01-100907 City of Federal Way
Community Development Services Mechanical Permit #:01 - 100907 - 00 - ME
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: INTERNATIONAL HOUSE OF PANCAKES RESTAURANT
Project Address: 178 SW CAMPUS Dr Parcel Number: 415920 0710
Project Description: MEC-Install remote ice machine&ice bin.
Owner Applicant Contractor
WAREMART INC NONE RON'S REFRIGERATION
17824 2ND AVE S
BURIEN WA 98148
NONE (206)242-3322
Mechanical Valuation 7525 Over the Counter Permit No
Mechanical Fixtures
-,Description Qaetititjr Description :,,,,'JQuantity Description ' Quantity
Refrigeration Systems 1
PERMIT EXPIRES September 5,2001,IF NO WORK IS STARTED.
Permit issued on March 9,2001
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 accord. e with the laws,rules and regulations of the State of Washington and
the City of Federal Wa .
Owner or agent / / ante t, Date:
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cn.of CONSTRUCTION PERMIT APPLICATION
APPLICATION NUMBER: O 1 - I QO gCI 7.--A
APPLICATION NUMBER: - -
4,gp 0 7 ''' APPLICATION NUMBER: - -
**The following is required information-Please print(in ink)or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
P PROPERTY INFORMATION
SITE ADDRESS:/0(4i 5.;--4, ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
'' Vi PROTECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING 0 MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑IENGGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT D SCRIPTION (Provide detailed description): L11Zi.4' Pl-ellag- CL%9; -19-, ,Z3
Ot
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PROJECT NAME: 1 f (....) i .
174 PEOPLE INFORMATION
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AYTIME PHONE:
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CON1 A ONAME:
e. DAYTIME PHONE:
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MA NG (SIREDDRES EVENING PHONE:1 , j 7 � / - 1 v'e - 5ot dierlih
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CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER: 1
CONT R'S REGI RATIO UMBER: EXPIRATION DATE: i
(co � 4Z/ - 3 / �/
APPLICANT: NAME: DAYTIMEE PHONE:�j r� , I
P-r/, e 7/- 5a e �Q',,) (gq2 )027 v:-3 2
MA1I NGG(AADDREEES�SS(STREET A�DDD SS•CITY,STATEE,jZZIP): - /jv` EVENING P"`HONE:
�ECATIV 5 PTO PROJECT:�/ 5 r /34/7 /WAS , 'V FAX NUMBER:
❑ ARCHITECT ❑ TENANT 0.41THER(DESCRIBE): (y130 c: -(? _ 5O j
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ONTRACTOR I
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ /J
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ 1..CD Z 2 _ 4-
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
I
- ■ PROJECT FLOOR AREAS
FLOOR EXISTING SQ. FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
-
FOURTH {
OTHER FLOORS(DESCRIBE)
-
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
•
Indicate num er of each type of fixture
MECHANICAL 'e fJ/',.,�,�v
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) 1 j REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
_� BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
. DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ElELECTRIC CIGAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S) {
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
!1 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 i .fficers and emplo ees,upon the accuracy
of the information supplied to the city as a part of this application.
e 7-7 /...-NAME/TITLE: �/P 'e JGZ ` iP sem . , /- " DATE: ,zoo/
❑ PROPER OWNER ❑ AP LICA lfr<NTFtACTOR
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FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION: BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129