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13-103177 411. _ 'lu> bng City of FederalWay Permit. #: 13-103177-00-PLCommunity&Econ.Dev.Services , r��;;,.A 33325 8th Ave S E .o Federal Way,WA 98003 r'y_.. Inspection Request Line: (253)835-3050 Ph:(253)835-2607 Fax (253)835-2609 r Project Name: MINISUPER LA FAMILIAR Project Address: 29100 PACIFIC HWY S Unit 1/2 Parcel Number: 042104 9073 Project Description: Mop sink as required by KC Health Department. NOTE: Sink was already installed by previous tenant without permit. Owner Applicant Contractor MINISUPER LA FAMILIAR PABLO LIZAMAROS MINESUPER LA FAMILIAR 27023 MILITARY RD S 29100 PACIFIC HWY S SUITE 1/2 KENT WA 98032 FEDERAL WAY WA 98003 Plumbing Fixtures Sinks 1 PERMIT EXPIRES Monday, January 13, 2014 Permit Issued on Wednesday, July 17, 2013 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 P, /G/ Z i ®�G�'�cx} Date: D ?—1 7—/ THIS CARD IS TO • I ON-SITE J • CITY OF ' • Construction Ins-r •ction Record Federal vvay INSPECTION REQUE TS: (253)835-3050 PERMIT#: 13-103177-00-PL Address: 29100 PACIFIC HWY S Unit 1/2 Project: MINISUPER LA FAMILIAR 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. 0 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 `B Datq ,_____.(\--7 /� l . . Rough Electrical Final Electrical ❑ Right of Way ❑ Approved ElApproved Approved By Date By Date By Date RECEIVED �,roF JUL 1 � 3 PERMITIPPLICATION Federal Way CITY OF FEDERAL WAY CDS• 7 PERMIT NUMBER / 3 _ l- (6 7 — 'A t TARGET DATE SITE ADDRESS SUITE/UNIT# ,94/r)/nom Pckc vL t\vJ S reds./ way a). 4 5 'ooh PROJECT VALUATION ZONINGASSESSOR'S TAX/PARCEL# TYPE OF PERMIT ❑ BUILDING PLUMBING El MECHANICAL El DEMOLITION ❑ ENGINEERING 0 FIRE PREVENTION NAME OF PROJECT PROJECT DESCRIPTION e1/4-4 C)1� Detailed description of work to be included on this permit only NAMEic A n PRIMARY PHONE PROPERTY OWNER fA I A�� c)6 Com( Irk aS 3 MAIL G ADDRESS E-MAIL 11Jei0A STATE ZIP W c� 0.),A cleo s 0 (/S PHONE MAILING ADDRESS E-MAIL CONTRACTOR CITY STATE ZIP FAR WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# NAME PRIMARY PHONE APPLICANT MAILING ADDRESS E-MAIL CITY STATE ZIP FAX AME PIY PHONE/ PROJECT CONTACT &.'/'O 1/' — - j /�� .��?O cc 2 (Tile individual to receive and MAILING DRESS E-MAIL respond to all correspondence concerning this application) CITY STATE ZIP FAX NAME PROJECT FINANCING 0 OWNER-FINANCED Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE (RCW 19.27.095) 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 part of this application. SIGNATURE: � © ( I�2 N'7p DATE D�/j 7/f 3 PRINT NAME: ��Q 2 d?cP y✓c<''�s Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit Application • VALUE OF MECHANICAL WORK MECHANICAL PERMIT $ Indicate how many of each type of fixture to be installed 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 FIREPLACE INSERTS HOODS(commercial) BOILERS FURNACES HOT WATER TANKS(Gas) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES PLUMBING PERMIT VALUE OF PLUMBING WORK o7N Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. BATHTUBS(or Tub/Shower Combo) LAVS(Hand Sinks) TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe) DRAINS T SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS_ _I _SINKS(K;tch.„fury _ ____ — WATRR HEATERS41_a.I---- HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS EXISTING/PREVIOUS USE LOT SIZE)Ia Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? ❑Yes❑ No ❑Yes ❑ No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE FIRST FLOOR(or Mobile Home) E COVERED ENTRY BECK J g aa l , s C Iii GARAGE 0 CARPORT 0 Area Totals ST®O PROPOSED TOTAL IIMMENV1r1MIFIBEIVINEWIlffAttlrEk400VWWINOME0810101005024 ESTIMATED SELLING PRICE$ #OF BEDROOMS COMMERCIAL-N ''/ADDITION AREA DESCRIPTI•. Area Occupancy Group(s) Construction 'f Additional Information in Square FeetType Stori NEW s DING % x •DITION COMMERCIAL-REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information in Square FeetType Stories TOTA BUILDING ' *R k , �G ?t N .°moi; .e .x ..,,.,.m .,O,(WA,. -. a TENANT AREA ONLY PItOJECY A EA ONL Bulletin#100—January 1,2013 Page 2 of 3 k:\Handouts\Permit Application