21-105155City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 635-2609
Project Name: LAKEHAVEN - ADMINISTRATION BUILDING
Project Address: 31627 1ST AVE S
Project Description: Refrigeration piping to (1) VRF system.
Plumbing
Permit #:21-105155-00-PL
Inspection Request Line: (253) 835-3060
Parcel Number: 072104 9017
Owner
Applicant
Contractor
LAKEHAVEN WATER & SEWER DISTRICT
CONNIE HARDINHOLADAY PARKS INC
HOLADAY PARKS INC (GENERAL)
31627 1ST AVE S
4600 S 134TH PL
HOLADPI379NO (9/3/21)
FEDERAL WAY WA 98003
SEATTLE WA 98168
4600 S 134TH PL
TUKWILA WA 98168
Other Plumbing Fixtures
Plumbing Fixtures
PERMIT EXPIRES Sunday, 12 June, 2022
Permit Issued on Tuesday; December 14, 2021
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
Washingld and -the -City. of Federal Way.
Owner or agent:
`7 t 1 ��— � I= date:
s
THIS CARD IS TO REMAIN ON -SITE
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 21 105155 00 Address: 31627 1ST AVE S
Project: LAKEHAVEN WATER & SEWER D] FEDERAL WAY WA 98003-5201
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.
l Plumbing Groundwork (4190) 0 Rough Plumbing (4230) Q Final - Plumbing (4075)
Approved to cover Approved per A' Approved
By Date By Date 11 ti V-, By Date
Ltlatij C�uC� Zone. � DEC
i�
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
RECEIVED CITY OF �� PERMIT APPLICATION
DEC 0 8 2021 PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
Federal Way
CITY OF FEDERAL WAY 253-835-2607 + FAX 253-835-2609 + Pernzitcentct@cityoffederalway.coln
CQMMINliY DEVELOPMENI'
PERMIT NUMBER
TARGET DATE
SITE ADDRIM — — -- —
SIIITEjUHiT #
O.TECT ALir�OH Ifl[i AiSSEMUR'S TAX/PARCEL N
�T"?�_]F
Q - f 7
PERMIT ❑ BUILDING ❑ PLUMBING MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION r �'
Detailed description of work to r
be included on this permit only
- = --- - -. —. NAME
r FWMARY PHONE
PROPERTY OWNER xa � - I
MAILNG ADDRESS E-hLUL
Y
Nam
PHONE
r
MAILING ADDRESS
CONTRACTOR
T►" STATA ZIP FAX Vt7
WA STATE CONTRACTOR'S LICENSE 8 XXPIRATIOX DATE_ UBI Y
PRIKARY PHONE nn
APPLICANT MA1,LIXGADDRE88 t �, MAIL
ix c
UITY
ST
IM TTa FAX
-- '
AM j PRSINARY FHQk{$
PROJECT CONTACT `•, { - i
(The individual to receive and bWLIX kADDRZ80 _ respond to all correspondence S-MAIL _
concerning this application) CI ®r►E SIP FA8 '
7��
PROJECT FINANCING ❑ OWNER -FINANCED
When value is $5,000 or more MAILMO ADDRESS. CITY, STATE, ZIP - at3�h'L -
(RCW 19.2Z095)
I certyfle underpena{ty of perjury that I am the property owner or authorised 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 udif comply with
alI 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 responsfbitity for compliance with local, state, or federaf 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 cfaimf, which may be made by any person, including the undersigned, and flied against the city,
but only whs such claim arises out of the reliance of the city, including its officers and employees, upon the ace racy of the
Wormation s pp tO I .melt as a part of this application.
SIGNATURE: DATE
PRINT NAME: l 1 - �� -
u eilD • U — •t; rua13' aye o _ J ............_- ____-.
MECHANICAL PERMIT
Indicate now owny of each tyP4
AIR HANDLING UNITS
AIR CONDITIONER
BOILERS
COMPRESSORS
DUCTING
VALUE OF MECHAWCAL WORK
$--
txture to be fnstalled or relocated as part a this uro ect, Do not include existfnq ta'tteres to remain,
FANS ,;GAS` PIPE OUTLETS O-.T�] [E-R (Describe)
FIREPLACE INSERTS HooDs (C.mmcrria) 7 t_ I-tF
FURNACES HOT WATER TANKSGAS LOG
GAS PIPING SETS
REFRIGERATION SYST
WOODSTOVES
PLUMBING PERMIT VALUE OF PLUMBING �D Y
Indicate how MSM o each ttlpe o
fteture to be installed or relai
BATHTUBS ).r Tub/Shower Comb.)
. , , �)
DISHWASHERS
�NWATERSYSTEMS
DRAINS
OWERS
NG FOUNTAINS
SINKS )K tcben/utwry)
HOSE BIBBS
SUMPS
_GENERAL IN_F_ORM.ATION
CRITICAL AREAS ON ,PROPERTY? I WATER FURVEFOR B WZR
Do not include exis 'rw krtures to remain.
TOILETS
URINALS
VACUUM BREAKERS
WATER HEATERS (rlt trio)
WASHING MACHINES
WATER PIPING
OTHER (Describe]
TOTAL FLXTUREB
$7CI5TIlVG/PRSVLO08:JBE LdT 9ft Ifn $ RE TING FIRE MqU NKWa SYSTM? FIlOP08SD >cLRB $ 8ID8
❑ Yes u No L:i Yes E, No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet) EXISTING PROPOSED . TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR (or Mobile Home)
SECOND FLOOR
COVERED ENTRY ~
DECK
GARAGE O CARPORT ❑
OTHER (describe)
r~ -- - Area Tattx FM TrNG PROPOSED TOTAL
"REW HOMES omy**
ESTIMATED SELLING PRICE
# OF BEDROOMS
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION
Area in
Square Feet
Occu anc Grou s
p Y P()
Construction
Type
# of
Storiga-
—
�� trawl Information
NEW BUIIDING
ADDITION
— -
COMMERCIAL — REMODEL/TENANT TMPI
AREA DESCRIPTION
_N_TS
Area in' Occu Group(S)
Square Fes Panc F p(s)
Construction
T;vpe
# of
Stories Additional Information
TOTAL BUILDING
TENANT ARL
L'rcT AREA ONLY
—
Bulletin #100 — February 19, 2020 Page 2 of 2 k:\lJandouts\Perrnit Application