08-105973 • P1uming
City of Federal'fay' Q
Community Development Services Permit #: 08-105973-00-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: ALBERTSONS#496
Project Address: 31009 PACIFIC HWY S Parcel Number: 082104 9062
Project Description: Meat department upgrade including moving or adding.A total of(5) floor sinks,relocate
(2)prep sinks and installing(2) new RPBP
Owner Applicant Contractor
NEW ALBERTSONS INC WILLIAMS MECHANICAL INC WILLIAMS MECHANICAL INC
PO BOX 20 3903 SMITH AVE WILLIMI088PA(10/1/09)
BOISE ID 83726 EVERETT WA 98201 3903 SMITH AVE
EVERETT WA 98201
lu � // ;����z s t
' .i4. ...3.':•. .\\' r. 4;��A 9a.RS: us..4.'�. ,_. .e P-.�,m,. a:. 6 �•__ k , f �' h'OO yi... .s....,
Drains 5 Other Plumbing Fixtures 2 Sinks 2
CONDITIONS:
Subject to field inspection without plans.
PERMIT EXPIRES Monday, June 15, 2009
Permit Issued on Wednesday,December 17, 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
=Wand the City of Federal Way.
Owner or agent:/ Date: D-- 17 0 t�
f
-o" ilk.
0 THIS CARD IS TO MAIN ON-SITE =
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 08-105973-00-PL
Owner: NEW ALBERTSONS INC
Address: 31009 PACIFIC HWY S •
FEDERAL WAY, WA 98003-4903
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) 0 Gas Piping(4125)
Approved to cover Approved Approved to release test
By Q., 4""3 Date t` -),,,x-po, By Date By Date
0 Final-Plumbing(4075)
Approved
By Q ., Date lik, —2_._09
For inspector reference only
0 Rough Electrical 0 • FINAL-Electrical
Approved Approved
By Date By Date
ill Q .-----7„7......
% CFeYderal CES PERMIT — —
SF MF CO ME EL PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES
3332E R WA SWATH•PO63 BOX 9 I APPLICATION
I'D y---r- ----
FEDERAL
26 7.FAX
53-83-97�d�- ,. 7 200BAPPLICATION T
253-835-260 E FAX 253-835-2�-
un11w.cOrroffederaiway.corn
The foUkiis 67).bgtEVat&LnViiigicomplete application will not be accepted. Please print legibly(in ink)or type.
�j• PROPERTY INFORMATION
SITE ADDRESS 3//CC ' / 7/ (C �'
SUrrE/UNIT#_
ASSESSOR'S TAX/PARCEL# A Z / O d- 7 l./�� LOT SIZE(sj)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
rt.,*sirmute pngefur Ier!l by kw&deurtptlmJ
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING UMBINHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPUON 1°
(Prov" detailed description of work included on this pert onlu)
Mr-A+�� 11 DCPA C!li • VFGratdt L t/41 c�XX i Ail° �V, CIC /kJ J 1'iuq
A 4z A Q5j( F ` r' '.� N F s z Few 54.665 J
Aal , s W.', 'A Nem 2P8P
PROJECT NAME(Name of Business or Owner Last Name) Al Fv 4 SO N 5 t1- ti 9c( la + W/ll f'A s
• PEOPLE INFORMATION
PROPERTY Ab a,s .z r44
(z PRIMARY)PHONE -bz$
(11 Fso C ck al V ;3.O S. ava1J3I J
MAILING ADD
E IJa DRESS
CONTRACTOR NAME APPLI OFFICE PHONE
rIIAM
W $ M•BG/I, I A7� is (4Zc )$di. - o�L.
MiRING ADDRESS
CAY,STATE,ZIP CELL PHONE
(( 3903 $C'4L E-v�r t Wit 1 $ZA I ('Z5 ) 'T Sit 1
-Ast.
FAX NUMBER
I Oc4/ CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
\n,
2.0-en- 106on- cad-EL itt .31 I Zgt (414) 33q - 9zy4
CONTRACTOR'S REGISTRATION EMBER TION DATE E-MAIL ADDRESS
W i II i int 0 ssPP‘ 1 616177409 Po.ik.5 bac c,'200. '+
APPLaCANrAPPIICAMT NAME OFFICE COW `I i14µf Metit,4 .*l Fn�wi S"A'1 Wit ('t/L$ )PHONE�5 C5S28
MAILING ADD CITY,STATE,ZIP CELL PHONE
"3903 5 n1.l=!(. Ave
�u�,frCbl Imo ci$2O/ (4Z S) 3338 92Yy
RELATIONSHIP TO PROJECT ��yy FAX NUMBER
El Architect ❑Tenant ❑Agent o Other Pit/03,4 C i (4L4 )?Sy - 2754
N PRIMARY PHONE E-MAIL ADD
CONTACT 1 5;61\100 k (4116 )710:‘ - iS z� F? $
LENDER
NAME •�, Per RCW 19.27.095:
N Lender information is required(f project value exceeds$5,000
MAILING ADDRESS CITY,STATE.ZIP PHONE( h) A -
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑LAKEHAVEN ❑ HIGHLUNE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
I
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. Sg.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑COVERED OR D UNCOVERED?)
GARAGE 0 CARPORT ❑
NUMBER OF FLOORS =STING PROPOSED TOTAL TOTAL=STAG SF TOTAL PROPOSED wsr TOTAL
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
II FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existingfurfures to remain.
MECHANICAL
Value of Mechanical Work I 77-7 (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WPIH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(Commerdal)
„....-COMP' s' 'IRNACES RANGES
DUCTSQ/jt. I GAS LOG SLlb REFRIG.SYSTEMS
PLUMBING 434 , ,+ alone°` 2 14t('Srs4k
BATHTUBS(or Tub/Shower Combo) LAVS(Bathroom sinks) URINALS Z MISC(Describe)
DISHWASHERS RAINWATER SYST _____2,,_ Qp@ P
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(roue[)
ELECTRIC WATER HEATERS 5 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 applica .
SIGNATURE: t CJh 9 DATE )1( t ( I S
Property Owner and/or Authorized Agent
FOR OFFICE USE ONLY
o 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 o NO DEMO PERMIT REQUIRED? o YES o NO
Bulletin#100—January 1,2008 Page 2 of 4 k\Handouts\Pennit Application