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City of Federal way Permit #: 15 -101937 -00 -PL
Community &Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003 Inspection Request Line:
Ph: (253) 835-2807 Fax: (253) 835 ns -2809 pecti q (253) 835-3050
Project Name: HAYNES
Project Address: 29834 10TH AVE SW Parcel Number: 195460 0200
Project Description: Relocate existing waste lines to relocate shower and doorway. Replace 2" iron waste line
with 2" ABS to 6" above ground
Owner
BEN HAYNES
Aunlicant
MARK HAYNES
Contractor
OWNER IS CONTRACTOR
29834 10TH AVE SW
2983410TH AVE SW
FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
Plumbing FL es
Other Plumbing Fixtures ............ 1
AA
PERMIT EXPIRES Sunday, c r 18, 2015
Permit Issued on Tuesday, r-121,2015
I hereby certify that the above information is correct �q a constk
tion on the above described property and
the occupancy and the use will be in accord wilt aws, rulesregulations of the State of Washington
an i f Federal Wa
Owner or agent
\o'
Date:
E
City of Federal Way
Community 8 Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: YNES
Project Addre 29834 10TH AVE
1� J
Plumbing
Permit #: 15 -101937 -00 -PL
Inspection Request Line: (253) 835-3050
Parcel Number: 195460 0200
Project Description: lteleexte-ex-isTing waste lines to relocate shower and doorway. Replace 2" iron waste line
with 2" ABS to 6" above ground
Owner
Applicant
Contractor
BEN HAYNES
MARK HAYNES
OWNER IS CONTRACTOR
29834 10TH AVE SW
29834 10TH AVE SW
FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
Plumbing Fixtures
Other Plumbing Fixtures ................ 1
PERMIT EXPIRES Sunday, January 10, 2016
Permit Issued on Tuesday, April 21, 2015
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
anpAe City of Federal Way.
Owner or agent: Date:
/�7 1(fir
/ y '
/ Cp/77
1�q �� l� , %, �'7cC /7 e � y �
RECEIVED
JUL 2 2 2016
CITY OF FEDERAL WAY
CDS
cmr CW
Federal Way
PERMIT #:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
15 -101937 -00 -PL Address: 29834 10TH AVE SW
Project: BEN HAYNES FEDERAL WAY, WA 98023-8206
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 ( 190)
❑ Rough Plumbing (4 0)Gas
Piping (4125)
Approved to cover
Approved
Approved to release test
By A L Date 57
By fp (, Dates s, S
By Date
Final - Plumbing (4075)
Approved
By Date
Rough Electrical
Approved
1:1Approved
Final Electrical
1:1Approved
Right of Way -^
By
Date
By
Date
By
Date
CITY OF A i PERMON&PPLICATION
Federal Way
PERMIT NUMBER ( S
APR 21 2015
t O ( _ .PITY OF FEDERAL WAY
TAiQ6& DATE � � Z f!
SITE ADDRESS
SUITE/UNIT #
f4ffz 3
PROJECT VALUATI
ZONING
ASSESSOR TLP CEL # —I & 0 — 0 Z— 0 O
TYPE OF PERMIT
❑ BUILDING X PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION
Detailed description of work to
T
'a —
"/ i
be included on this permit only
02
NfidE
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
i
CITY
STATE
ZIP
D1
NAME �y ��� �
PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
APPLICANT
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
NAME
PRIMARY PHONE
PROJECT CONTACT
MAILING ADDRESS
E-MAIL
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
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 apart of this application.
SIGNATURE: 7 DATE
PRINT NAME:"LQ-S-
Bulletin #100 — January 1, 2013 Page 1 of 3 k:\Handouts\Permit Application
C p/rj
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existingfixtures to remain"
AIR HANDLING UNITS FANS , GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS �OODS(commercial)
BOILERS FURNACES HOT WATER TANKS (cas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT wIs
Indicate howf many of each type of ftture to be installed or relocated as part of this project. Do not include existing ures to remain.
BATHTUBS (or Tub/Slower combo) LAVS (Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe)
DRAINS_ SHOWERS_ .VACUUM BREAKERS
DRINKING FOUNTAINS SINKS pcitch—/utaity) WATER 4iATERS (Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR -
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
# of
AREA DESCRIPTION
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTINrIRt SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
r�
in Square Feet
❑ Yes ❑ No
❑ Yes K No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet) EXISTING
PROPOSED
TOTA4
FOR OFFICE USE
# of
AREA DESCRIPTION
FLOOR (or Mobile Home)
Additional Information
�F'aIIR�ST
.X`V' s"'x/
in Square Feet
.._...—._._.___
COVERED ENTRY
h . ,✓„rf`/.CS"14, /, 3�*'r75,.€t ,, ; , N•::c5 ,, J
,a� ! us�'�.&
,,,r �.
GARAGE ❑ CARPORT ❑
y, -so
ADDITION
EM' ING
Area Totals
PROPOSED
TOTAL
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
ESTIMATED SELLING PRICE $ # OF BEDROOMS
COMMERCIAL- NEW/ADDITION
Area
Construction
# of
AREA DESCRIPTION
Occupancy Group(s)
Additional Information
in Square Feet
Type
Stories
y, -so
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
Area
Construction
# of
AREA DESCRIPTION
Occupancy Group(s)
Additional Information
in Ssivare Feet
a
Stories
TOTAL
101
/i
r /, ., i ]7 / 3 x ;
,cx/ ✓ /
/// ,S, i//
/ i
ti /i
TENANT AREA ONLY
F7PROCT ARA'OIviY
y/;/ 11"/"/'11--
/
Bulletin #100 — January 1, 2013 Page 2 of 3 k:\Handouts\Permit Application