13-102096 •
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CommuCniy& coednerDeWv.aServices .,
Permit #: 13-102096-00-PL
33325 8th Ave S
Federal Way,WA 98003 L"
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: LEVI
Project Address: 31217 PACIFIC HWY S Unit C103 Parcel Number 082104 9186
Project Description: Installing one new vegetable wash sink
•
Owner Applicant Contractor
TERRI MEZGEBU JWJ CONSTRUCTION JWJ CONSTRUCTION
PAVILION CENTER ASSOCIATES 15118 110TH PL NE JWJCOC*8876L 9/13/14
C/O KIMCO REALTY CORPORATION BOTHELL WA 98011 15118 110TH PL NE
3535 FACTORIA BLVD SE SUITE 520 BOTHELL WA 98011
BELLEVUE WA 98006
•
Plumbing Fixtures
Sinks 1
PERMIT EXPIRES Saturday, November 9, 2013
Permit Issued on Monday, May 13, 2013
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: l _._. Date: '6-7/�
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3
THIS CARD IS TO MAIN ON-SITE
CITY OFoti • Construction In ction Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 13-102096-00-PL Address: 31217 PACIFIC HWY S Unit C103
Project: TERRI MEZGEBU FEDERAL WAY, WA 98003
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 Plumbing Groundwork(4190) - ❑ Rough Plumbing(4230) ❑ Final-Plumbing(4075)
Approved to cover Approved Approved
By Date By Date ByC, --) Date s_ `s_, -3
0 Rough Electrical El Final ElectricalEl Right of Way
Approved Approved Approved
By Date By Date By Date
lii, III
OTY OF PERMIT�PPwN
Federal Way
MAY 13 2013
PERMIT NUMBER J_ 0. ,4c?
_ I> CITY OF FEDERAL WAY
TARGET DATE CDS
SITE ADD 7
�'" (/l c` l3. E/UNIT#
PROJECT VALUATIOZONINGl ASSESSOR'S TAR/PARCEL#
$ VCS ( ,'.�� — — — — -
TYPE OF PERMIT ❑ BUILDING C(LUMBING 0 MECHANICAL 0 DEMOLITIStN 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT S t45,-G C",.T) k._ r 1 r V nb 16$ (A.'/1/1/ ./
PROJECT DESCRIPTION
Detailed description of work to
i -_,41.1.k__be included on this permit only
NAME „. /�-, PRIMARY PHONE
PROPERTY OWNER 9VC W f-k0 IL ”. „Ai 3 -3-43— (W
MAILING ADDS
� r).--(� foCtG Nw y 5 tbiif C-f o 7 - t e 27(y (;),‘ ctA,C@A,
CITY--,�� f%�� w / SUI ZIP
r G C 3
NAME N UA) V _iV�+c T 1 `�I C TI 0/S/ PHONE U -s- u 11S-1.
MAILING ADDRESS E-MAIL
CONTRACTOR IS !I' I/OTt, P1-- NE----
CITY SOT f l ` `-- STATE A- ZIP rc? I 1 FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME - PRIMARY PHONE
APPLICANT MAILING ADDRESS C G '__" E-MAIL
,c,„(...t
CITY STATE ZIP FAX
NAME -.. PRIMARY PHONE
PROJECT CONTACT
(The individual to receive and
MAILING ADDRESS E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
-
NAME - ...-..
PROJECT FINANCING 0 OWNER-FINANCED
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095(
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 • ••lication.
SIGNATURE: / 6------1_------ DATE 57/3 /3
PRINT NAME: Ky t' O- N (7 _CO V
Bulletin#100-January 1,2013 Page 1 of 3 k:\Handouts\Pennit Application
• •
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT $
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/shower combo) LAVS(Mand sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes❑ No ❑Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE E
FIRST FLOOR(or Mobile Home)
COVERED ENTRY
GARAGE 0 CARPORT 0
PR. .. • TOTAL
Area Totals •
aX',Z ial_,irjgr ` .s�"A
ESTIMATED SELLING PRICE$ ' OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square FeetType Stories
z `` 4,of
a a . «
ADDITION
COMMERCIAL—REM, I EL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Groups) Construction #of Additional Information
in Square Feet Stories
sass r a ';'14,-!-'r- • _ «:.
TENANT ' •EA ONLY
Bulletin#100—January 1,2013 Page 2 of 3 k:\Handouts\Permit Application