12-105364 Plumbing
City of Federal Way Permit #: 12-105364-00-P L'
Community&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 g
Ph:(253)835-2607 Fax (253)835-2609Inspection Request Line: (253)835-3050
e # fi
Project Name: PHO VIENG LAO RESTAURANT
Project Address: 30406 PACIFIC HWY S Suite B Parcel Number: 092104 9107
Project Description: Install 2 compartment sink
Owner Applicant Contractor
LOHER EUGENE TRUST VIENGVILAY YEEXOUNGKEO TENANT IS CONTRACTOR
30406 PACIFIC HWY S 2632 SW 351ST PL
FEDERAL WAY,WA 98003 FEDERAL WAY WA 98023
Plumbing Fixtures
Sinks 1
PERMIT EXPIRES Sunday, May 26, 2013
Permit Issued on Tuesday, November 27, 2012
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: • Date: ,/7// 2 .
pnJML 2./F/iz.
e
'4% THIS CARD IS TO MAIN ON-SITE
CITY OFConstruction- In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 12-105364-00-PL Address: 30406 PACIFIC HWY S Suite B
Project: LOHER EUGENE TRUST 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) 0 Rough Plumbing(4230) 0 Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date By Date By Date
0 Final-Plumbing(4075)
Approved
By ref Date /2 --7..../4
ID Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
-41111 _ I �- � -
�'
+..
Federal vu�ECEIVE® ERMI'I' SF MF CO ME PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES 2j P PLICATION
I
253-835-2607•FAX 253-835-21On A 7 201
CITY OF FEDERAI WAY
SUITE/UNIT#
SITE ADDRESS CDS , -
1 -s
PROJECT VALUATION ZO NG ASSESSOR'S T PARCEL 3 O
® z ( 04 _ 9 1
❑ BUILDING ® PLUMBING 0 MECHANICAL
TYPE OF PERMIT
0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT �I
(Tenant Name/Homeowner Last Name) O e i �/- ��
Vll 1-e,
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAMEPRIMARY PHONE
l�
PROPERTY OWNER L/ /�FtiL....-",.. „:.,:::
Ltil2 � Z�� �b —G�2 6r7
MAILING ADD S E-MAIL A
-//":'[Vi''e-1)1 gr--eV); Alair/4
CITY STATE ZIP
I 1 /4 l a
NAME PHONE
• 7V7y,tN
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE 0 EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE 0
/ /
_ PHONE
NAMEyr.. m`Al r
tT{T%�/IYRE E-MAIL
APPLICANT MAILING ADDRESS
CITY I4 I STATE I fl ZIP FAX ..
-- -- - _ - - -. " -
PROJECT CONTACT NAME 'rNw.r.- PHONE
(The individual to receive and .
MAILING ADDRESS E-MAIL
respond to all correspondence
concerning this application)
CITY I STATE ZIP FAX
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANC G NAMEOWNER- ' ANCED
Required value of 00 or more PHONE
IRCW - 7.095) MAILING ADDRESS TY,STATE,ZIP
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: it d `_ _ ' - DATE /7/.g 7// 5
PRINT NAME: 6/..r--_---/11�—f / ' U)2. k eQ
Bulletin#100—January 1,2011 Page 1 of 3 k:\Handouts\Permit Application
i7:17177:3'''''' ''
� •
VALUE OF MECHANICAL WORK $ (a copy of bid or estimate must be provided)
Indicate how many of each type offixture 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)commeraat)
BOILERS FURNACES HOT WATER TANKS)Gos)
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 fixtures 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 Z SINKS(Kitchen/ucairy) WATER HEATERS(Dear.)
HOSE BIBBS SUMPS WASHING MACHINES n, r
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR
�.w.
SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(Ia.Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes ❑ No o Yes o No
: +�<a n,ax:w,,,:..�; �-~tea; � Lf '<'>��. •a�a�;;�4a.. �, =..s, �' a' .�v - '3
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL
FOR OFFICE USE
•ss/ �. ,_ x •,;.:.iia ;;.e...-« •;# .�.�,�. ,;.`R • .• • "d
FIRST FLOOR(or Mobile Home)
COVERED ENTRY — — — — --e
GARAGE 0 CARPORT 0 -- ` — — --
i
Area Totals G PROPOSED TOTAL — __--------------_—_—
ESTIMATED SELLING PRICE$ #OF BEDROOMS
t ,
',nom •-. ��,..a,.. ,y<.x„......,.w,•�°aL.,�.,. ,s._...,.ft.., ..,a�....«s.., ..,� �.,. - <
AREA DESCRIPTION Area Occupancy Group(s) Construction #of
in •uare Feeta Stories Additional Information
.v.iwr. . xZ•' bem e._ .. '�% s:,:.x a,e-.�,hsex 3..0«xsv',r ,.,W,.L,.:.x»n.�„�...:x €.{a.,.s .:.S
ADDITION
m ...
c.� ,�r �•,.��;xiz r�a�,.�,.e>�.,x.�„�»:,-,..,,.�<�. ��3�Asx,, s � � ,� �
AREA DESCRIPTION Area Occupancy Group(s) Construction #of
in •uare Feet P y P1 1 e Stories Additional Information
z� � _..:. �.- .. A., s�''`�»' � R � r a� F t ° "�� ���"� �•s �'#a> � �”- rt�`� P ��" "� ..syr.<<p
v .�? �.::yi,�..�. s�,,.�4 .,sE.s wz�,,-•<,_, 45 .�.;�::'�S£����:�.z.�- san f ��.; g ° ':s " .s`:..y..��
TENANT AREA ONLY
; 3
Bulletin#100—January 1,2011 Page 2 of 3
k:U-Iandouts\Permit Application