11-104095 • - Plumbing
City of Federal Way .{{�.�
Community Development Services Pet
t #: 11-104095-00-P L
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: MEDICAL IMAGING ON 1ST
Project Address: 33915 1ST WAY S Suite 130 Parcel Number: 926504 0150
Project Description: Installation of sink.
Owner Applicant Contractor
MEDICAL IMAGING ON 1ST TACOMA PLUMBING&HEATING INC TACOMA PLUMBING&HEATING INC
PO BOX 1535 PO BOX 44601 TACOMPH271PR(5/12/12)
TACOMA WA 98401 TACOMA WA 98448 PO BOX 44601
TACOMA WA 98448
Sinks 1
PERMIT EXPIRES Wednesday, April 4, 2012
Permit Issued on Friday,October 7, 2011
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: MAI/Gc.^ Date:
FINAL,LSD iof' /ii
THIS CARD IS TO MAIN ON-SITE ‘
CITY OF • Construction I ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 11-104095-00-PL Address: 33915 1ST WAY S Suite 130
Project: MEDICAL IMAGING ON 1ST FEDERAL WAY, WA 98003
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.
El Plumbing Groundwork(4190) - ❑ Rough Plumbing(4230) 0 Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date By Date By Date
❑ Final-Plumbing(4075)
Approved
By Date /f/o—// .
❑ Rough ElectricalEl Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
�,�, "� / u 7 s
rot 1.i-'"`''• ERMIT S MF CO ME DE EN FP
edera e,
NITY DEVELOPMENT SERD'({'$S�,'t\ 1t'-;APPLICATION
';`�p p L I V i I O i
335-2607•FAX 253-835-20d `` �!
ill
-..___.._._. OF E®ERP4-"\\I
'E ADDRESS �� - SUITE/UNIT#
S
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL N
— :..:
9 a 6 5 o `f - 6 / 5 0
TYPE OF PERMIT ❑BUILG `6�PLUMBING 0 MECHANICAL
❑ DEMITION 0 ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT �jJ/JV
,
_iiii._
(Tenant Name/Homeowner Last Name) /� - lrCa / //v 1 // ��^^ � (/ d\I E.
i�� r � 7i�,v� �� 71-
/...i___, � n.- -(--0, f� ��r� ,1 (c SS 1,
PROJECT DESCRIPTION , / 7Detailed description of work to r "t �. ' c A[� .
be included on this permit onlyNAMED �n / PRIMARY PHONE
PROPERTY OWNER (i/,amAillA
'^'� llr` VMAILING ADSS `''`'' E-MAIL
CITYSTATE ZIP
NAME ,Q / `JPHONE
MAILINGADSS E-MAIL
Ir
CONTRAC'to,
CITYzblZIP FAX
_ WA STATE CONTRACTOR'S LICENSE N EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME PHONE
APPLICANT MAILING ADDRES E-MAIL
CITY STATE ZIP FAX
PROJECT CONTACT/1/
�7 / _ ( P ONE(The individual to rereiue a (C. -Cr�1C �L'►vl h'fir' ar1.ter T�SIG •'l�- �� �- 3 U
respond to all correspondence MAILINGCA�DDRESS r ! �E-MAIL
concerning this application) 0 2�� Sr cGAN �'� v(t61 \���{ �� �
CITY-4+C.[�C., STATE
`l� `-'f 4 �r71 1
ALTERNATE CONTACT NAME: .PHONE E-MAIL
PROJECT FINANCING NAME 0 OWNER-FINANc�ED
Required value of$5,000 or more
/RCW 19.27.095/ 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 knowledge, 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 out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a a'�poarttonf this application. �J )
SIGNATURE: ' /1,V� C ' Ck U DATE f --0.7- <-�i 1 1
7.,,fNT NAME: 7`3(Lt irCc/l Lei �-`E_ —
Bulletin#100 January 1,20116Page 1 of 3 k:\Handouts\Permit Application
• 4111
VALUE OF MECHANICAL Wo• (a copy of bid or estimate must be provided)
Indicate how many of each type of fixture to .- -. tall-s or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER F ' PLACE INSERTS •OODS)commercial)
BOILERS FURNACES HOT WA '-TANKS)Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing factures to remain.
BATHTUBS(or Tub/Shower Combo) LAVS(Hand sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS ) SINKS)Kitchen/utility) WATER HEATERS(Elertrr)
HOSE BIBBS SUMPS WASHING MACHINES
CRITICAL • ' •S ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS US LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
E, Yes❑ No ❑Yes o No
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL / FOR OFFICE USE
FIRST FLOOR(or Mobile Home)
T1s-0„Ditg1 LOOR
COVERED ENTRY
441 �a
GARAGE ❑ CARPORT ❑
OT
HER(�lescrrlie}r
_.
EXISTING PROPOSED TOTAL
Area Totals
•
HE
ESTIMATED SELLING PRICE$ # OF BEDROOMS
AREA DESCRIPTI• ' Area Occupancy Group(s) Construction # ' Additional Information
in Square FeetType Storie
F:
ADDI ION
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additio 1 Information
In Square FeetTyye Stories
Sr r ' ' z�a, *' k"^' •" v m u ^" r
TENANT AREA ONLY
z tz� re" i
Bulletin#100—January 1,2011 Page 2 of 3 k:\Handouts\Permit Application