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05-104294• 0 City of Federal Way Plumbing Permit #: 05 - 104294 - 00 - PL Community Development Services P.O. Box 9718 Federal Way, WA 98063 -9718 ' Ph: (253) 835 -7000 Fax: (253) 835 -2609 Inspection request line: (253) 835 -3050 Project Name: GROUP HEALTH ROOM R103 Project Address: 301 S 320TH Parcel Number: 172104 9105 Project Description: Install of new floor sink, steam generator piping, two RPBD's, and hook up new sterilizer Owner Applicant Contractor GROUP HEALTH COOP & PUGET *GROUP 1 WA BOTTING WA BOTTING 521 WALL ST 20300 WOODINVILLE SNOHOMISH RD 20300 WOODINVILLE SNOHOMISH RD SEATTLE WA FEDERAL WAY WA FEDERAL WAY WA 98121 -1524 (425) 483 -7500 Plumbing Fixtures a Dishwashers 1 Other Plumbing Fixtures 5 Sinks I d d G of fi f it THIS CARD IS TO0MAIN ON -SITE CITY OF tommunity Development Inspection ection Record Federal Wav IVR INSPECTJON REQUEST PHONE # (253) 835 -3050 w PERMIT #: 05- 104294 -00 -PL Owner: GROUP HEALTH COOP & PUGET Address: 301 S 320TH ST FEDERAL WAY, WA 98003 -5200 This card is part of your required inspection documents. 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. ❑ Plumbing Groundwork (4190) ❑ Rough Plumbing (4230) ❑ Gas Piping (4125) Approved to cover Approved Approved to release test By Date By Date By Date Final - Plumbing (4075) Approved By Date �`j� CMYDF A. Federal Way C01fMUX YDEV=PAfi YrSBRVK9S 3331S Sm AVBNUE SOUM • PO BOX 9718 FEDERAL WAY t 063.9718 S33.i^ FAX 153-83 - The-ollourino is reauirel PE MI T ECI� CO ME El APPLI CATI O NAUG 2 nh"� . / - an SITE ADDRESS __4? t ASSESSOR'S TAX /PARCEL # LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) PL E EN FP !in ink) or tune. SUITE /UNIT / LOT SIZE (s] (Aft-* aqmao PreeJw 1mvft lagW damOfim4 - - -- PROJECT • • TYPE OF PERMIT ❑ BUILDING *PALUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of Mork included on this permit only) C�c�ivC�►%� �✓—, /N �� L / �"wv 2�,d D 3 � � Lr � x�e� � PROJECT NAME (Name of Business or Owner Last Name) (Z60 l tP 4 ece Ilk- PEOPLE INF•- • PROPERTY OWNER CONTRACTOR APPLICANT CONTACT LENDER IPRIMARY PHONE li► MAIUNO ADDRESS I CITY, SEAT , ZIP 3(3 / -S' 300 �'✓ ' /'Lc.� l tf�4. X003 COMPANY ES Y NAM � � ) APPUCANT NAME O CE PHONE MAIUN`'O��ADDRESS , STATE, ZIP CELL PHONE 3 CITY OF' FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX' NUMBER CITY, STATE, ZIP it�v�vc.L tle — 7Z CELL PHONE (2,06) >-S -3y� RELATIONSHIP TO PROJECT CONTRACTORS REOISTRATION NUMBER (copy of card required with each applicatioal EXPIRATION DATE !N ± § S? 'r C. o 9(?,T /+' 1,31 lo.0 COMPANY NAME APPUCANT NAME OFFICE PHONE MAIUNO ADDRESS P /Z CITY, STATE, ZIP it�v�vc.L tle — 7Z CELL PHONE (2,06) >-S -3y� RELATIONSHIP TO PROJECT FAX NUMBER ❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe) ( /�Zr) t k, 3 -76111 EXISTING USE —H.LQ � t' 1 n � PROPOSED USE U��'r� EXISTING ASSESSED /APPRAISED VALUE 0$ VALUE OF PROPOSED WORK $ SPRDYKLERED BUILDING? NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? 0 YES10 WATER SERVICE PROVIDER VLAMMUiN 0 HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) / SEWER SERVICE PROVIDER 11 HIGHLINE . 0 PRIVATE iSEPTICI Value of Mechanical AIR HANDLING °V'.. FI E INSERTS COMPRESSORS ACES DUCTS GAS PIPE OUTLETS PLUIMNG BATHTUBS WTUb/slmaetCombo( SHOWERS DISHWASHERS SINKS �s GAS PIPE OUTLETS SUMPS WASHING MACHINES URINALS LAVS (seem. shL" VACUUM BREAKERS GAS LOGS REFRIG. SYSTEMS HOOD (;c m..ckq SC (Describe) GAS WATER HEATERS n WATER CLOSETS lrn�q r' MISC (Describe) DRINKING FOUNTAINS RAINWATER SYST HOSE BIBBS ELECTRIC WATER HEATERS I certify underpenalty 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, including the undersigned, and filed against the City of Federal Way, but only where such claim arises out of the reliance of city, inclu g its officers and employees, upon the accuracy of the ir4formation supplied to the city as a part of this application. NAME /TITLE DATE 46�_'© S (Sign (Title) RELATIONSHIP TO PROJECT re) Owner ❑ Agent ❑ Contractor ❑ Architect ❑ Other Buuean It)(1 January 7, 2005 Page 2 of 4 MandoutsTertnit Application