06-104396 City of Federal Way Plumbing Perm#: 06-104396-0O-P L
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: BOYKO
Project Address: 31617 13TH AVE SW Parcel Number: 416795 0260
Project Description: ALT-installation misc plumbing to addition.
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Owner Applicant Contractor
VITALIY BOYKO VITALIY BOYKO VITALIY BOYKO
PO BOX 23814 PO BOX 23814 PO BOX 23814
FEDERAL WAY WA 98093 FEDERAL WAY WA 98093 FEDERAL WAY WA 98093
plumbing Fixtures
Bathtubs 1 Laundry Washer Outlets 1 Lavatories 1
Showers 1 Sinks 1 Water CIosets 1
Hose Bibbs 1
PERMIT EXPIRES Thursday, August 28, 2008
, h, Perinit''Issued on Tuesday, August 29, 2006
reby rtity t the above information s correct And that the construction on the above described propertyland
the up n y=; the : vii "_• d tan `w>�th ws,ru s a dreg at pi s of the State of 1 shingti
and a City of Federal Way. ,
Owner or agent: ��A-4_ _ Date:
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THIS CARD IS TO MAIN ON-SITE -
CITY OF tommuni tY Develo i t Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 06-104396-00-PL
Owner: VITALIY BOYKO
Address: 31617 13TH AVE SW
FEDERAL WAY, WA 98023-4722
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
RECE ED
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CITr or AUG 2 9 'LOS za - I a -_ _2 _k
Feder�al way PERMIT
COMMUNITVDRVBLOPMBRr3BRVI�'�y OF FEDE SF MF CO ME EL ED DE EN FP
33325 FEDERAL AY,WA f!•�971 ATP L I C AT I O N
FEDERAL WAY,WA 98069-9718 BV�LD�N(�
253-835.2607•FAX 253-835-2609 r ,"`
www,Muolhcdemlwau.mm
The ollowin• is re• ired in ormatlon—an inco •lete a••lication will not be acce•ted. Please •rint legibly in in or 1•
1,� /1416 ■ PROPERTY INFORMATION
SITE ADDRESS .1611 /3 v (00 SUITE/UNIT'
ASSESSOR'S TAX/PARCEL# 4 I 6 1 ' 6'- e) G O LOT SIZE(sf
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(mock separate page for lengthy legal d•aaipfla.q
■ PROJECT INFORMATION
TYPE OF PERMIT ❑BUILDING ,!� PLUMBING ❑ MECHANICAL
❑ DEMOLITION/❑\ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
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PROJECT NAME(Name of Business or Owner Last Name) �/i �/W
III PEOPLE INFORMATION
PROPERTY NAME � � (''. ARYPHONE
OWNER V `s` ./11� qq7
p1{' �( e ( \ �.�Ay,7 lam./ �uiy i �"�
M8.(LI `D G x� , G.)9 1 Y;- ,'•_ vi'+ It u) -LgO
ACC))
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
•
-s L / I ( ) -
CONTRACTOR'S REGISTRATION NUMBER loopy of card required with etch application) EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
CI Architect ❑:Tenant ❑Agent ❑ Other(Describe) ( ). -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
LENDER
MAILING ADDRESS CITY,STATE,ZIP PHONE
( ) -
•
DETAILED BUILDING INFORMATION .'
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ • - ••SED WORK $ •
SPRINKLERED BUILDING? • -.� ❑ NO FIRE SUPP•1 , • SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE P• • , •ER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACO k r ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SE IC)
1111 1111/
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.,FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
•
-ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT❑
NUMBER OF FLOORS susraa rsorosso I roT.v
**NEW HOMES• • NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of facture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
ME IVICAL
Value of eN • . .rk $
AIR HANDLING UNITS •-•: TIVE ••- GAS LOGS REFRIG.SYSTEMS
BBQS HOODS(Commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS . . MISC(Describe)
C. -'ORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING •
BATHTUBS(or Tub/Shower Combo) SHOWERS ' WATER CLOSETS bones MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
I WASHING MACHINES URINALS I HOSE BIBBS
LAVS!Bathroom VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
I cert(fy 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 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 ty, ncluding i officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE !�i :41� auso►.sms. DATE ____LA.A../42f2 ;>_____
(s atu I (Title)
RELATIONSHIP TO PROJECT Owner 0 Agent 0 Contractor 0 Architect I7 Other •
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