07-102362 w
City of Federal Way PlumbingPeri'#: 07-102362-00-PL
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: AMERICAN FAMILY INSURANCE
Project Address: 31653 PACIFIC HWY S Suite C Parcel Number: 082104 9196
Project Description: Installation of plumbing for tenant improvements.
Owner Applicant Contractor
HARSCH INVESTMENT PROPERTIES LLC AMERICAN MECHANICAL CORP AMERICAN MECHANICAL CORP
1121 SW SALMON ST PO BOX 1136 AMERIMC071BH 1/8/09
PORTLAND OR 97205 MONROE WA 98272 PO BOX 1136
MONROE WA 98272
Plumbing Fixtures
Lavatories 1 Water Closets 1 Water Heaters 1
PERMIT EXPIRES Thursday, April 30, 2009
Permit Issued on Tuesday, May 1, 2007
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 acco dance ith the laws, rules and regulations of the Stateof Washington
.* nd City of Federal Way.
Owner or agen
Fl NALED
RTHIS CARD IS TO MAIN ON-SITE-
CITY OF 41Pommunlty Develo m t Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 07-102362-00-P L
Owner: HARSCH INVESTMENT PROPERTIES LLC
Address: 31653 PACIFIC HWY S 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.
0 Plumbing Groundwork(4190) 0 Rough Plumbing(4230) 0 Gas Piping(4125)
Approved to cover Approved Approved to release test
By, - Date s_Z .. 7 %By V3 Date 5 8? C5 By Date
❑ Final-Plumbing(4075)
Approved
BS Date
For inspector reference only
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
RECEIVe 0
CA OF A 7 - t 0 `' T 6, 7
Federal Way MAY 0 1 2007 PERMIT
SF MF CO ME EL 6 DE EN FP
COMMUNITY DEVELOPMENT SERVICES
333258r"AVENUESOUTH•POBL�.�Bu�LDINQ 1°LICATION TD —�
FEDERAL WAY.WA 980639718 �'
253-835-2607•FAX 253-835-2609 `4,-- -� 1
tliC .Cal,ojjeae^au CCC Con.
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
• PROPERTY iIN�F`ORMATION
SITE ADDRESS-\\a ��SCA •\�_1 � �1'i S% SUITE/UNIT#C.
ASSESSOR'S TAX/PARCEL#' AJ \ - O\_ `� LOT SIZE(sJ)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING )4LUMBING 0 MECHANICAL
0 DEMOLITION////❑ _ELECTRICAL 0 ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTI N(Provide ddetaile escription of work included n this permit only)
. c iT -NC.X-ssat.
-,_\'\c -N\CNN,\ V NC.c, \CA\C;A` ;\,. C.11\\A \-- \"..,1\A 70‘‘C
PROJECT NAME(Name of Business or Owner Last Name)" \C C A. . \�>,._. ._1-J` \�� 1Q l \��Q r
• PEOPLE INFORMATION
PROPERTY �t SPRIMARY PHONE
OWNER \'\ \ �\V\ -S) -, ✓ \ ( )
-
MAILING
f � kfE-MAIL ADDRESS
\\ \ V C.Si\N Vh � c c )
CONTRACTOR OMPANY NAME LICANT NAME FFICE PHONE
LI C STATE,ZIP CELL PHONE
v. " O ( \\4C )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIR�I ON DA FAX NUMBS
COPY of Dara required
{CONTRACTOR'S
(REGISTRATION
`NUMBER t� Ep\\o \cD\IRATIO TE E-MAIILL AADDRESS f
with euh application \' \'V \ \ e1 `e3 '‹ C:�` j (� C) 's r.`\S"V""N
APPLICANT\KV\ \ccT WV. \ f c\S\NL "k6_7\\ --:J-1\c-c-k .:•FFICE ^ r
VI E 1�7� ,p \\,--)4._e
`1� . V\ST�1� a V 1\ pEL NUM)NE
ER
RELATIONSHIP TO PROJECT _
0 Architect ❑ Tenant o Agent OtherQ0 , �C "t \ - 9
PROJECT NAME PRIMARY PHONEE-MAIL DRESS
CONTACT V--V-) 1/4/-5 \ ,P e.. \\3 C Q- k°4--A.A c4 4.,C'- -Q
LENDER NAME Per RCW 19.27.095: 1/4AOaV Nc "C'
Lender information is required if project value exceeds$5,000'
MAILING ADDRESS CITY,STATE,ZIP PHONE
) -
II DETAILED BUILDING INFORMATION
EXISTING USE PROPOS D USE
EXISTING ASSESSED/APPRAISED VALUE$ \ ,— VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO • 'PRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES o NO
WATER SERVICE PROVIDER ❑ LAKEHAVE ❑ HIGHLINE o TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKE N ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
17 t (14
IN PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
•
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑COVERED OR ❑UNCOVERED?)
GARAGE ❑ CARPORT ❑
EXISTING ()POSED TOTAL . EXISTING SF TOTAL PROPOSED SF TOTAL SF
NUMBER OF FLOORS
**NEW HOMES ONLY** NUMBER OF EDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not inclutIP existing fixtures to remain.
MECHANICAL
�f`\
Value of Mechanical Work$ � ' �-_ + ‘-CA COPY OF BID O .•_-:' 1 'TE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS ii;ORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSE• ' HOODS(commercial)
COMPRESSORS FURNACES RANGES
DUCTS / GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/Shower Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(Toilet)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
I certunder penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and further,that I
am authorized 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 re lance of the city,includi i and employees,upon the accuracy of the information supplied to the city as a part of
this applic (
`_. �:�
NAME/TITL � � ""'--' DATE 11 V�
(Signature) (TYlle)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent yContractor ❑Architect ❑ Other
❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? Li YES ❑NO BASIC PLAN? ❑YES n NO
ZONING DESIGNATION CHANGE OF USE? ❑YES o NO
NEW ADDRESS REQUIRED? ❑YES ❑NO UP/SEPA/SU? ❑YES ❑NO
PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? ❑YES o NO
Bulletin#100-April 2,2007 Page 2 of 4 k\Handouts\Pennit Application