06-102584• City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609
Plumbing Permit' #: 06- 102584 -00 -PL
Project Name: VALLEY RADIOLOGY, INC.
Project Address: 533 S 336TH ST Suite C
Project Description: Relocating a new sink and e-n} rL
Inspection Request Line: (253) 835 -3050
Parcel Number: 926480 0260
Owner
Applicant
Contractor
CURRAN PROPERTIES
DAVIS SCHUELLER INC
CITY PLUMBING, INC.
160157111 AVE #1703
20700 44TH ST W
CITYPI *955KJ 8/1/06
SEATTLE WA
LYNNWOOD WA 98037
222 ANDERSON RD UNIT A
98101 -1657
MOUNT VERNON WA 98273
Plumbing Fixtures
Other Plumbing Fixtures ............... 1.00 Sinks............... ............................... 1.00
• THIS CARD IS TO MAIN ON -SITE ,
CITY OF Community Developm nt Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 06- 102584 -00 -PL
Owner:
Address: 533 S 336TH ST Suite C
FEDERAL WAY, WA 98003
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 Dates'. By G (� Date • 2 p ` By Date
❑ Final - Plumbing (4075)
Approved
By Date 17101.
RECEIVED 0 a ct
Federal W - p0 � C —
CONMUM7'Y DBVBLOFYBKI 38RVIC8S
& `'1 PERM ' SF MF CO ME E PL DE EN FP
33345 d^t AVSNUB, WA 9 • ro BOX 9718 A P P L '
53-83 -2607- WA 53- MS-260 � ' .7,:, 0W �— .�J �
Z53- Q35.2607• FAX Z53- 635 -2609 4�l l� ` /L /1/ � (�'--
mmm.&wffb*n matr.pm
The LbllowiEW is EMLfred in ormatton - an incom
j2tete application will not be acceL7ted. Please print kqLbkALn in or
2 -PROPERTY •- •
SITE ADDRESS �f J, J � ✓ SUITE /UNIT #
ASSESSOR'S TAIL /PARCEL Z C7 - LOT SIZE (s])
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach sq—te ~Jbr kVft AWd do —wd-1
PROJECT • •
TYPE OF PERMIT ❑ BUILDING '�(PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only)
PROJECT NAME (Name of Business or Oumer Last Name)
) _/943,
PROPERTY
OWNER
CONTRACTOR
APPLICANT
NAME
PRIMARY PHONE
APPLICANT NAME
OFFICE PHONE
MAILING A DR
e � , 1 -703
CITY, STATE, ZIP
S loe_
COMPANY NAME
I
APPLICANT NAME
APPLICANT NAME
OFFICE PHONE
CITY, STATE, ZIP
/CELL PHONE
l
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe)
FAX NUMBER
MAILING #DDRESS
CITY, STATE, ZIP
CELL PHONE
(3w) && i
-
OF DERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBE`R
' /
CONTRACTORS REGISTRATION NUMBER (coPy of card required with each application)
C 1 7TH 5:Sl�T
EXPIRATION DATE
8/o %/0('
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
/CELL PHONE
l
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe)
FAX NUMBER
CONTACT NAME PRIMARY PHONQ ( - ��� E -MAIL ADDRESS
PN VL /(O
LENDER
NAM$
MAILING ADDRESS CITY, STATE, ZIP PHONE
( )
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)
AREA DESCRIPTION
EXISTING
S . FT.
PROPOSED
S . FT.
TOTAL
S . FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS (DESCRIBE)
DECK (COVERED ?)
GARAGE O CARPORT ❑
NUMBER OF FLOORS
�'' "O
rROro.so
rorar
"NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing, fixtures to- remain..
Value of Medm cal Work $
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
BATHTUBS for T b /shower comet►
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINES
LAVS p-, sm*
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS PIPE OUTLETS
SHOWERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
GAS LOGS
HOODS (comma i q
RANGES
GAS WATER HEATERS
REFRIG. SYSTEMS
WOODSTOVES
MISC (Describe)
WATER CLOSETS rroaeq MISC (Describe)
DRINKING FOUNTAINSLL' C Q�
RAINWATER SYST
HOSE BIBBS
ELECTRIC WATER HEATERS
I certVy under penalty of perjury that the ir4 formation furnished by me is true and correct to the best of mg 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 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 the city, including its officers and employees, upon the accuracy of the tr{/ormation supplied to the city as a part of
this application.
NAME /TITLE DATE 5—
RELATIONSHIP TO PROJECT er ❑ Agent o Contractor ❑ Architect a Other
Bulletin #100 —January 1, 2006 Page 2 of 4 Mwdouts\Pennit Application