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02-104661 • City of Federal Way Community Development Services Fire Prevention System Permit #:02 - 104661 - 00 - FP 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: NORTHSHORE CHEVRON GAS PIPE Project Address: 34007 HOYT SW Parcel Number: 308900 0355 Project Description: FPS-Install hood and duct supresssion system. Owner Applicant Contractor NORTHSHORE CHEVRON*RAY EBERT* FIRE&SAFETY NORTHWEST FIRE&SAFETY NORTHWEST NORTHSHORE CHEVRON 2724 BLACK LAKE BLVD SW 2724 BLACK LAKE BLVD SW 34007 HOYT RD SW OLYMPIA WA 98512-6118 OLYMPIA WA 98512-6118 FEDERAL WAY WA 98023 (360)943-3507 PERMIT EXPIRES April 22,2003,IF NO WORK IS STARTED. Permit issued on October 24,2002 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,ru s and regulations of the State of Washington and the City of Federal Way. Owner or agent: firf1( Date: Zi— • RECEIVED 411/ �.� CONSTRUCTION PERMIT APPLICATION uV FlY O C T 2 1 2002 APPLICATION NUMBER: _ __- 1' `f/p(p L - CO Fjv APPLICATION NUMBER: - CITY.OF FEDERAL WA'T APPLICATION NUMBER: - - BUILDING 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 • 72 SITE ADDRESS: 34vt /7 "T /z�O J� ASSESSOR'S TAX/PARCEL #: ,3G' . , Q - �c2j-X' LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IFIF ` LENGTHY): / V . -- ' •'PROJECT INFORMATION TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING El MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERIN(KFIRE PREVENTION SYSTEM �7� PROJECT DESCRIPTION (Provide detailed description): �-T-'f'r,� /YA.J71 S csle-ti..r C/41.��' tb 1,1 /tT) PROJECT NAME: NO/Z j-7-`r/riVi e` r'/'d lr`,:/.. / i - ►/ PEOPLE INFORMATION 'r- PROPERTY OWNER: NAME: pA ' / DAYTIME PHONE: /(/44!>l$j/d2,, el4Y �J ( ) - MAIUNG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): CONTRACTOR: NAME: DAYTIME PHONE: fits.: NZ sfl : '/114KT/i'M/JJr (36e) q - 3s07 MAILING ADDRESS(STREET ADDRE,SS;CITY,STATE,ZIP): EVENING PHONE: /2719 £/Ac ''''i'At /j/k, 174-xi W -11l/1m, (SW ) / - Yei'/ CITY OF FEDERAL WAY BUSINESS UCENSE NUMBER: FAX NUMBER: - - (See ) 9(43 - yes3 CONTRACTOR'S REGISTRATION NUMBER: �� w' r EXPIRATIO ATE: , / (copy of card required) �••i.✓/Y o 4" �� //(//[�7 Jy1(/ APPLICANT: NAME: DAYTIME PHONE: .J/ /16/ 70 ‘e.04a j'�— ( ) - MAIUNG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: ( ) RELATIONSHIP TO PROJECT: FAX NUMBER: ❑ ARCHITECT ❑ TENANT I OTHER(DESCRIBE): (!.jM /_7( ( ) - E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR II ■ DETAILED BUILDING INFORMATION " EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ 6 Sod SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO I WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER: 0 LAKEHAVEN ❑ FIIGHLINE ❑ PRIVATE(SEPTIC) **NEW RESIDENTIAL CONSTRUCTION LY** NUMBER OF BEDROOMS: W ESTIMATED SELLING PRW $ ._ ■ PRO3ECT FLOOR AREAS " FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL BASEMENT FIRST SECOND THIRD FOURTH OTHER FLOORS(DESCRIBE) DECK GARAGE HOW MANY FLOORS? TOTAL: ..r.. -w ..•..ea r+w«,.::.%^ks:aa. ^s....n«J..-M:R�Icb2oivnr+h*+str/^aMgtisa'1tii R s:FIXTU�Gs'X;nyc st w+i+iYrt%se..r:.wi.iwe.wu.r3>s.i.++c.-.ttFit°ai:i%r�kv4r-i ;s:F>�-siaNi�►.w.itti+t�.. Indicate number of each type of fixture MECHANICAL AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S) BBQ(S) j 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: ❑ 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) -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,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. /�/�_ kATE: NAME/TITLE: !'4114 Lf��e// //;‹� �i ��'f t / 1L^0/6 (-i C ❑ PROPERTY OWNER ❑ APPLICANT K CONTRACTOR ;FOR OFFICE USE ONLY -❑-NEW ❑;ADDITION ❑ ALTERATION ❑ REPAIR_.." ❑iiTENANTeIt0ROVEMENT4Y41 CENSUS CODE z ��„�,�_Y _ ,. ;- LOT SIZE ttoNIN_ DESIGNATION _,', �_ }_�� .._. " -`_ . �-_= BUILDING SHELL ONLY?;.�❑YESrAn COMP LAN DESIGNATION. t 4- r_; ; "BASIC PLAN? U]'YES ❑ N( P #SECTION '"Y TOWNSHIP ' RANGEx' NEW ADDRESS REQUIRED?; PL 1TTED'LOT? ❑ YES ❑ NO^ '; CHANGE OF USE?; [ YES=l© NO i` y COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129 www.cttv40ede'ra Tway.com