15-101523 ar
Plumbing,
City of Federal Way
Community&Econ.Dev.Services Permit #: 15-101523-00-PL
33325 8th Ave S
Federal Way,Fax
98003 Inspection Request Line: 25
Ph:(253)835-2607 Fax:(253)835-2609 p q ( 3) 835-3050
Project Name: LUBIC
Project Address: 31440 8TH AVE S Parcel Number: 858800 0180
Project Description: Replacement of 70 feet of water service from meter to the house
Owner Applicant Contractor
CHARLEEN LUBIC SOUTH WEST PLUMBING SOUTH WEST PLUMBING
TOM LUBIC 2401 SW ALASKA ST SOUTHWP071C6(4/1/15)
31440 8TH AVE S SEATTLE WA 98106 2401 SW ALASKA ST
FEDERAL WAY WA SEATTLE WA 98106-1445
98003
Plumbing Fixtures
Other Plumbing Fixtures 1
CONDITIONS:
This parcel is located within a Wellhead Protection Area(Capture Zone 5) and must comply with FWRC
Chapter 19.185 and fill out a Hazardous Materials Inventory Statement,if applicable.
PERMIT EXPIRES Saturday, September 26, 2015
Permit Issued on Monday, March 30, 2015
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 City of Federal Way.
Owner or agent: \ c y Date: CJS - 3- C�
w 0 THIS CARD IS TOMAIN ON-SITE , . __
'CITY OF Construction In ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT#: 15-101523-00-PL Address: 31440 8TH AVE S
Project: CHARLEEN LUBIC FEDERAL WAY, WA 98003-5302
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.
O Plumbing Groundwork(4190) "0 Rough Plumbing(4230) ❑ Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date By Date By Date
O Final-Plumbing(4075)
Approved
By 0v Date -1./...._1 _..1 ) -r_
•
❑ Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
RPC
y)
CITY OFA.
PERMIT‘PPLICA
Federal Way MAR 3 0 2015 TIO N
CITY OF FEDERAL WAY 1706)
PERMIT NUMBER 1 — / J C/ O-) 3 _ QD L TARGET DATE A-1/24
1/24—
SITE ADDRESS SUITE/UNIT#
`? 1 ,f ^ Z
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 7, D 0 0 45- 7 ' o O - D ) c;? 0
TYPE OF PERMIT ❑ BUILDING E PLUMBING ❑ MECHANICAL 0 DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION /,.,
Detailed description of work to 'f- r-,;).-7 m e -e r V 11 4' II e /lV C1 S C'-
be included on this permit only
NAME _ PRIMARY PHONE
PROPERTY OWNER C \,.1 c71 A e yl e Ar 1 0T £Ulf> i C
MAILING ADDRESS E-MAIL
Z I `f v0 r 1- 11 Ave, S
CITY C STATE ZIP
1- e( P r-cl 1 s(,) 1 y VU C2 c C) L 3
NAME PRONE
S \ 11 C� e,1 f i L r,--� a btu,1046(20 0 9s 2-177 7
MAILING ADDRESS E-MAIL
CONTRACTOR r� �i 0 S A\as\ci s
CITYw
F �, �e STATE ZIP
Lbc( R �U ( C) J C/g3-1576
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
,--S L) Ct) �). (
NAME\ P MARY PHONE
34-) llI-; ( ctrci6 ( 2-S)_-32V-2276
APPLICANT MAILING ADDRESS r E-MAIL
S 77.S 2.6 I� A v Q. S0.-.)v / c_ 1979'6 icLei •cDm
CITY STATE ZIPFAX /1/
��t�i �!.(i (- 1,_ /q L'G C.3
NAME _ PRIMARY PHONE
PROJECT CONTACT 1. p1 e QSA1 C C1
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
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 to the city as a part of this application.
SIGNATURE: J 0 1 ( � b arC 1 4 DATE 0 3 -30- /5..
PRINT NAME: Li 1 l O G Or C 1 G
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 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
VALUE OF PLUMBING WORK
PLUMBING PERMIT $ 7/0 0 0
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower combo) LAVS(Hand Sinks) TOILETS I 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 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 0 No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE 0 CARPORT ❑
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet Type Stories
NEW BUILDING
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area rea Occupancy Group(s) Construction # of Additional Information
in Square Feet Type Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—January 1,2013 Page 2 of 3 k:\Handouts\Permit Application