08-104009 ,, RECEI D • S- - ± off 009
FederalWay
PERMIT SF MF CO ME E DE EN FP
COMMUNITY DEVELOPMENT SERVICES AUG 2 5 2008
3332F8D'AVENUE WA, A7N•63DOA 97i8 AiX W CATION
FEDERAL WAY,WA 98063.9718 TO
2S3-835-2607•FAX 2S
anlr„r.aluarrvl�� O F F(('En�DC� ...__:.....,��.. /
The following is required i>�fbracatlton-an incomplete application will not be accepted. Please print legibly(in ink)or type.
• PROPERTY INFORMATION�^
SITE ADDRESS 1300 S C C�r i p o.S b k. T ed t ca.I b./A( 9 W63 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# I 0 2. I 0 4 - -1V e,Q `y LOT SIZE(sj
1 1
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) CO/VI p U S Cr r'o Ve, J�O i n C)1"'f ,•e
(Attach
separate;page far lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 36,PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJEC ESCRIPTION(Provide rdetailed desccrIptionoof work included on this permit onit� i
Ke_ Occ. - t -cktin J 1,/11P�i I n E} ( -n W Ai 1 Ce ✓1C 180ZC
PROJECT NAME(Name of Business or Owner Last Name) C aril()LIS a(OVQ. f rl.c fQ I A rylp-N L rr1
• PEOPLE INFORMATION
PROPERTY NAME REA/ r r PRIMARY PHONE
OWNER CREA/ Legacy TedLCb1 Way G-LC ( ) -
MAILING ADD ESS CITY,STATE,ZIP E-MAIL ADDRESS
5 zS a.1-1 ra S+ inkctc SSIGYA GOA glib qa
CONTRACTOR rceMPANY NAME APPLICANT NAME OFFICE PHONE
RFsse,7 t'i4) WI A14110�.1 aUlafr' (953 )tly( -792d°
ITY STATE,ZIP CELL PHONE
2goi '.," s+ tut. ' 1t] PJ&)CA tA)cA O OOZ- ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
�. ! \.,Tt& jt,.) cot S 'rtJl. ( ) -
CO R'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
0r •d►:" AP c -ly r✓10 ?/(Fs/ iO
APPLICANT MPANY NAME ...„,‘ APPLICANT NAME OFFICE PHONE
MAILINGADDRESS I LYN16),11 (2S 7) Ciq 1 - 2920
CITY,STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
a Architect ❑Tenant a Agent a Other ( ) -
PROJECTE PRIMARY PHONE E-MAIL ADDRESS
CONTACT HARD/0 ( p)a•S5 -'3&IZ
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAlLIN ADD CITY,STATE,ZIP PHONE
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
cv
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ /coo—
SPRINKLERED BUILDING? a YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES a NO
WATER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE a TACOMA ❑PRIVATE(WELL)
SEWER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE 0 PRIVATE(SEPTIC
PROJECT FLOOR AREAS
•
AREA DESCRIPTION EXISTING PROPOSED TOTAL
• SQ. FT. SQ.FT. SQ. FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS susnea PROPOSED TOTAL ram=ATOM sr TOTALFeaPOSnaar 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(co.....)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS Lor pub/sboaer combo) LAVS Ie.enmom s URINALS I MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERSf804
DRINKING FOUNTAINS SHOWERS WATER CLOSETS ITo q L � /+�7`(� t�{_
ELECTRIC WATER HEATERS I SINKS WASHING MACHINES CI"'a}t�su�p)�C+ �r-�
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 ap tion.
SIGNATURE: DATE C�c
Property Owner and/or Authorized Agent
a NEW o ADDITION a ALTERATION a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? a YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a YES a NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? a YES a NO
Bulletin#100—January 1,2008 Page 2 of 4 k\Handouts\Pemiit Application
City of Federal Way Plumbing Permit #: 08-104009-00-PL
Community Development Services
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: CAMPUS GROVE - OFFICE { ,
ti Project Address: 1300 SW CAMPUS DR Parcel Number: 182104 9064
.Project Description: Add/Relocate(1)sink and (1)water supply for ice maker.
Owner Applicant
Contractor
CAMPUS GROVE LLC&BORN L DRAIN AWAY PLUMBING INC DRAIN AWAY PLUMBING INC
BOW WA 3401 "C"ST NE UN 14 DRAINAP944MO(7/20/08)
98232-0178 AUBURN WA '.10 3401 "C"ST NE UNIT 14
AUBURN WA 98002
•
Plum I ; Fixtur.
Other Plumbing Fixtures. Si 1
PER EXPIRE' Saturday, Fe ru , 2009
Pkn:i,t)fided a Monday, . ug s 25 2 08
I hereby certify that the above information is. orre a d:' h o t on o t :bove described property and
the occupancy and the us will be in acco 'a _- ith e , rule' and ulati;=_. - the State of Washington
-I•it a ity ederal
9 ,�--,._ ---. I.
rs,/,.
Owner or agent OP
�'
i
e
Y"\C1:1111:111161::".t1/4:1):
DATE INSPECTOR AREA AND TYPE OF INSPECTION
ilk THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 08-104009-00-PL
Owner:
Address: 1300 SW CAMPUS DR
FEDERAL WAY, WA 98023-5363
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.
.❑ Plumbing Groundwork(4190) ❑ Rough Plumbing(4230) ❑ Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date f7 <<�iU.i, By %�<:.� Date 0� i% By Date
— 0 Final-Plumbing(4075)
Approved
By Date
i
For inspector reference only
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date