10-103328 (,r,. t ` HERMIT sp.F CO ME PL D EN FP
Federal Way E k
EIS/
COMMUNITY DIi6BLlIMENTSERVICES APPLICATION
25:3-835-2607•FAA 253.835-2609 "��
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SITE ADD7 OF FEDE L WAY SUITE/UNIT#
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PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
TYPE OF PERMIT ❑ BUILDING f<PLUMBING ElMECHANICAL
❑ DEMOLITION 0 ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
..
PROJECT DESCRIPTION IttS-ittli k7.2 al Zen C- J kektV l` ' ' ,V •
Detailed description of work to
be included on this permit only
-.
NAME _- .. .. PRIMARY PHONE
PROPERTY OWNER "--17-.N. i c f
MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAME I. ' CLI L \ ��`i Y Vleh. 7S-el tim )P(\�!0 �� )Fk/ . r
MAILING ADDRESS �('� E-A[kIL •
CONTRACTOR - /' y/J- ('/1 yL '� S
CM STATEZIP FAX
- t6Ct/ aid- � Ct , 9 c-N3
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME '1 .e V y 4^ d Ycttjn PHONE ? W.. 3cg
APPLICANT MAILING ADDRESS (1Vl ,�/ �� i E-MAIL /\
( ) 12&C Wif c C /L- / - 7` )- (
CITY STATE ZIP-1
.'_O' -& / Cv (tiy C L & _ r c'
PROJECT CONTACT NAME PHONE
(The individual to receive and
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application)
CITY STATE ZIP FAX
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME
0 OWNER-FINANCED
Required value of$5,000 or more
(RCW 19.27.095) MAILING ADDRESS,CITY,STATE,ZIP PHONE
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,tlye ty as a part of this application.
SIGNATURE: �_� --A / DATE . 0
PRINT NAME: /4 /) —��DA // - L e/
Bulletin#100-April 14,2010 Page 1 of 3 k:\Handouts\Permit Application
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VALUE OF MECHANICAL WORE $ (a copy of bid or estimate must be provided)
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe) •
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
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Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing futures to remain.
BATHTUBS(or Tub/shower combo) LAVS(RandSinla) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS / SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS
WASHING MACHINES
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CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF'EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes❑ No ❑ Yes ❑ No
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AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
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FIRST FLOOR(or Mobile Home)
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COVERED ENTRY
GARAGE 0 CARPORT 0
........... ..... .......... ...............................::::EXISTDco:. .:::.PROPOSED:.::...........::..TOTAL:.:.
Area Totals
ESTIMATED SELLING PRICE$ #OF BEDROOMS
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Area Construction #of
AREA DESCRIPTION Occupancy Group(s) Additional Information
...............................
in Square Feet Type Stories
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ADDITION
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AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square Feet Type Stories
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TENANT AREA ONLY
Bulletin#100-April 14,2010 Page 2 of 3 Ic\Handouts\Permit Application
• • Plumbing
City of Federal Way
Community Development Services Permit #: 10-103328-00-PL
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p q
Project Name: SOL DE MEXICO
Project Address: 29418 PACIFIC HWY S Suite A Parcel Number: 304020 0085
Project Description: Installing a new hair sink.
•
Owner Applicant Contractor
SAWYER TOM ENTERPRISES INC BERNARDA BRAVO BERNARDA BRAVO
2016 38TH ST NW 9050 37TH AEV SW 9050 37TH AEV SW
GIG HARBOR WA SEATTLE WA 98126 SEATTLE WA 98126
98335
Tu I
Sinks 1
PERMIT EXPIRES Sunday, January 30, 2011
Permit Issued on Tuesday, August 3, 2010
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use wilfrbe in accordance with the laws, rules and regulations of the St. e of Washington
and the of Federal Way.
Owner or agent: L't; . r.^ I ( Date: 0 -
F1NM.WtFt Nitaax 41/4/Ic
• l'A_k. THIS CARD IS TO MAIN ON-SITE
CITY OF
Federal Way0 Construction In miction Record
INSPECTION REQUE TS: (253)835-3050
PERMIT #: 10-103328-00-PL Address: 29418 PACIFIC HWY S Suite A
Owner: SAWYER TOM ENTERPRISES INC FEDERAL WAY, WA 98003-3829
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) ❑ Rough Plumbing(4230) El Final-Plumbing(4075)
Approved to cover Approved Approved
By Date By Date By R,K: Date /// ://:1
0 Rough ElectricalEl Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date