19-105087 Mechanical
City of Federal Way Permit #:19-105087-00-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: CAMPUS SQUARE BULDING A
Project Address: 33320 1ST WAY S Parcel Number:926500 0250
Project Description: Replacing(2)rooftop units-like for like
Owner Applicant Contractor
HIGH POINT LIGHTHOUSE SAMOA LEO TERESHCHUKPACIFIC AIR PACIFIC AIR CONTROL INC(GENERAL)
ASSEMBLY OF GOD CONTROL PACIFAC230P8(10/01/21)
P O BOX 3781 1916 220TH ST SE SUITE M101 1916 220TH ST SE
FEDERAL WAY WA 98063 BOTHELL WA 98021
USA BOTHELL WA 98021
Additional Permit Information
Mechanical Work Valuation? 85700 Is this an Online or O.T.C.application? Yes
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Roof Top Units 2
PERMIT EXPIRES Monday,20 April,2020
Permit Issued on Wednesday,October 23,2019
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 of Federal Way.
Owner or agent: oZLp�l�.p C ��' Date: 1620 5
,07,4 THIS CARD IS TO REMAIN ON-SITEOf
Federal Way Co struTION REction ral Way TS:(253)CoRe 35-350ord
PERMIT#: 19 105087 00 Address: 33320 1ST WAY S Bldg A
Project: HIGH POINT LIGHTHOUSE SAMO. FEDERAL WAY WA 98003-4544
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) ® Final-Mechanical(4065)
Approved Approved to release test i Approved
By Date By Date By Date J i
•
El Rough Electrical 0 Final Electrical ❑ Right of Way
Approved Approved Approved
By Date By Date By Date
` RECEIVED
PERMIT APPLICATION
CITY OF OCT 2 3 2019
PERMIT CENTER. +33325 8th Avenue South+ Federal Way,WA 98003-6325
Federal Way 253-835-2607 + FAX 253-835-2609 +permitcenter@cityoffederalway.com
CRY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
PERMIT NUMBER 1 _ / OS 0 k ?
- / / TARGET DATE
SITE ADDRESS I SUITE/UNIT#
333) b 15A" WC`) S , C4e-nal c''� I V\fC Gig vb fg n a
PROJECT VALUATION ZONING ASSESSOR'S TAR/PARCEL#
$ gs , 766 `t S 0 _ S 0
TYPE OF PERMIT 0 BUILDING ❑ PLUMBING cRiMECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT C,Ia h"PvS SctV4et- 6 I d5 . P- RTU R,etc,.(,, v--
PROJECT DESCRIPTION •
Detailed description of work to t 1 I i kg._ -cc> rte- 'r-Q.001/4.(-e-IN-LIINk
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAME 1 4 U' L. P \T C 6 n PHONE( ) 2 -q7 9 (2 _q e .-7MAILING ADDRESS * - E-MAIL J
CONTRACTOR
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CITY I I STATE ZIP 6 1 FAX
WA STATE CONTRACTOR'S LICENSE# W rt ��/lf fEXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
P C) F A C a 3 0 f<3
NAME „,_ PRIMARY PHONE
i... > C.eC1 i) c,/'u k- (Zc>6) S 12_-R-i) --1
MAILING ADDRESS / E-MAIL ��
APPLICANT ICII6 Z2G� St SE tbl iYo1-Lu'ruci-4-%(_cic-CQYI `.
CITY3 c 1�`f-t( STATE ZIP qg CiZ I FAX
NAME t T r ii VV ft PRIMARY PHONE
PROJECT CONTACT LCA I�et ck L nv ` Li2O9 --C 1.Z._-cirg 1.Z._-c6 7 �I�
(The individual to receive and MAILINGADDRESS ZO M Sts F '� l O E-
/e c1-L'�” P 4I c 01 r(�io
respond to all correspondence tel
concerning this application) CITY
)5 C-hk II STA ZIP is;G I FAX
NAMEL ....
PROJECT FINANCING / / °G1 h 0 fJ i h+ L,` I1c )j 0 OWNER-FINANCED
When value is$5,000 or more MAILING ADDRHS.S(,CITY,STATE,ZIP \�,\ (p�yA� 7PHONE (J
(RCW 19.27.095) `Z�'1� .Z� I-"1- W o.D S ! V v‘1�/ V V 1` 2s 3-3?-2,-LJ AL1 c\
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 any 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.
_. f
SIGNATURE: 040/1.16 GAJ Auk-
Bulletin
_- {, DATE / 0/23/)9
PRINT NAME: ® is(t1 h L by k-
Bulletin#100-January 29,2016 Page 1 of 2 k:\Handouts\Permit Application