09-100491 ''' CITY OF AR
E C E I V P _ /oo 'f 7
Federal Way PERMIT
T COMMUNITY DEVELOPMENT SERVI 0 5 2009
SF MF CO ME E .PL E EN FP
333258.D AVENUEALWASWATH.PO 9APPLICATION
FEDERAL WAY.WA 98063-9718 m 09. / /
253-835-2607•FAX 253-835-2
W.w.etl .:r . -Co t- FEDERAL WAY
The following is required'tiJnation-an incomplete application will not be accepted. Please print legibly(in ink)or type.
• PROPERTY INFORMATION
SITE ADDRESS 1 3 2-C '. 3 2-tw" S'i'zE T �t'Dt SZi-L )-.*-1 SUITE/UNIT#_ t1)(7C
ASSESSOR'S TAX/PARCEL# / S 0 0 S C. - 0 i 0 0 -0 1 LOT SIZE(sf
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)
(Anach.separate page Jor lengthy legal descnplion)
• PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING PLUMBING ❑ MECHANICAL
❑ DEMOLITION 0 ELECTRICAL 0 ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this pen-nit onit))
6-4.-rel-A) •\--)m.kEs•clL v3(-TE1z tAv.AN 1"' )T3ZC TE i c3T SpPtc-ES
) 13 sREi.l_ 6L)1LOIN(,
PROJECT NAME(Name of Business or Owner Last Name) CEL- 'R 6-l(N Sa 3PrCZE
M PEOPLE INFORMATION
PROPERTY NAMEPRIMARY PHONE
OWNER NNesc_V, • %-•W Si I-1 131 ? _-r (933 ) 2q -2900
MAILING ADDRESS CITY,STATE.ZIP E-MAIL ADDRESS
1\Z1 SLJ SArt.,*Ion' `RgTL-RI,11, 0V- cRz-ms —
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
U�r �MC�E ` t-�13Uti>C. ( pe.r4ESTP) (Lits ) e27 -92121
MAILING ADDRESS CITY.STATE,ZIP CELL PHONE
61( (/� i3so2 /J& 1z-i4-"Si. Kf(zaA 98034 (zoc. ) 7l -os3Z
CITY OF FEDERAL WAY BUSIN%LICENSE NUMB EXPIRATION DATE FAX NUMBER
Has-) 82i -�9Ey
CON OR'S REGIS I1TION NUMBER EXPIRATION DATE E-MAIL ADDRESS
1.AK4-2()WA'ooS?.lc U136/ i( ft_JN64,GOh4
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
` pN'S CO 1 .11Zi7M R- ( ) -
MAILING ADDRESS CITY,STATE.ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect ❑Tenant ❑Agent 0 Other ( ) -
PROJECT NAME fit. PRIMARY PHONE p E-MAILAA,D,D�R,ESSS� ,�/ `T
CONTACT �� A (I{ZS ) 827 -12(02._ J Rgiet(IE l A tk/6.COM
LENDER NAME 1 Per RCW 19.27.095:
/ ef- Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( )
MI DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
4111 •
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. sg.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑COVERED OR ❑UNCOVERED?)
GARAGE ❑ CARPORT ❑
EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
NUMBER OF FLOORS
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• FIXTURES
Indicate number of each type of fixture 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
(PLUIKBING
—BATHTUBS(or Tub/Shower Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS r:i Ter,D C7
DRINKING FOUNTAINS SHOWERS WATER CLOSE IS Irounq 11t1 j 1( �}� � tj NC
ELECTRIC WATER HEATERS SINKS WASHING MACHINES e
HOSE BIBBS SUMPSSSE
Iv�l TS.—
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 certtfy 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 he reliance of the c'ty, including its officers and employees, upon the accuracy of the information supplied to
the city as a part of this applic do .
SIGNATURE: DATE 9-/c/O
/Property Owner and/or Authorized Agent
FOR OFFICE USE ONLY
c NEW ❑ADDITION C ALTERATION o REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? c YES c NO BASIC PLAN? c YES o NO
ZONING DESIGNATION CHANGE OF USE? c YES c NO
NEW ADDRESS REQUIRED? o YES c NO UP/SEPA/SU? c YES o NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? ❑YES c NO
Bulletin#100—January 1,2009 Page 2 of 4 k\Handouts\Permit Application
City of Federal Way IPlumbing
Q
Community Development Services r \-3'9� Permt #: 09-100491-00-P L
P.O.Box 9718 -.
Federal Way,WA 98063-9718
Ph (253)835-2607 Fax (253)835-2609 pec
ection Request Line: (253) 835-3050
: :
Project Name: CELEBRATION CENTER-BUILDING 0
Project Address: 32225 PACIFIC HWY S b' i." i- --Part Number: 150050 0100
Project Description: Extending domestic water main lines to future tenant spaces
Owner Applicant Contractor
HARSCH INVESTMENT PROPERT LAKERIDGE PLUMBING&MECHANICAL LAKERIDGE PLUMBING&MECHANICAL
PORTLAND OR INC INC
97208-2708 13508 NE 124TH ST LAKERPM099RK(5/25/10)
KIRKLAND WA 98034 13508 NE 124TH ST
KIRKLAND WA 98034
\14 '''''..- 4'' '''::;"*“"SA ' '.;"ki''. : ox0,/w`40,-Aittlikt-Ar6040.
,ytpC �, ,#,eumbli a , v 0
Other Plumbing Fixtures 1
PERI IT EXPIRES Tuesday, August 4, 2009
P•r it Issued on Thursday, February 5, 2009
I hereby certify th. the ab.ve` for, ation is correct and that the construction on the above described property and
the occupancy - d the u.e ill b: in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: r'L Date: /' 5
--Q— ..1..x.,.ex... i
11
,V t
C.Y
THIS CARD IS TO&MAIN ON-SITE
CITY OF ommunity Develo m nt Inspection Record
Federal p p
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 09-100491-00-PL
Owner:
Address: 32225 PACIFIC HWY S
FEDERAL WAY, WA 98003-6000
This card is part of your required inspection documents. Scheduled inspections maybe 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) I Rough Plumbing(4230) Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date By Date By Date
•
0 Final-Plumbing(4075)
Approved
ByeAs.,v3 Date I-ct`6
•
For inspector reference only
❑ Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date