22-100915City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: LAKEHAVEN PUMP STATION
Plumbing
Permit #:22-100915-00-PL
Inspection Request Line: (253) 835-3050
Project Address: 200 S 359TH ST Parcel Number: 292104 9157
Project Description: Installation of (1) toilet, (1) lav, (1) HWT and (2) floor drains.
Owner
Applicant
Contractor
LAKEHAVEN WATER & SEWER DISTRICT
KENNEDY WILLIAMSHERMANSON
HERMANSON COMPANY LLP
31627 1ST AVE S
COMPANY
(PLUMBING)
FEDERAL WAY WA 98003
1221 2ND AVE N
HERMACL9/10/23)
KENT WA 98032
12212 AVE N
K E Ti 98032
PiliIkkl)kll "kxt L'5' kv�
Drains 2 Lavatories 1 Wat Clc s s i
Water Heaters 1
PERMIT Ex IRES Sates ay, 3 Septemb 22
Permit Iss d�nAnday, Mar , 20 2
I hereby certify that the above information is correct and that the cos uction on the above described property
and the occupancy and Ike use will be in accordance with Alaws, rules and regulations of the State of
on and the Cit eral Way,
4 J
Owner or agent: NO! , s Date:
NIA
V
<V
AN� THIS CARD IS TO REMAIN ON -SITE
C$TY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 22 100915 00 Address: 200 S 359TH ST
Project: LAKEHAVEN WATER & SEWER D] 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)
2❑
Rough Plumbing (4230)
3❑
Final - Plumbing (4075)
P A Approved to cover
rw ,
Approved
Approved
By Date 1.
By
Date
By
Date
❑
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
ritUtIVED
FEB 2 8 2022
CITY OF ,��
CfTY OF FEDERAL WAY
Federal Way COMMUNITY DEVELOPMENT
PERMIT APPLICATION
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
PERMIT NUMBER
Rdlfl _ 2[d21E2[0
_ VIP TARGET DATE
SITE ADDRESS /� 4
V� / 54
SUITE/UNIT #
PROJECT VALUATION
ZONING ASSESSOR'S TAX/PARCEL #
$ 24,000.00
M ® LIE]
® ® ®_ ® ® ® M
TYPE OF PERMIT
❑ BUILDING IN PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
11-21-20590 Lakehaven Pump Station
Installation of (1) toilet, (1) hand sink, (1) instantaneous water heater, and (2) floor drains.
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
Lakehaven Water and Sewer District
253-946-5415
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
31627 1 st Ave S
CITY
STATE
ZIP
Federal Way
WA
98032
NAME
PHONE
Hermanson Company
206-638-6961
MAILING ADDRESS
E-MAIL
1221 2nd Ave n
kwilliams@hermanson.com
CONTRACTOR
CITY
STATE
ZIP
FAX
Kent
WA
98032
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
UBI #
HERMACL792NW
9 10 23
602-004-844
NAME
PRIMARY PHONE
Kennedy Williams
2066386961
APPLICANT
MAILING ADDRESS
1221 2nd Ave N
E-MAIL
kwilliams@hermanson.com
CITY
STATE ZIP
FAX
Kent
WA 98032
NAME
PRIMARY PHONE
PROJECT CONTACT
Kennedy Williams
206-638-6961
MAILING ADDRESS
1221 2nd Ave N
E-MAIL
kwilliams@hermanson.com
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
Kent
I WA
98032
PROJECT FINANCING
NAME
Kennedy Williams
❑ OWNER -FINANCED
When value is $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
1221 2nd AVe N
2066386961
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.
-u�cayw�brx�r�
SIGNATURE: Kennedy Williams"`��4VQou=oa,anma�euwAc�o�,is.
oc.ne,masa,oci DATE 2/18/2022
PRINT NAME: Kennedy Williams
Bulletin #100 — February 19, 2020 Page 1 of 2 k:\Handouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
Indicate how many of each ttlp
AIR HANDLING UNITS
AIR CONDITIONER
BOILERS
COMPRESSORS
DUCTING
PLUMBING ' PERMIT
Indicate how maRM of each typ
BATHTUBS (or Tub/Shower Combo)
DISHWASHERS
2 DRAINS
DRINKING FOUNTAINS
HOSE BIBBS
`o be installed or rei
FANS
FIREPLACE INSERTS
FURNACES
GAS LOG SETS
GAS PIPING
GAS PIPE OUTLETS
HOODS (Commercial)
HOT WATER TANKS pas)
REFRIGERATION SYST
WOODSTOVES
OTHER (Describe)
VALUE OF PLUMBING WORK
$ 24, 000
Pfixture to be installed or relocated as part of this protect. Do not include existina fLxtures to remain.
LAVS (Nana Sinks)
TOILETS
RAINWATER SYSTEMS
URINALS
SHOWERS
VACUUM BREAKERS
SINKS (Kitchen/Utility)
WATER HEATERS (Fiectriq
SUMPS
WASHING MACHINES
WATER PIPING
OTHER (Describe)
instantaneous WH
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 USE
BASEMENT
FIRST FLOOR (or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER (describe}
Area Totals
EXISTING
PROPOSED
TOTAL
.............................•...........
"NEW HOMIrS ONL.Y—
ESTIMATED SELLING PRICE $
I # OF BEDROOMS
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
a
# of
Stories
Additional Information
NEW BUILDING
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
a
# of
Stories
Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin #100 — February 19, 2020
Page 2 of 2
k:\Handouts\PerTnit Application