08-103413 r .. .. w
a
III
City°rFederal Way illi
Plumbing Permi • 08-103413-00-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: EVERGREEN BANK 1÷4" 5l'
Project Address: 31433 PACIFIC HWY S 1---* d �1 r Parcel Number: 082104 9013
Project Description: ALT-installation of a (1) new sink.
`
Owner Applicant Contractor
PAVILION CENTER ASSOCIATES THE ROBSON COMPANY INC THE ROBSON COMPANY INC
120 W DAYTON SUITE D9 9531 NE 140TH ROBSO**055QA 11/2/09
EDMONDS WA 98020 BOTHELL WA 98011 9531 NE 140TH
BOTHELL WA 98011
,
Plumbing Fixtures
Sinks 1
PERMIT EXPIRES Friday, July 16, 2010
Permit Issued on Wednesday, July 16, 2008
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
he Ci isf ederal Way.
Owner or agent 0.I Date: '-7.401iW
1 W
\‘.0
„. 4kk THIS CARD IS T EMAIN ON-SITE
CITY OF �� ��� °Community Develop lent Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 08-103413-00-PL
Owner: PAVILION CENTER ASSOCIATES
Address: 31433 PACIFIC HWY S
FEDERAL WAY, WA 98003-5405
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) ❑ Gas Piping(4125)
Approved to cover Approved Approved to release test
By C t_dj Date 7-17. th$ By gof / Date f ,/0 . By Date
0 Final-Plumbing(4075) /
Approved
By C t \ Date 3 a
•
For inspector reference only
--
❑ Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
I ti
CRY
AUCEIVE#PERMIT
Alt- I 0 3 Y 1
FeSF MF CO ME EL1P DE EN FP
COMMUMTY DEVELOPMENT SERVI
8
P
•
33353-83 AWA 253-835-26099 - 18s Z° APPLICATION ���j1�._...
FEDERAL WAY,FAX
33TD /
www.cituo e�drtiTiB�il.a1111�F FEDERAL WAY
The following�iits reequir �ermation-an incomplete application will not be accepted. Please print legibly(in ink)or type.
//J • PROPERTY INFORMATION
SITE ADDRESS 3/% 3 S /k 4, ,"p�.'G ie/i4/5" 5. SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# _ - _ LOT SIZE(s,7
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING WPLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu)
Ti .tC. v.•-4. SioA
PROJECT NAME(Name of Business or Owner Last Name) e " - -t� G. s if '7
• PEOPLE INFORMATION
PROPERTY NAME ,^ -� _ PRIMARY PHONE
OWNER 'hl1 t l O" �_lw (4 "• ( ) -
MAILING ADDS CITY,STATE,ZIP E-MAIL ADDRESS
'
C. AI
CONTRACTOR COMPA NA APPLICANT NAME OFFICE PHONE
�:v��� (0 ,7��. ��s� KO O)1"-- (V.6) 0.2/ -B s3 0
MAILING9 3/ SS h- /YQ CITY,S71-14-1
1m.1(( CELL PHONE - g1 9
3
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
6-
( )
CONTRACT R'S R�RATION NUMBER d EXPIRATION DATEE-MAIL ADDRESS
4 50g. Ak. 5 5 4 k 210
APPLICANT COMLNY NAME APPLICANT NAME OFFICE P)ONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant 0 Agent ❑ Other ( )
PROJECT NAM J PRIMARY PHONE E-MAIL ADDRESS
CONTACT 7... 9 S�� ( )82' - g 3 O ,/
�5�.�x.ro�)Jh.cD.GO AN.
LENDER NAME Per RCW 19.27.095: v
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( )
• DETAILED BUILDING INFORMATION
EXISTING USE 1:r PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER o LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE o PRIVATE(SEPTIC)
1 %
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR ❑UNCOVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL MISTING SF TOTAL PROPOSED SF TOTAL SF
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(commerciai)
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 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.
�/I 6/V U q
SIGNA _IL — DATE �/
Property Owner and/or Authorized Agent
/ft-.° • 0 1
❑NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES o NO
PLATTED LOT? o YES ❑NO DEMO PERMIT REQUIRED? o YES o NO
Bulletin#100—January 1,2008 Page 2 of 4 k\Handouts\Permit Application