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07-100207 r , I ' City Opfer:ederal Way • i r Community elopment Services Plumbing Permit #: 07-100207-00-P.!,,. 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: CAMILLE VANDEVANTER DENTAL OFFICE r' Project Address: 33507 9TH AVE S Bldg G Parcel Number: 926500 0020 Project Description: Plumbing for new dental office. Owner Applicant Contractor ` TONY STARKOVICH THE ROBSON COMPANY INC THE ROBSON COMPANY INC VINTAGE CAPITAL INVESTMENTS 9531 NE 140TH ROBSO**055QA 10/25/07 1611 9TH AVE N BOTHELL WA 98011 9531 NE 140TH EDMONDS WA 98020 BOTHELL WA 98011 • Plumbing Fixtures Dishwashers 1 Drains 1 Laundry Washer Outlets 1 Lavatories 3 Other Plumbing Fixtures 2 Sinks 7 Water Closets 3 PERMIT EXPIRES Sunday, January 18, 2009 Permit Issued on Friday, January 19, 2007 I hereby certify that e bove information iorrect and that the construction on the above described property and the occupancy a d the se will .- ii act.rdanc ith the laws, rules and regulations of the State of Washington -,d City of Federal Way. Owner or agent: ,4^) Date: i 1110 THIS CARD IS TO aMAIN ON-SITE - CITY OF tY Developm Develo m t Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT#: 07-100207-00-PL Owner: TONY STARKOVICH Address: 33507 9TH AVE S Bldg G 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) S� Rough Plumbing (4230) 0 Gas Piping(4125) Approved to cover Approved Approved to release test By Date B y Date a By Date 0 Final-Plumbing(4075) Approved By L Date et s- c)7 fg REG IV• - t ( °i r Federal Way 2007 PERMIT COMMUNITY DEVELOPMENTSERV10ESJAN 1 SF MF CO ME EL ODE EN FP 33325 STM AVENUE SOUTH 63 BOX 9718 , LI CATI O N FEDERAL WAY.FAX 53-83-9718 q / 3 / 253-835-2607.FAX253-835-Y6Q9_�'(�F FEpER I� erl www.cituo(lederalwau.con1 BUILDING DEPT. The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type. J IN PROPERTY INFORMATION SITE ADDRES - . m' l ,--- g!,--7. SUITE/UNIT# 6 ASSESSOR'S T /PARCEL# J (0 C3 l 6- 0 `/, 0 LOT SIZE(sj) LEGAL DESC ION(e.g.Acme Estates,�js,Lot 1) (yq 4-30-7_ 3 //f V�achseptIcr . lent -pquLdescripdot1 -. • PROJECT INFORMATION - TYPE OF PERMIT ❑ BUILDING %PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING ❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu) -` rte,...? t- y�-C' , PL-0� ► ac � `w fi�J.l .4.....„- ie„.., �++1-p"- -'Ae.,.J.. f 1. , 11111 PROJECT NAME(Name of Business or Owner Last Name) C (3\0\ it.l t- VAti©�ti/PS N D • PEOPLE INFORMATION PROPERTY NANI � `` ``�}- ,,� /� � 1_1.,_.. P MARY PHONE OWNER m1 �ee CA1c\7i-\ i,\ k v- , L(-C ( 4/-PCj� tMAILINs L {iJ'1 ,�V� � �'P���5 'E /MAILADDRES lG CONTRACTOR c PANY NAME '1 APPLICANT NAME it OFFICE PHONE " 7 �°x Li C C� ty y S°C '..."--\t V`' V (9 2> ) 2.t -Z2' 3C MAI ING ADDRESS CITY,STATE IP tt _ NEI I `4i, j� (4.1 PHONE ^� rl ,.7)r ,I .fir'-L-�. - I,{,`l 1 mow, - ( a2 ) �� - �- 22_ CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER / EXPIRA ON DATE FAX NUMBER �ter�-cr( (2'1t6--7 ( H25)%2s) - 5351 Copy of card ragWr.d CONTRACTOR'S REGISTRATION NUMBERUEXPIRATION DATE E-MAIL ADDRESS rttL L application /w.- C. J + -i C�'a �C ��� iti1 /GJz.c/t ") \�� �1�N �r4.„Scl,ec-'rC 011.17 APPLICANT veunp APPLICANT NAME (/'J OFFICE PHONE 'T(Atrr-- '-‘?--C-1:).4-,.. r..8-..-- ,,,cov%T, r"-CITY, :'L.��K ( ) - MAILING �J� STATE, p \ CELL PHONE RELATIONSHIP TO PROJECTFAX NUMBER 0 Architect 0 Tenant ❑Agent fithjOther �,clrliiZiyt�'2 a_ ( ) _ PROJECTE PRIMARY PHONE t E-MAIL ADDRESS CONTACT xnt"''n% t1 i\jf lir ? �-.C`r.� (1)21 ) •- )cell,'; 'DOC fl LENDER NAME Per RCW 19.27.095: K ! -; L S t es.t-' Lender information is required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP PHONE ( ) M DETAILED BUILDING INFORMATION EXISTING USE PROPOSED USE EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑ NO WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) OK PROJECT FLOOR AREAS s _7_____________14AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ. FT. SQ.FT. SQ. FT. BASEMENT FIRST SECOND / THIRD X \\\\ ADDITIONAL FLOORS(DESCRIBE) DECK(❑COVERED OR ❑ UNCOVERED?) GARAGE ❑ CARPORT ❑ NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ • FIXTURES Indicate number of each type 0j-fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. MECHANICAL Value of Mechanical Work $ ( COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION) 9 , -j AIR HANDLING UNITS E ORA COOLERS GAS PIPE OUTLETS WOODSTOVES BBQS FAN GAS WATER HEATERS MISC(Describe) BOILERS FIREP E INSERTS HOODS(Commercial) COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS REFRIG.SYSTEMS PLUMBING _a. BATHTUBS(or Tnb/Showcr Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe) I DISHWASHERS _ RAINWATER SYST VACUUM BREAKERS DRINKING FOUNTAINS SHOWERS -___ _a__ WATER CLOSE-15(roux[) t R�� � y�J ELECTRIC WATER HEATERS -) SINKS i WASHING MACHINES 2. �a�S HOSE BIBBS SUMPS SIGNATURE I certify under alty of perjury that the inform on 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 p •mises o perform the work for which the permit application is made. I further agree to hold harmless the City of F deral Way as o an claim cluding costs, expenses, and attorneys'fees incurred in the investigation and defense of such claim),which may a made by •ny pe••n,inc ing the undersigned, and filed against the City of Federal Way,but only where such claim arises out of the reliance of the ci .,incl ,ing its fficers and employees,upon the accuracy of the information supplied to the city as a part of this application. t ,lI1 NAME/TITLE -1E.^/ jPcZ.C;s.,.� r F+,p tL�_ DATE I IC PQ I _ (Si;nature (Title) RELATIONSHIP TO PROJECT 0 Owner 0 Agent Contractor 0 Architect ❑ Other / o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT BUILDING SHELL ONLY? a YES ❑NO BASIC PLAN? o YES a NO ZONING DESIGNATION CHANGE OF USE? ❑YES o NO NEW ADDRESS REQUIRED? o YES ❑NO UP/SEPA/SU? o YES o NO PLATTED LOT? o YES a NO DEMO PERMIT REQUIRED? o YES ❑NO Bulletin#100–January 1,2007 Page 2 of 4 kvHandouts\Permit Application