /25 / 06
APPLICANT COMPANY NAME APPLICANT NAME ' i .1^ ' OFFICE PHONE
A06 CCOkQC\ Co . J V Mpg l X (25'x) f31k - `jam?53
MAILING ADDRESS CI STATE,Z - CELL PHONE
11411 R 3)-. vuArn( ( 4 c7 ) (. ) -
RELATIONSHIP TO PROJECT FAX NUMBER
o Architect a Tenant a Agent ' Other(Describe) ac_ (2,53 ) giq
b - ql3c
CONTACT NAME/'Jar
tioir-cc‘`� PRIMARY PHONE
(Z3) b i(0 - 5133 E-MAIL ADDRESS
LENDER , NAME
yR k r r e s
MAILING ADDRESS segegP-0 -4
: CITY,STATE,ZIP
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE a TACOMA a PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
4'7 9..2 'DORN
S
PROJECT FLOOR AREA
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
EXISTING PROPOSED TOTAL TOTAL'EXISTR6 SF TOTAL P20POSED SF •''d�" "�+
NUMBER OF FLOORS
'`°r"aP
**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.
MECKAHICAL
Value of Mechanical Work $ ,�Z®Q
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS I FANS HOODS(commecciaq WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower combo) SHOWERS WATER CLOSETS poleq MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAYS(BatkDoom SiSICS 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 officers and employees,upon the accuracy of the information supplied to the city as a part of
this application. /�
NAME/TITLE , %2ADATE L/"21 -D 5
(Signa[ ) (Tile)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent , Contractor ❑Architect 13 Other
ffi�F e ® I. RATION PIR � , I I � f r '' r,
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6 6 6E • '•• .4).4.14,---.1 d e x .. -
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...,,. ;max r. �� .aa -- UP -3-
P. r $ �- , •
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Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application