15-101285City of Fed" way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835 -2607 Fax: (253) 835 -2609
Project Name: CHA CHIROPRACTIC
Project Address: 1700 S 105TH PL
Project Description: Replace electric hot water tank.
Plumbing
Permit #: 15- 101285 -00 -PL
Inspection Request Line: (253) 835 -3050
Parcel Number: 255817 0130
Owner
JASON CHA
ARRIIcan t
JASON CHA
Contractor
OWNER IS CONTRACTOR
CHA & LEE CHIROPRACTIC CLINIC
CHA & LEE CHIROPRACTIC CLINIC
1700 S 305TH PL SUITE A
1700 S 305TH PL SUITE A
FEDERAL WAY WA 98003
FEDERAL WAY WA 98003
Plumbing Fixtures
Water Heaters .. ............................... 1
PERMIT EXPIRES Saturday, September 12, 2015
Permit Issued on Monday, March 16, 2015
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 a rdance with the laws, rules and regulations of the State of Washington
!7e City of Federal Way.
Owner or agent: Date:
F.'�"1-tA
crrr .
Federal Way
PERMIT #:
Project:
. THIS CARD IS TO MAIN ON -SITE
Construction In ection Record
INSPECTION REQUE TS: (253) 835:3050 `
15- 101285 -00 -PL
JASON CHA
Address: 1700 S 305TH PL
FEDERAL WAY, WA 98003 -4814
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.
❑ Final - Plumbing (4075)
Approved
By Ai,) Date g I r
Plumbing Groundwork (4190)
Rough Plumbing (4230)
Final Electrical
Approved
Gas Piping (4125)
Approved to cover
By
Approved
Approved to release test
By
Date
By
Date
By
Date
❑ Final - Plumbing (4075)
Approved
By Ai,) Date g I r
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF 'A
Federal Way
RECWD
MAR 16 2015
PERMIT APPLICATION
CITY OF FEDERAL WAY
PERMIT NUMBER / S _ aC ?S _
_f� % TARGET DATE
SITE ADDRESS
TOO (Day" [�� a3
SUITE /UNIT #
PROJECT VALUATION
ZONING
ASSESSOR'S TAX /PARCEL #
TYPE OF PERMIT
❑ BUILDING PLUMBING ❑ MECHANICAL 11 DEMOLITION 1:1 ENGINEERING El FIRE PREVENTION
NAME OF PROJECT .-
c 1 wor�'-Vy 1/k-GCF v 4c) C-r X01/1
PROJECT DESCRIPTION —.
Detailed description of work to
`e 1 `22
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER , __._
L.--
MAILING ADDRESS t
E -MAIL
CITY
STATE
ZIP
NAME D
PHONE
MAILING ADDRESS
E -MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
APPLICANT
MAILING ADDRESS
E -MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
AME
—TA —1; 0 0
MAILING ADDRESS
E -MAIL
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
OWNER- FINANCED
Required value of $5, 000 or more
(RCW 19.27095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
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 knobledge, 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 once of the city, including its officers and employees, upon the accuracy of the
information supplied to.the "c'ityas a part of this app tion.
GNATURE: DATE
PRINT NAME:
Bulletin # 100 — January 1, 2013
Page I of 3
k:\Handouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
Indicate how nzany of each type offixture to be installed o cated art o this project. Do not include existin res to remain.
AIR HANDLING UNITS FAN GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER N S HOODS BOILERS FUR H ATER TANKS (Gas)
COMPRESSORS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
V
OF PLUMBING WORK
PLUMBING .PERMIT
�
AREA DESCRIPTION
-"!-L, ) —
��
Indicate how many o each type offixture
to be installed or relocated as part o this project. Do not inc
o remain.
BATHTUBS (or Tub /shower Combo)
LAVS (Hand sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
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DRINKING FOUNTAINS
SINKS (Kitchen /utility) _�_
WATER HEATERS (Electric)
lr�
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
F OFFICE USE
�
AREA DESCRIPTION
EXISTING /PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
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/
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❑ Yes ❑ No
❑ Yes ❑
RESIDENTIAL - NEW ADDITION
AREA DESCRIPTION (in square fe )
EXISTING
PROPOSED
TOTAL
F OFFICE USE
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AREA DESCRIPTION
Occupancy Group(s)
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Additional Information
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Bulletin # 100 —January 1, 2013 Page 2 of 3 k:\Handouts\Permit Application