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05-100303City of Federal Way Plumbing Permit #: 05 - 100303 - 00 - PL Community Development services P.O. $ox 9718 Federal Way, WA 98063 -9718 Ph: (253) 835 -7000 Fax: (253) 835 -2609 Inspection request line: (253) 835 -3050 Project Name: MEDICAL EVALUATION SPECIALISTS Project Address: 3200132nd S Suite340 Parcel Number: 215465 0010 Project Description: Plumbing for 2 sinks, 1 dishwasher, 1 electric hot water tank and 1 indirect drain. Owner Applicant Contractor FOSS DEVELOPMENT SAGER MECHANICAL INC SAGER MECHANICAL INC FOSS DEVELOPMENT 8425 219TH ST SE 8425 219TH ST SE 1151 FAIRVIEW AVE N WOODINVILLE WA 98072 WOODINVILLE WA 98072 SEATTLE WA 98109 1 (425) 402 -1930 Plumbing Fixtures Description Quanti Description FQuanfityl I Description Auantityd Dishwashers t 1 Drains F-1 —] Sinks 1� u Water Heaters 1 DATE 1 TYPE THIS CARD IS TO JPMAIN ON -SITE CITY OF Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050 PERMIT #: 05- 100303 -00 -PL Owner: FOSS DEVELOPMENT Address: 32001 32nd AVE S Suite 340 FEDERAL WAY, WA 98001 -9625 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 B Date z,-A- By Date Final - Plumbing (4075) Approved B Date i RECEIVED My., V& 0 JAN 2 5 2005 ��- � O � 3 Federal Way 2005 PERK -�'TF FEDERAL WAY SF MF CO ME E PL E EN FP COMMUNITY DEVELOPMENT SERVICES p� AL, AY IL ING DEPT. 33325 8TH AVENUE SOUTH • P01 71 F I1- D "` FEDERAL 07- PAX 53-8 98063- -2609 U I LD I� ®E P P L I C Al i 0 N 253-8wwAt 7• FAX 253-835-2609 O www. cituoffederaiwau. com The followina is reauired information - an incomplete application will not be accepted. Please print legibly (in ink) or type. SITE ADDRESS v �� '� l `�` y'�� SUITE /UNIT # 3 ASSESSOR'S TAX/ PARCEL # j -•� - CJ © LOT SIZE (s,) LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) (Attach separate page for lengthy legal description) PROJECT INFORMATION TYPE OF PERMIT ❑ BUILDING APLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlul PROJECT NAME (Name of Business or Owner Last Name) PROPERTY OWNER CONTRACTOR APPLICANT NAME PRIMARY PHONE mss - �'0 -r G ® ( - MAILING ADDRESS CITY, STATE, ZIP COMPANY NAME f� �i 1 L APPLICANT N OFFICE PHONE (Y1 Noa - 1�i3 f� MAILING ADDRESS 8 1 S7 CITY STATE, ZIP CELL PHONE CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE '�P- o -o T- 1 6 o ©mss' =B L 1,;�- 131 1aS FAX NUMBER (Y;5-) q09 -b791 CONTRACTOR'S REGISTRATION NUMBER (copy of card required with each application) EXPIRATION DATE COMPANY NAME / • `t+G1 1 /' ,L•F+/ C.. / ( L•' APPLICANT NAME_ �t�� ,ZZZII7PV\ ("( iC'� —'r �ra� ®- 1 ! J MAILING ADDRESS CITY, STA E pin��i t.-c.� ,.� g�7a CELL PHONE (z/�3a� -97'x• RELATIONSHIP TO PROJECT ❑ Architect ❑ Tenant /Agent ❑ Other (Describe) FAX NUMBER ( ,-,N �) "!(v -67? CONTACT PRIMARY PHONE - E -MAIL ADDRESS LENDER EXISTING USE PROPOSED USE EXISTING ASSESSED /APPRAISED VALUE * VALUE OF PROPOSED WORK SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC) �i>� \ AREA DESCRIPTION EXISTING PROPOSED TOTAL 3 . FT. SO. FT. 3 . FT. BASEMENT FIRST SECOND THIRD FOURTH ADDITIONAL FLOORS (DESCRIBE) DECK (COVERED ?) GARAGE ❑ CARPORT ❑ wasnso NUMBER OF FLOORS rnorosao Toner 1YkCt � xw rrto�nr 4t as Mat, * *NEWHOMES ONLY** NUMBER OF BEDROOMS E ATED SELLING PRICE $ Indicate number of each type of fixtu FIXTURES to be installed or relocated as part of this pro] Do not include existing fixtures to remain. MECHANICAL Value of Mechanical Work $ AIR HANDXIUS EVAPORATIVE COOLERS GAS LOGS REFRIG. SYSTEMS BBQS FANS HOODS (commercial) W OODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC (Describe) COMP SSORS FURNACES GAS WATER HEATERS DUCTS GAS PIPE OUTLETS PLUMBING BATHTUBS (or Tub /Shower combo( SHOWERS WATER CLOSETS (Toilet MISC (Describe) L DISHWASHERS SINKS DRINKING FOUNTAINS j4h( JEC—r GAS PIPE OUTLETS SUMPS RAINWATER SYST baA I NV WASHING MACHINES URINALS HOSE BIBBS LAVS (Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS 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 authorised 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 madl by apy person, including the undersigned, and filed against the City of Federal Way, but only where such claim arises out of the reliance of th citr its officers and employees, upon the accuracy of the information supplied to the city as a part of this application. NAME /TITLE DATE i tun (Title) RELATIONSHIP O PROD T Cl Owner ❑ Agent contractor ❑ Architect ❑ Other Bulletin 9100 - January 7, 2005 Page 2 of 4 k \Handouts\Permit Application