19-104568 Mechanical
City or Federal Way Permit #:19-104568-00-ME
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax(253)835-2609
Project Name: EVERGREEN EYE CENTER
Project Address: 33600 6TH AVE S Parcel Number: 926480 0205
Project Description: Replace existing unit with a new FUJITSU ductless split system-equipment will be in same
locations as existing.
Owner Applicant Contractor
SHARON LACHNERAULUKISTA LLC BRETT ROEBUCKAIR SYSTEMS AIR SYSTEMS ENGINEERING INC
5015 BUSINESS PARK BLVD SUITE 3000 ENGINEERING INC (GENERAL)
ANCHORAGE AK 99503 3602 S PINE ST AIRSYE*229KN(2/1/2D)
USA TACOMA WA 98409 3602 S PINE ST
TACOMA WA 98409
Additional Permit Information
Mechanical Work Valuation? 6992 Is this an Online or O.T.C.application? No
V, 4 €. 4 4 ,ate,a,,, a ,E, " � f'„s.
04,
Air Handling Units 1 Compressors/Heat Pumps 1
PERMIT EXPIRES Sunday,22 March,2020
Permit Issued on Tuesday,September 24,2019
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
� I)of Federal Way.
t '
Owner agenv ` ` 5 Date: Z d T i
THIS CARD IS TO REMAIN ON-SITE
CITY Oi 044
Construction InspectionsRecord
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 104568 00 Address: 33600 6TH AVE S Unit 200
Project: SHARON LACHNER FEDERAL WAY WA 98003
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 2❑ Gas Piping(4125) ® Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By G Date g- t
•
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
...__ _A. PERMIT APPLICATION
CITY OF
Fe de ra I Way RECEIVED PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
253-835-2607+FAX 253-835-2609 +permitcenteil5icitvoffederalway.com
SEP2332�001119
•
PERMIT NUMBER _ � ruEvEro
ITY FILL PeL — M I /y
TARGET DATE
/ /
SITE ADDRESS SUITE/UNIT#
3300 G 1" Ali- els
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL 8
$ G°192 . 00 9 2 (, 4 5 0 — 0 2 a 5
TYPE OF PERMIT 0 BUILDING 0 PLUMBING X MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT R\I SS�LL PlA2A EV MORRIA, FIE 5E?-V1 K ROO M A e
PROJECT DESCRIPTION F URt1I 51i MI? INS- I NSW F1)S l75V
Detailed description of work to
be included on this permit only D U CLY5 ell\ S`I D1 R41 - k)\?c ll NZ "N 1 Ll.
C5C Its SAJ1I LOCA-1110N5 A5 -EX tS T A I ,�
NAME R 1 CNAVV 5 Al\R VAR PRIMARY 0-1 PHONE V�L!r+rU 1 (01
PROPERTY OWNER MAILING ADDRESS it
MAIL
5015 5\/516W) PF'iNV, 91;6ELa EMI-1007A r5t1(-t°''
CITY STATE ZIP
RN C_KGCkACI'` RY• `1150') A25 643 9203
NAME RI& 5`115'FP ER4ItiWR1NC� rKG, PHONE 25-5 sit `\4Y, k
MAILING ADDRESS 'LJ co 01,
5 P 1 N C cjT E-MAIL V)' ft C nt-7Fr1 X115
CONTRACTOR
CITY STATE ZIP FAX
7 6,k1R '.Oft 9 55 A 01 Z .2) 383 G351
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE M
Yk1V\Svt lt, 221Y\N 2 / 1 / /o 19--i3 -000006- or"-BL
NAME 13�E77 �0V��CV\ PRIMARY PHONE
APPLICANT MAILING ADDRESS C 7.R,IA 0 b A) E-MAIL
CITY STATE ZIP FAX
PROJECT CONTACT NAMEV)1� �7 tko tV7 U CK PRIMARY PHONE
(The individual to receive and NAMING`DDRESS c2 C 01k7);2••,A C CA7:7 E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME
PROJECT FINANCING la OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095)
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
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 arty person, including the undersigned,and filed against the city,
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.
SIGNATURE: %Q asAt 0(2E0 DATE Cr ` '2-C) �(1 1
PRINT NAME: 1/r e-H R.00 ke,u t k
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $ G cri 2 , as
Indicate how many of each type of future to be installed or relocated as part of this project.Do not include existing fixtures to remain.
(- AIR HANDLING UNITS -FANS ---- CAS PIPE OUTLETS OTHER(Dcscribc)
AIR CONDITIONER FIREPLACE INSERTS HOODS(Commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PL[ PERMIT $
Indicate how many of each tore to be installed or_rebeercls part of this project.Do not include existing fixtures to remain.
BATHTUBS(or Mb/shower Combo) P ..sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER ' ),- URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRI . . I UNTAINS SINKS(Kitchen/Utility) W' ' - LTERS(Electric)
HOSE BIBBS SUMPS WASHING MACH '' TOTAL FIXTURES
GENERAL INFORMATION
CRITIAREAS CAL\OA PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVI USE LOT SIZE(In Square Feet( EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE ON SYSTEM?
❑Yes ❑ No ❑Ye ❑ No
RESIDENTIAL - W OR ADDITION ./
AREA DESCRIPTION(in sq feet) EXISTING PROPOSED TOTAL OR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home) /
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE 0 CARPORT 0
OTHER(describe)
Area Totals COSMO PROPOSED TOTAL
1.
"NEW HOMES of r N
ESTIMATED SELLING PRICE$ # OF BEDROOMS_
COMMERCIAL—NEW/ADDITI
AREA DESCRIPTION AreaOccupancy Group(s) Constructs . #of Additional Information
Squsyt Feet Type Stories
NEW BUILDING �'`r
ADDITION j
COMMERCIAL ' MODEL/TENANT IMPROVEMENTS N
of
AREA DESC- ' ION Area in Occupancy Group(s) Construction ik Addi al Information
Square Feet Type Stories
TOTAL :'i, ..
RANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—January 29,2016 Page 2 of 2 k:\Handouts\Permit Application