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08-105705 r � City of Federal Way '4 . � v Pli�"mbing Community Development Services Permit #: 08-105705-00-PL 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: CHRISTIAN FAMILY CARE Project Address: 33507 9TH AVE S Bldg A Parcel Number: 926500 0020 Project Description: Plumbing for exam room hand sinks, breakroom and mop sinks, hose bibbs and electric hot water tank. Owner Applicant Contractor CHRISTIAN FAMILY CARE MCCONAGHY CONSTRUCTION MCCONAGHY CONSTRUCTION 8725 S TACOMA WAY 2601 70TH AVE W SUITE S MCCONI*221B3(1/23/10) LAKEWOOD WA 98499 UNIVERSITY PLACE WA 98466 2601 70TH AVE W SUITE S UNIVERSITY PLACE WA 98466 Plumbing Fixtures Lavatories 12 Sinks 2 Water Heaters 1 Hose Bibbs 2 PERMIT EXPIRES Saturday, May 30, 2009 Permit Issued on Monday, December 1, 2008 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 e i of Federal Way. Owner or agent: /1//14/ Date: /2-- / "O k L4":1, t) 1 THIS CARD IST EMAIN ON-SITE CITY OF ' �CommunitY Develop ent Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT #: 08-105705-00-PL Owner: CHRISTIAN FAMILY CARE • Address: 33507 9TH AVE S Bldg A 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) 0 Rough Plumbing(4230) EI Gas Piping(4125) Approved to cover Approved / Approved to release test / By Date By 2i Date /Z/ 1/o� By Date Final-Plumbing(4075) i Approved By (\ `t Date 7,-) For inspector reference only ❑ Rough Electrical 0 FINAL-Electrical Approved Approved By Date By Date RECEIVED aofI • 2_ - L. oS 71� S Federal Way DEC PERMIT COMMUNI7YDEVELOPMENT SERVICES SF MF CO ME E PL �E EN FP 33325 B AVENUE SOUTH• BOR 97180F FED RPR 'C AT I O N FFII RAL WAY,WA 9806363.9718 ID / 25: :-2607.FAX 253-835-2609 i ,w.[ituofederalutau.aim CDS �s.Js The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type. • PROPERTY INFORMATION SITE ADDRESS 73: (37 q 7/1 Xiv 'SAS /y SUITE/UNIT# ASSESSOR'S TAX/PARCEL# 9 Z G. -: © .t3 - © C 'L C LOT SIZE(sJ) LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) (Attach separate page for lengthy legal desaiption) ■ PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING ( PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this permit onig) ,14,42 A t4 ytci V.4,.4 c,04'I;'' < PROJECT NAME(Name of Business or Owner Last Name) Cti�(U Aft] -4- / Ca,cx,- U PEOPLE INFORMATION PROPERTY NAME `� PRIMARY PHONE OWNER w flit i sr I it h% i:04).-114.y t14061. ( ) - MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS 872-c s MC 9y Ar4ki 1 1..41- giy9s CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE Pa e''''1( /t7 c wsi /Ne a iiui( WA:aLi_ ( ) . - /7-34' MAILING ADDRESS CITY,STATE,ZIP CELL PHONE -C,c; 707a ni-, .-utt1C .S yr 4 g7Y4 L ( - ) ,` -s7 7E* CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER Q — 10 55,0 -its 1/zsE f ' ( - . ) .' - L'1 CONTRACTOR'S REGISTRATION NUMBER IRATION DATE E-MAIL ADDRESS 'Ai C CO N2- .Ar Lam/ 5 APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE MAILING ADDRESS` CITY,STATE,ZIP CELL PHONE RELATIONSHIP TO PROJECT FAX NUMBER 0 Architect 0 Tenant ❑Agent 0 Other ( ) - PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS CONTACT ( • ) ( - 572 7 r LENDER NAME Per RCW 19.27.095: Lender information is required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP PHONE ) _ ■ DETAILED BUILDING INFORMATION 1 EXISTING USE PROPOSED USE EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) ■ PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ. FT. — SQ. FT. SQ. F'". BASEMENT FIRST SECOND �" THIRD ADDITIONAL FLOORS(DESCRIBE) DECK(0 COVERED OR 0 UNCOVERED?) GARAGE 0 CARPORT ❑ o PROPOSED TOTAL TOTAL S7QSTINO sr TOTAL PROPOSED Sr TOTAL Sr NUMBER OF FLOORS **NEW HOMES ONLY** ER 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(commereiaq COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS REFRIG.SYSTEMS PLUMBING BATHTUBS(or Tub/Shower Combo) LAVS(Bathroom Sinha) URINALS MISC(Describe) DISHWASHERS RAINWATER SYST VACUUM BREAKERS DRINKING FOUNTAINS SHOWERS WATER CLOSETS croitet) ELECTRIC WATER HEATERS .2 SINKS WASHING MACHINES 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 application. / SIGNATURE: t )f4 9'74:,‘"--- �,,,-1. % DATE f'L/IP Property Owner and/or Authorized Agent IIIIIIIIIIIIIIIIIIL--❑NEW o ADDITION ❑ALTERATION o REPAIR o TENANT IMPROVEMENT BUILDING SHELL ONLY? a YES ❑NO BASIC PLAN? o YES a NO ZONING DESIGNATION CHANGE OF USE? o YES o NO NEW ADDRESS REQUIRED? o YES a NO UP/SEPA/SU? o YES o NO PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES a NO Bulletin#100—January 1,2008 Page 2 of 4 k\Handouts\Permit Application