06-105718 0 .w ' ♦ s 1
City Federal Way ! PlumbinQ Perm#: 06-1057"18'-00-iPL
CommunityDevelo ment Services b
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: DR BRIAN WILLIAMS FILE
Project Address: 32225 PACIFIC HWY S Suite 102 Parcel Number: 150050 0100
Project Description: Installation of plumbing fixture work for new dental office.
Owner Applicant Contractor ,
HARSCH INVESTMENT PROPERTIES DEAN SAFFLE SAFFLE COMPANY
PO BOX 2708 SAFFLE COMPANY SAFFLC*001P1 10/21/06
PORTLAND OR 97208-2708 7350 CIRQUE DR 7350 CIRQUE DR
TACOMA WA 98457 TACOMA WA 98457
Plumbing Fixtures
Laundry Washer Outlets 1 Lavatories 3 Other Plumbing Fixtures 2
Sinks 13 Water Closets 3 Water Heaters 1
PERMIT EXPIRES Thursday, November 6, 2008
Permit Issued on Tuesday, November 7, 2006
I hereby� that the above' ormation�ls correct and than,a Construction on the abovdefl3edproperty an
lit
the.occupancyend the use will In cc rdar�wl ;•the la rules and esti s of the State 2f Washing `
and the Ci of F e Way. -
Owner or agez)..„,
; �• ;�, ! n� '_` late: T
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- THIS CARD IS TO MAIN 01‘i-SITE
CITY OF ! ommunity DevelopmTnt Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 06-105718-00-PL
Owner: HARSCH INVESTMENT PROPERTIES
Address: 32225 PACIFIC HWY S Suite 102
FEDERAL WAY, WA 98003-6000
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.
❑ Plumbing Groundwork(4190) 0 Rough Plumbing(4230) ❑ Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date By 0 1
44,
Date fi _ ,¢y By Date
"O
❑ Final-Plumbing(4075)
Approved
By Date — 7
6
411) `- -.( 0
CIOF ' 4✓-. 6-� - of Li-
Federal
lNay�ECEIVD � � —
`/ n PERMIT SF MF COME EL /1= ., DE EN FP
T3334 8 NIAVEDNUE SOUPTHE NPO BOX r O 7 2"06 /�p-�
FEDERAL WAY,FAX
98063-9718 A PLICATION TD
FEDERAL
WAY,
FAX 253-835-2609 C p p 'iYhYi7Al
www.cihloffedera(watt.etTy OF FEDERAL
BUILDING DEPT.
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
• . . ■ PROPERTY I•
✓NFFORMATION '
SITE ADDRESS 3Z 5 `�) K,f/- ia SUITE/UNIT N lD
ASSESSOR'S TAX/PARCEL# /- `) CD (2_ S c".__. - O / 0 0 LOT SIZE(sf)
LEGAL DESCRIPTION (e.g.Acme Estates, Lot 1) `Qe-407
(Attach separate page for legal description)
•
■ PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING XPLUMBING ❑ MECHANICAL
O DEMOLITION ❑ ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only)
Qa -� / . .
PROJECT NAME(Name of Business or Owner Last Name) /L Or/e.-/-7 Me....." ,3'
•
■ PEOPLE INFORMATION
PROPERTY NAME�L / -`�,l PRIMARY,PHONE
OWNER I: ',6s $CA 4.7�t254 � ( 1 I $tib
MAILING ADDRESS CITY,ST TE,•ZIP - E-MAIL ADDRESS •
/30/e) /ff� 2 A-v , obsli'9$
CONTRACTOR COMPANY NAME APPLICANT NAME • OFFICE PHONE
'S)61C " co.j / - �l / Ss� -� (23) �'CS' 665'51
MAILING ADDRESS , CITY,STATE,ZIP CELL PHONE
•
• iso c/ c _Z: Jct ee.,?/ /X 963Y6,7 (23 7) 5�- ave,
CITY OF FEDERAL BUSINESS LICENSE NUMBER EXPIIRATT N DATE - FAX NUMBER '
2Z) c /o3 3�.� --r�,5G- Jyj irg 1233) /32$
COPY o(ea:d required CONTRACTOR'S REGISTRATION NUMBER - EXPIRATION DATE E-MAILMAILADDRESS.
with eae applleatloa . 5�7.LC A7.5/�. . /0/2 1/C98 C'-e l3-'7C�.' -`Y/�i` GQ_
CM
�
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
4y Q6 � • ( ) -
MAILING ADDRESS - CITY,STATE,ZIP CELL PHONE
• . RELATIONSHIP TO PROJECT. FAX NUMBER
❑ Architect 0 Tenant 0 Agent 0 Other 607 ( ) -
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
. CONTACT C-5-64;54--- (23-3)O G S-- 3"•
LENDER NAME Per RCW 19.27.095: ' ' •
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( ) -
• DETAILED BUILDING INFORMATION •
EXISTING USE PROPOSED USE •
EXISTING ASSESSED/APPRAISED VALUE $ 'VALUE OF PROPOSED WORK $ .
SPRINKLERED BUILDING? 0 YES 0 NO FIRE.SUPPRESSION SYSTEM PROPOSED/REQUIRED? &YES 0 NO '
WATER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE a TACOMA a PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN . 0 HIGHLINE 0 PRIVATE(SEPTIC)
■ PROJECT FLOOR AREAS
AREA DES y PTION EXISTIN PROPOSED TOTAL
SQ. FT. SQ.FT. SQ. FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑ COVERED OR ❑UNCOVERED?)
GARAGE ❑ CARPORT 0
EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL Sr
NUMBER OF FLOORS
**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(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 BREAKERSA #' J
DRINKING FOUNTAINS SHOWERS 3 WATER CLOSETS(Toilet)/
ELECTRIC WATER HEATERS /3. SINKS / WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
I certify under 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. iled against the City of Federal Way,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.
/�
NAME/TITLEr� �� / `t DATE
(Signature) (Title)
RELATIONSHIP TO PROJECT 0 Owner ❑ Agent ,>if Contractor 0 Architect 0 Othet
❑NEW a ADDITION a ALTERATION o REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? • a YES a NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES ❑NO UP/SEPA/SU? o YES ❑NO
PLATTED LOT? a YES o NO DEMO PERMIT REQUIRED? o YES o NO
Bulletin#100—January 1,2006 Page 2 of 4 k\Handouts\Permit Application