09-100199 •
City of Federal Way • • Plumbing
Community Development Services Permit #: 09-100199-00-PL
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: THREE DOG DELI
Project Address: 35425 21ST AVE SW Suite A Parcel Number: 252103 9002
Project Description: Plumbing for bathroom and kitchen. ****6130/09****Adding grease trap and hot water
tank.
Owner Applicant Contractor
DAVID HOEK GRAHAM PLUMBING/MECHANICAL INC GRAHAM PLUMBING/MECHANICAL INC
DAVID'S FEDERAL WAY LLC 19410 HWY 99 SUITE A-111 GRAHAPI948LO(6/20/10)
PO BOX 8164 LYNNWOOD WA 98036 19410 HWY 99 SUITE A-111
TACOMA WA 98418 LYNNWOOD WA 98036
Plumbing Fixtures
Lavatories 2 Other Plumbing Fixtures 1 Sinks 3
Water Closets 1 Water Heaters 1
_ .,. PERMIT EXPIRES Tuesday, July 14, 2009
Permit Issued on Thursday, January 15, 2009
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: C'
Date:
F/N 7/'/°'1
THIS CARD IS TOEMAIN ON-SITE
CITY OF community DevelopnWnt Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 09-100199-00-PL
Owner: DAVID HOEK
Address: 35425 21ST AVE SW SUITE A
FEDERAL WAY, WA 98023
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) EI Rough Plumbing(4230) 0 Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date e.By (�: � . Date/-2 7-r By Date
— 0 Final-Plumbing(4075)
Approved
By C. �.J Date? . l - p 4,
•
' I
For inspector reference only
. 0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
+ CITY OF >u•.`+�ir _ e • ! D 6 /
Federal Way
J PERMIT SF MF CO ME E (1....30)E EN FP
COMMUNITY DEVELOPMENT SERVICES
33325 Br"AVENUE SOUTH•PO BOX 9718 JAN 1 I APPLICATION
FEDERAL WAY,WA 98063-9718 TD / /
253-835-2607•FAX 253-835-2609 L 1)
taww.citgofkrieruiwart.corn v
The following f`required informatlplyk- a!,i complete application will not be accepted. Please print legibly(in ink)or type.
1 M PROPERTY INFORMATION
SITE ADDRESS_ ,36 Li;b (7'-1 - Ave_ 6 A) �i-e___ "\ SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# _ _- LOT SIZE(s)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of wor included on this permit onlu)
i 1
v K\,L, 1tJ �.�e-rIGS , ��j3 -I . �ItJ.n,l-�i I..'r ( (� / �a )
4),- iI—f2L 'GA,- - Slir 1 ( <-J Com+P. �if�Y- l " (� , it,,le ? I Mr,E7 Sr
1- 1-1 ( "S-C> (-,,,,-f „ r(1.,c
PROJECT NAME(Name of Business or Owner Last Name) _Th - /" • - CO..1
• PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER ( ) -
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
CONTRACTOR COMPANY NAME I APPL9NT NAME . OFFICE PHONE
(3C'lig , P�u4410'17,4\P;I4, c f, . 1-vae-, 6r,il_- ,,,y, (��.=C,) 94/ -2-`1( I
MAILING
`AlD�-D",ADDRESS JV,`'_-, /+%�y� J*�' i i' CI"Y,STATE,ZIP r CELL PHONE
CITY FEDERAL WAY BU ESS LICENSE NUMBER y n v EXPIRATION RATIODATE / ,�
T` AX NUMBER
S -. -
CONTRAC OR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
C77V^AA P i 9 LIB LCD
APPLICANT COMPANY,NAME APPLICANT NAME OFFICE PHONE
6(?3k -, g(✓,M�'�4 , 2c t• �.� , C,,�����--- (z ) i -7 - -2-Li t /
MAILING ADDRESS f �j r / )CITY,STATE,ZIP
Q ry(� ( CELL PHONE
t( 1V F4.. ? 1 AM I ( (vtI7r..J::ux-�S r W P.i /:.yOl C �NUMBER - -..
RELATIONSHIP TO PROD T J /�,
0 Architect 0 Tenant o Agent -Other V(, ,,-t-✓'r-� (,_---) -
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT ( )
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? ❑ YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
•
• 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 ❑
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SP
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type offvcture 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 / t1/44„.42
BATHTUBS(or Tub/Shower Combo) "H LAVS(Bathroom Sinks) URINALS ( MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS I WATER CLOSETS(rode[) 1 LI>
ELECTRIC WATER HEATERS . SINKS WASHING MACHINES
HOSE BIBBS SUMPS
ro.. 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.
SIGNATURE: ��� DATE
�� lllIP"-and/or Authorized Agent
o NEW o ADDITION ❑ALTERATION a REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? ❑YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES ❑NO
• PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES o NO
Bulletin#100—January 1,2009 Page 2 of 4 k\Handouts\Permit Application