01-103717 City of Federal Way
Community Development Services Mechanical Permit #:01 - 103717 - 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: KING TERIYAKI
Project Address: 34417 PACIFIC S Parcel Number: 202104 9109
Project Description: MECH-Install(1)gas range in existing restaurant.
Owner Applicant Contractor
SECOMA HOLDING CO#1 *SECOMA HOLE KING TERIYAKI&DELI KING TERIYAKI&DELI
4650 W OAKEY BLVD#2120 34417 PACIFIC HIGHWAY SOUTH 34417 PACIFIC HIGHWAY SOUTH
LAS VEGAS NV FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
89102-1514 (000)952-2215
Mechanical Valuation 700 Over the Counter Permit Yes
Mechanical Fixtures
,V; q Description ,°'1QUantityl '' Description (Quantity Description 'Quantity!
Ranges I 1
PERMIT EXPIRES March 23,2002,IF NO WORK IS STARTED.
Permit issued on September 24,2001
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 accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: --,_ rte. i--/ ,,i Date: / .2 4/ '
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�� f�Y: •.- CONSTRUCTION PERMIT APPLICATION
L APPLICATION NUMBER: Or - t V.
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APPLICATION NUMBER: _ - _ -
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d f, . ,..111.. . ,-/L1?.Vr1YAPPLICATION NUMBER; - - - - - - - -
* T'e following is required information-Please print(in ink)or type**
Please note: Electrical,Fire Prevention S stems and Engineering permits may require a separate application.
r4 PROPERTY INFORMATION
SITE ADDRESS: /_,_ PAC i - .- ASSESSOR'S TAX/PARCEL#:020`2(i al/- /�j
0 9
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
R PRO3ECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING CI PLUMBIN MECHA ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERIN IRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): (1.4q/,), c tea r) I 74 K' ti ep, 0
d,.`11.r) d reoA coca V 1 a.c.e tn1 a X11-} -...p , 0-01-h -1,'d2 a»A-1 Ce.:1 i vi . 4-t
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PROJECT NAME,WA' A/C/
►=1 PEOPLE INFORMATION
PROPERTY OWNER: NAME: // DAYTIME PHONE:
LCI
MAILING ADDRESS((STREE ADDRESS;CITY,STA1 ZIP)CI , ( )
CONTRACTOR: NAME: ,..._
DAYTIME PHONE:
+- u r' Z '"tin - (2S-- ) .'J - 5'31 2-
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
X83, _4% — _e.' 717'- mac' - S - / ','4gl`o -' ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
- - ( ) -
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) / /
I APPLICANT: NAME: DAYTIME PHONE:
CM N re' f[' '�[�'` Tyc (
F MAILING ADDRESS'(STREET ADDRESS;CITY,STATE,ZIP): EVENING HONE:
a$3a4 IS " AuQ S . .)e.d. iuA cie60 3 (-)53) 531 - 9352.
i RELATIONSHIP TO PROJECT: _ FAX NUMBER:
CI ARCHITECT CI TENANT Vi OTHER(DESCRIBE):13 OS 4 MISS flU IJI ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER APPLICANT ❑ CONTRACTOR
R DETAILED BUILDING INFORMATION
EXISTING USE: fr$4-0.LL Vet K 4 EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: eels+-am Ya Al-. *ROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES ANO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: XLAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: )LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
/_ 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 number of each type of fixture
�QU
MECHANICAL
AIR HANDLING UNITS) _ EVAPORATIVE COOLER(S) _ _ GAS LOG(S) _REFRIG.SYSTEM(S)
_4 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: D ELECTRIC GAS
—
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)
&I 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 daim(induding costs,expenses,and attorneys'fees incurred in the
investigation and defense of such daim),which may be made by any person,induding the undersigned,and filed against the City of
Federal Way,but only where such daim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
of the information supplied to the city as a part of this application.
NAME/TITLE: DATE:
❑ PROPERTY OWNER KAPPLICANT ❑ CONTRACTOR
FOR OFFICE USE ONLY:
•NEW: ` _. ❑ADDITION ❑ ALTERATION ❑ REPAIR - ❑ TENANT IMPROVEMENT
CENSUS'CODE: -LOTSIZE: -
ZONING.DESIGNATION BUILDING SHELL ONLY? ❑ YES ❑ NO
4 COMP.PPLAN-DESIGNATION BASIC PLAN?' ❑YES ❑ NO
SECTION .TOWNSHIP RANGE NEW ADDRESS REQUIRED? ] YES CI.NO
'.PLATTED LOT? ', ❑YES ❑ NO CHANGE OF USE?, ❑YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129