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03-100783 ACONSTRUCTION PERMIT APPLICATIO CITY OF �../ _ APPLICATION NUMBER: 03,. 423- Federal Way APPLICATION NUMBER: - - (APPLICATION NUMBER: - - **The following s required information-Please print(in ink)or type** Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application. ■ PROPERTY INFORMATION SITE ADDRESS: .32-9!--3-5 1 S{ j4,-*- , ASSESSOR'S TAX/PARCEL #: - LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): • PROJECT INFORMATION TYPE OF PROJECT(This application): ❑ BUILDING A f4BING ❑ MECHANICAL o DEMOLITION o ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description): Lc( �t� �} * S c"—'L Lit le 0`./ ,h - (A/- c L PROJECT NAME: - if ■ PEOPLE INFORMATION PROPERTY OWNER: NAME: DAYTIME PHONE: 7 ...' 1.1 4.1 ALC• , ) - e'l5') MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): 2S.Ii ? CONTRACTOR: ; DAYTIME PH E: NA MAILING ADDRESS(STREET ADDRESS;• ,STATE.ZIP): EVENING PHONE )3 J7 S( X 4s,"t i',0 S �t\ ' n ) s s - . 2.?CITY.,,OF FEDERAL`BUSINESS LICENSE NUMBER: - WO NUMBER: - ' lil (.) CONTRACTOR'S REGISTRATION NUMBER: Q 8'3-6 EXPIRATION DATE: 4 C (copy of card required) C< I i'c7 1 ("3-6I C, ) / c 1 / /�3 APPLICANT: NAME• 7 DAYTIME PHONE: l`' L k k/Se1 .--LA,j4-:2 � ( ) i �-.•1, MAI NG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: 1411-41A ( RELATIONSHIP TO PROJECT: i FAX NUMBER: 0 ARCHITECT 0 TENANT ❑ OTHER( DESCRIBE): ( ) - I E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER o APPLICANT ❑ CONTRACTOR � I ■ DETAILED BUILDING INFORMATION EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ SPRINKLERED BUILDING? o YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES o NO WATER SERVICE PROVIDER: o LAKEHAVEN 0 HIGHLINE o TACOMA o PRIVATE(WELL) SEWER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE 0 PRIVATE(SEPTIC) **NEW RESIDENTIAL CONSTRUCTION ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ ■ PROJECT FLOOR AREAS FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL BASEMENT FIRST SECOND THIRD FOURTH OTHER FLOORS(DESCRIBE) DECK GARAGE HOW MANY FLOORS? TOTAL: ■ FIXTURES Indicate number of each type of fixture MECHANICAL AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S) BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S) BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( ) COMPRESSOR(S) FURNACE(S) DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC o GAS PLUMBING BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S) DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC o GAS DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) L—�MISG(,� f�E ) INTERCEPTOR(S) SUMP(S) ■ DISCLAIMER/SIGNATURE BLOCK I certify under penalty 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 daim(induding costs,expenses,and attorneys'fees incurred in the Investigation and defense of such claim),which may be made by any person,induding the undersigned,and filed against the City of Federal Way,but only where such daim arises out of the reliance of the city,induding its officers and employees,upon the accuracy of the information supplied to the city as a part of this application. ,/� / CV NAME/TITLE: .40- 7_4 ��%��'�f_'��"�' DATE: / ��3 o PROPERTY OWNER o APPLICANT ❑CONTRACTOR FOR OFFICE USE ONLY I]NEW 0. )DIiION [ALTERATIONS 7uREPAIR�,� TENAN IMPROVEMENT 'CENSUS CODE��¢ p LOT SIZE vogarrowaen—tokomti N ZONING DESIGNATION ? � � BUILDING SHELL�ONLY? 0 YES ❑NO ;:COMP PLANDESIGNATION - ` Ar'' ^,BASIC,PLAN?' ❑AYES Afl NO ' , SECTIONS c TOWNSHIP RANGE NEW ADDRESS REQUIRED?` - ❑YES ❑NO PLATTED LOT?; ❑.YES ©NO4 ,CHANGE OF USE? ,i :' .n YES ❑ NO ,,,, COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129 www.dtvoffederalway.com City of Federal Way Community Development Services 33530 1st Way S Federal Way, WA 98003 -6210 Ph: 253.661.4000 Fax: 253.661.4129 Plumbing Permit #:03 - 100783 - 00 - PL Inspection request line: 253.835.3050 Project Name: 7 -11 Project Address: 32935 1ST S Parcel Number: 7182104 9037 Project Description: Replace broken sewer line digging up and replacing as needed Olvner - Applicant Contractor 7 -11 SOUTHLAND CORP. ROCK OF AGES PLUMBING INC ROCK OF AGES PLUMBING INC 104 SW 312TH ST 13527 SULTAN BASIN RD 13527 SULTAN BASIN RD FEDERAL WAY WA 98023 SULTAN WA 98294 SULTAN WA 98294 (425) 308 -5241 Descrl�tio> i t fix' Other Plumbing Fixtures_ -� Plumbing Fixtures PERMIT EXPIRES August 23, 2003. Permit issued on February 24, 2003 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: //I�,.t (� ,,,, Date: 02- V,? L ''-3. 03 -d3