07-105569 V ' a
City of Federal Way •
Community Development Services Plumbing Permit. #: 07-105569-00-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: RITE AID
Project Address: 32015 PACIFIC HWY S Parcel Number: 150050 0110
Project Description: Adding a new sink for a remodel.
,
Owner Applicant Contractor
HARSCH INVESTMENT PROPERTIES BELLEVUE PLUMBING&HEATING INC BELLEVUE PLUMBING&HEATING INC
851 SW 6TH AVE SUITE 550 14111 NE 24TH ST BELLEPH288NU 8/4/2008
PORTLAND OR 97204 BELLEVUE WA 98007 14111 NE 24TH ST
BELLEVUE WA 98007
Plumbing Fixtures
Sinks 1
MEXPIRES , 9, 2009
PermitPERIssued
IT on WednesdayFriday ,October October 10, 2007
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
nd , ity of Federal Way.
Owner or agent: Date:
THIS CARD IS TO MAIN ON-SITE
CITY OF ` ommunity Develo m t Inspection Record
p p
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 07-105569-00-PL
Owner: HARSCH INVESTMENT PROPERTIES
Address: 32015 PACIFIC HWY S •
FEDERAL WAY, WA 98003
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) ❑ Rough Plumbing(4230) ❑ Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date By 'Date li® ,�� p By Date
❑ Final-Plumbing(4075)
Approved 11._Q sr b1
By C s Date i
For inspector reference only
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By . Date
•
v� •
AR GEI cx-? - _1 Uclrr of
Federal Way O C T 1 0 2007 PERMIT SF MF CO ME EL 8 DE EN FP
COMMUNITY DEVELOPMENSERVICES
333253D8 AVENUE SOUTH.Ti,O BOX 9718 JAPPLI CATI O N
FEDERAL WAY.WA 98066 OFEDERA TD
253 835 2607•FAX 253 83
u.,ItlorrFderalt at1. „t BUILDING DEPT. _____-/--
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
i _
• PROPERTY INFORMATION
SITE ADDRESS ..;:20/6-- f/�lt,L�t tJ !7�/t SD u, # SUITE/UNIT#_
ASSESSOR'S TAX/PARCEL# { 5- 0 C .0 - ® / I 0 LOT SIZE(s,)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) tl0,
(Attach separate page Jor lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT ❑BUILDING ;PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
0.,:f7:.:±....-:' Re?mad‘4
,1,i 'A.4) /(-4 s-,A.)" ;., e,..i.�;.ni Ky&- A;42 bc.s;.-,'er-C
PROJECT NAME(Name of Business or Owner Last Name) 1c irc 4i,e a S723€.1. 44/- /7
• PEOPLE INFORMATION
PROPERTY NAME �� j / PRIMARY PHONE
OWNER I `0Y 5( '✓t v e-b /---4 �/(92 ) .7, 0 - 33r-7
MAI G ADDRESS CITY,STATE,ZIP E-MAILADDRESS
)CONTS ( 5u. 6.t;i rix-c.-.t .5-07) /9,,, ,...i 0) ---
CONTRACTOR
RACTOR COMPANY E / APPLICANT NAME OFFICE PHONE
8 � J�.� ' 4 //4. (A/2fl6W -V2Z2
MAILING ADDRESS/{'® y"r� CITY.STATEE..4IPP^'// /�// CELL PHONE
L''<FEDER if aY 2BUSINESS- LICENSE NUMBER 8 / EXPIRATION DATE�c1iO2 FAX NUMBER
A (�t�CJ tD-t0- 0-7 (y�z�) 6' 7-ff q
CONTRACTOR' S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
r3��, x��a WO
APPLICANT r nm,9ANY NA E / S APPLICANT NAME OFFICE PHONE
GL ( ) -
MAILII gl99.D ES — - CITY,STATE,ZIP CELL PHONE
( ) -
_:PROJECT FAX NUMBER
❑ Architect 0 Tenant 0 Agent 0 Other ( ) -
PROJECTNAME A PRIMARY PHONE E-MAIL ADDRESS
`�W G
CONTACT \ C/fUf ( ) -
LENDER NAME Per RCW 19.27.095:
, `- Lender information is requ' f p ct value exceeds$5,000
MAILING ADDRESS , TY,STATE,ZIP ONE
�� ,���� ( )
• DETAILED BUILDING INFORMATION
EXISTING USE N PROPO '' USE
\- /
EXISTING ASSESSED/APPRAISED VALUE$ V ' OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSI•'• STEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINEI ❑ TACOMA------„0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHL 0 PRIVATE(SEP`tIC)-
• •
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(El COVERED OR ❑UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
**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(commeredo
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or lob/Shower combo( LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
ir DRINKING FOUNTAINS SHOWERS WATER CLOSETS(Tone)
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.
SIGNATURE: _‘,141‘,/____.6 :1 DATE `D/a- v',
Property Owner and/or Authorized Agent
S� e., K to 'USE l%„,
o NEW c ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? n YES n NO BASIC PLAN? n YES n NO
ZONING DESIGNATION CHANGE OF USE? ❑YES n NO
NEW ADDRESS REQUIRED? ❑YES n NO UP/SEPA/SU? c YES o NO
PLATTED LOT? D YES o NO DEMO PERMIT REQUIRED? o YES c NO
Bulletin#100—August 16,2007 Page 2 of 4 k\Handouts\Permit Application