07-105929 f r t 4 . s,
City of Federal Way • nIIII ,
l inQ Permit #: 0?-105929-00- L.
Community Development Services Plu b
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: PACIFIC RETAIL „ : 72
Project Address: 31'721 PACIFIC HWY S Parcel INlumber: 082104 9078
Project Description: Adding 120' of 6" sanitary underslab,(3)cleanouts and 130' of 2" cold water,_(1)6" roof
drain with overflow and adding (1)50' of 3/4" pipe for(2)hose bibs.
Owner Applicant Contractor
DANIEL NIEDER. STATE MECHANICAL CO STATE MECHANICAL CO
ELLAYENN'S LLC 600 INDUSTRY DR SUITE 8 STATEMC141C7 9/1/08
5363 S KENYON SW TUKWILA WA 98188 600 INDUSTRY DR SUITE 8
SEATTLE WA 98118 TUKWILA WA 98188
Plumbing Fixtures
Other Plumbing Fixtures 3 Rain Water Systems 1 Hose Bibbs 2
CONDITIONS:
Subject to field inspection without plans.
_ ___-___-----i
PERMIT EXPIRES Saturday, October 24, 2009
Permit Issued-on Thursday, October 25, 2fO07
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 ity of Federal Way.
Owner or agent: _3/174" :-..--,
A. Date:
1
1
r ' THIS CARD 1S TO EMAIN ON-SITE
CITY OF --- tY � Inspection Develo m nt Ins ection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 07-105929-00-PL
Owner: DANIEL NIEDER
Address: 31721 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
O Date/�'„Z . 67 By9)7 -% "ate Z ��// By Date
- ❑ Final-Plumbing (4075)
Approved
By `elate
•
For inspector reference only_..__
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
0. 1 - ( 41.Federal way 7. EclibEci
C 12 5 2007 PERMIT
COMMUNITY DEVELOPMENTSERVICES
SF MF CO ME EL L . E EN FP
3332E 8.D AVRAL WA SWATH•63PO 971 97} ,I CATI ON
FEDERAL WAY WA 98063 BOX (5 O F F E D t r„„...a...�../`”
fin,., <^'`
253 835 2607FAX 253 835 2609 BUILDING T. ''•'•.a...,.„,,,, -"`
The ollowin• is re•uired in ormation-an incom•lete a••lication will not be acce•ted. Please •rint le,'•I. (in ink)or
N PROPERTY INFORMATION
SITE ADDRESS .. ‘1 I I Pa.ttO
Q%,.. SUITE/UNIT#
QASSESSOR STAR/PARCEL# S LOT SIZE(s,)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
N 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 onitl)
Cab�nc5 \I.0‘ o'C G2 ° Novi I,4�`,c� UVXC O r (4)/ CA,.6" 0 (N ha
c6o, c�-F- ) `` Cv« co-0.4e.-y 4(la% vi I CaB co- �t1 v(
o vtc, )ow , 4,),6 k 50' cc VG( )1 ',CIA- 4.6 3.4 c0.10 s
PROJECT NAME(Name of Business or Owner Last Name) pci.L(f,t- e--4-rid,
• PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER -' 1 1 C Jnr c L LC._ ( )
MAILING ADDRESS CITY,STATE,ZIP
53 c03 S , I, s e,v\yoV\ Sea-tile., WA ct g l Iq
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
5-1-o. ( 1 ,n
%co, ud 1 s tumo,.n (ab(o )5-75 15 a.--)
MAILING ADDRESS ((✓✓`j� 8 CITY,STATE,ZIP (�t gas CELL PHONE
610°05 FEDERALJS#OWAY Bu) ) LICENSE NUMBER 1 v CLW l l`k.,EVIA XP ON/DATED a. s F 3OX 5 41 - 1).9'9
0 0 _ /D0-0 iSf-B L ( 2 ' ?( / 67 ( X )51 5 - 15x9
CONTRACTOR'SREGISTRATION NUMB�(copy of card regv3�with each application) EXPIRATION DATE
`„ G / 1 /0 8
APPLICANT CO ANY NAME APPLICANT NAME OFFICE PHONE
S+ e, a1e("lncnk.o•1 �c\ yiUS -cmuh ( O( )37S -75 , 7
`���M�AAIIILING ADDRESS �y�, -t CITY,STATE,ZIP / ut (QQ (CELL PHONE
[�/ ('',
RELATIONSHIPCT�r �•i=$ 1 U 1w t , IA/4/ ! �{O 0 T )35 q -1��"1 of
FAX NUMBER
0 Architect 0 Tenant 0 Agent II Other(Describe) RQ(o )5 /5 -75R-1
CONTACT PRIMARY PHONE E-MAIL ADDRESS
E
KkDS+e'rr V\ ( )57S - 75a"7
LENDERPer RCW 19.27.095: Lender information is NAME
required if project value exceeds$5,000
MAILING ADDRESS COY,STATE,ZIP PHONE
) -
Ill DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE 11
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ q/ )b 03 U
SPRINKLERED BUILDING? 0 YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)
• 410
i
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ,FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT❑
EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
NUMBER OF FLOORS
**NEW HOMES ONLY** NUMB ' OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project.
ff Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(Commerc al) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or nib/Shower Combo) SHOWERS WATER CLOSL1b(Toilet) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS f RAINWATER SYST •
WASHING MACHINES URINALS (/\ HOSE BIBBS
LAVS(Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and further,that I
am authorized by the owner of the above premises to perform the work for which the permit application is made. 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 of Federal Way,but only where such claim
arises out of the reliance of the city,including its o I Iters and •1. upon the accuracy of the information supplied to the city as a part of
this application.
5.__ 67NAME/TITLE / £(./
DATE 4�
(S•nature) (ntie)
RELATIONSHIP TO PROJECT 0 Owner ❑ Agent ❑ Contractor E Architect ❑ Other
FOR OFFICE USE ONLY
o NEW ❑ADDITION ❑ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? u YES o NO BASIC PLAN? ❑YES ❑NO
ZONING DESIGNATION CHANGE OF USE? ❑YES 0 NO
NEW ADDRESS REQUIRED? ❑YES n NO UP/SEPA/SU? n YES D NO
PLATTED LOT? ❑YES o NO DEMO PERMIT REQUIRED? o YES ❑NO
Bulletin#100—January 1,2006 Page 2 of 4 k\Handouts\Permit Application