01-104364 • f f t
City of Federal Way Mechanical Permit #:01 - 104364 - 00 - ME
Community Development Services
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: VALLEY RADIOLOGIST
Project Address: 181 S 333RDISuite210 Parcel Number: 926500 0258
Project Description: MEC-relocate}mechanical diffusers in conjunction with tenant improvement.
Owner Applicant Contractor
VALLEY RADIOLOGISTS INC PS HEAT TRANSFER CO HEAT TRANSFER CO
POB 26730 BOX 1268 BOX 1268
FEDERAL WAY,WA CARNATION,WA CARNATION,WA
98093 98014 (425)885-3247
Mechanical Valuation 1000 Over the Counter Permit Yes
Mechanical Fixtures
l j Description Quantity Description Quantity Description ;i;; Quantity
rAir Handling Units 10
PERMIT EXPIRES May 12,2002,IF NO WORK IS STARTED.
Permit issued on November 13,2001
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: Date: /I !//
c � G
_ FtEeterVert CONSTRUCT ION PERMIT APPLICATION
VV F3Y L NM, 3 200 APPLICATION NUMBER: 0 1 - L 0 Y 3 (O /-�
APPLICATION NUMBER: - _ _ _ _
GIITY OF FEDERAL WAY APPLICATION NUMBER': -
�DEPT. - - — — — — — — - -
**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.
- ■ 'PROPERTY INFORMATION
SITE ADDRESS: /8/ 3.33 1.-
6 s' .s' 'd 2/e7 ASSESSOR'S TAX/PARCEL#: 9.2s oa - 0 , g
f� 4id ki.- 7e ,3
LEGAL DESCRIPTION OF SUBJECT YSROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROTECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING A MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): _51/(--P4". 1 4i"4 cAc7e , "+C'.
J
.7 .. If/5 Vali
PROSECT NAME: 14 Rct i,/MI_
■"PEOPLE INFORMATION -
PRPPERTY OWNER: NAME: DAYTIME PHONE:
-.5 d9-$ YAC.�� s��." P:..,,10,07-CQ ( ) -
MAIUNG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
his //� A--. ,</E '6/7o //«,, Com. ?e moi — 5-zz471
CONTRACTOR: NAME: DAYTIME PHONE:
fi' sP- ("5-) $9 - 3-z Y7
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
, tedc r"2-6,9 cry-...'. ‘c/0-‘c/0- 994 ,'q ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: � FAX NUMBER:
- - ( ) -
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) /
APPLICANT: NAME: DAYTIME PHONE:
,../......,..Q.. (;e:z.e - z- s y) (gs s) 99 - 32 y7
t MAILING ADDRESS(STREET ADDRESS,CITY,STATE,ZIP): EVENING PHONE:
.,3ox /26g ,. /o... 4/., Stull' ( ) -
I RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT .CONTRACTOR
■;•DETAILED BUILDING INFORMATION =.
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ /® f o0
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 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:
• ■ FIXTURES .
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE($
BOILER(S) FIREPLACE INSERT(S) RANGE(S) iO MISC.( .moi )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC 0 GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC 0 GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
• 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 daim),which may be made by any person,induding 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: DATE: ,///1,4
❑ PROPERTY O ER ❑ APPLICANT prCONTRACTOR
FOR OFFICE USE ONLY:
NEW: 1❑ADDITION ❑ ALTERATION ❑;REPAIR'- , l TENANT IMPROVEMENT
CENSUS CODE: -LOT SIZE:
.ZONINGDESIGNATION: BUILDING SHELL ONLY? .❑ YES ❑ NO
COMP PLAN DESIGNATION = BASIC PLAN? 'El YES ❑`;NO'
SECTION TOWNSHIP ' RANGE NEW ADDRESS REQUIRED? ❑YES El NO
PLATTED`LOT? ❑ YES 0 N 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