13-104082 Plbmbing
City of Federal Way
Community&Econ.Dev.Services Permit #: 13-104082-00-PL
33325 8th Ave S
Federal Way,WA 98003
Request Line:
Ph:(253)835-2607 Fax (253)835-2609 InspectionQ (253)835-3050
Project Name: STARBUCKS MODULAR
Project Address: 28722 PACIFIC HWY S Parcel Number: 332204 9119
Project Description: Installation of backflow prevention device.
Owner Applicant Contractor
POLL FEDERAL WAY LLC S J S MECHANICAL SERVICES S J S MECHANICAL SERVICES
8915 SE 44TH ST 3317 3RD AVE S SUITE 100 SJSMEM5951KL(5/17/15)
MERCER ISLAND WA SEATTLE WA 98134 3317 3RD AVE S SUITE 100
98040 SEATTLE WA 98134
Plumbing Fixtures
Other Plumbing Fixtures. 1
PERMIT EXPIRES Saturday, March 15, 2014
Permit Issued on Monday, September 16, 2013
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the u will be in accord-nce with the laws, rules and regulations of the State of Washington
I'. the City of Federal Way.
Owner or age !> / Date: 9:/Z//4
N
CITY OF Construction In ection Record
Federal Way
INSPECTION REQUE TS: (253)835-3050
PERMIT#: 13-104082-00-PL Address: 28722 PACIFIC HWY S
Project: POLL FEDERAL WAY LLC FEDERAL WAY, WA 98003-3224
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) 0 Rough Plumbing(4230) Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date By Date By Date
Ell Final-Plumbing(4075)
Approved
By c `l',(%. Date 1 ‘_ ...`1—1"'�
0 Rough Electrical El Final ElectricalEl Right of Way
Approved Approved Approved
By Date By Date By Date
�moF REC•VE® PERMI1$ PPLICA'TION
Federal Way SEP 1 2013 LI '3 S4
,41
sexvi_
CITY FFDE LWY -ii
PERMIT NUMBER / 3 _ y
// TARGET DATE
SITE ADDRESS SUITE/UNIT#
PROJECT VALUATION ZONIN ASSESSOR'S TAX/PARCEL#
TYPE OF PERMIT ❑ BUILDING'PLUMBING ❑ MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT S2/4/41.4.6e6/ ' �/ ,� /' /3 0 5--g
PROJECT DESCRIPTION " hiV/ae G1fG ehpoUh 471 N ri ill iva`cie I i '
/� /- ��y /J 4A .� ���i
Detailed description of work to ! YJ l(/'/'M/A .5' T,/� lti%�'' e I(�I�NL®1.��CJ .
be included on this permit only ��„ / /, �i p /4 d�/d �jQ1/ J
�( (/Ii V / //, Y'IC Y
_ .
NAME PRIMARY PHONE , _
PROPERTY OWNER ��// F.
frilia<
7 MAILING ADDRESSC^ gl 7 -- //,/y ,co� / , E-MAIL
CITY a/eta !n-G� IN AT, ZIP/ '8 0
/ ' .._ 983
STs ii j'ki4 e ' PHG 6 76 -6.3gr
.�{MAILLINNG ADDR S / E- L /
CONTRACTOR 33/T 2f � at"'! #iV� /� L h4 ,fi SfYec -co,/
CITY C. %TA ZIP /]l//� FAX
,6� IO! �
WA STATE CONTRACTOR'S LICENSE# /V `EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
SJR iWEA lSgSlkL o5 / /7 //S
NAME PRIMARY PHONE
/ /17Gf{ii/ Sa,1-i.e
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME/duo_/, < PRIMARY PHONE
PROJECT CONTACT ACL Z)jrmkG _1 s,,,,,7 e
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence S'Q t_
concerning this application) CITY STATE ZIP FAX
NAME
PROJECT FINANCING 0 OWNER-FINANCED
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095)
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 the city as a part of this application.
SIGNATURE:f Of / 1127-----1----\--- DATE //‘//3
PRINT NAME: 1a q 4-41 7::),1/24,,, /
Bulletin#100-January 1,2013 Page 1 of 3 k:\Handouts\Permit Application
• • VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Descrtoibe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(Commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT $
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.
BATHTUBS(orub/shower combo) LAVS(Hand sinks) TOILETS WATER PIPING
'I
DISHWASHERS RAINWATER SYSTEMS URINALS 1 O ER Dbe
DRAINS SHOWERS VACUUM BREAKERS I/
esc f(OCU
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES l TOTAL FIXTURES
GENERAL INFORMATION
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
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT . -. `,
a
FIRST FLOOR(or Mobile Home)
SECOND.FLOOR `: '0 N. , r{ '.,
x
COVERED ENTRY
DECK mow,-4 , t .:
GARAGE D CARPORT ❑
OTHER(describe) , ;.4,,,,'-'14,-,%:' 5 it
EXISTING PROPOSED TOTAL
Area Totals
"*NEW HOMES Mar*
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NEW/ADDITION
AREA DESCRIPTION
AreaConstructionGroup(s) Construction #of Additional Information
in Square FeetType Stories
NEW BUILDING , v x t , � ,° #
ADDITION
COMMERCIAL-REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
AreaConstructionGroup(s) Construction #of Additional Information
in Square Feet Type Stories
;
TOTAL BUILDING
TENANT AREA ONLY
ROJECTTAREA ONLY x .,,'..'4,',114.t"
Bulletin#100—January 1,2013 Page 2 of 3 k:\Handouts\Permit Application