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17-104824 RECEIVED OCT 09 1m1 CITY OF PERMIT APPLICATION PERMIT CENTER+ 33325 8th Avenue South + Federal Way,WA 98003-6325 Federal Way CITY OF FEDERAL WAY 253-835-2607 + FAX 253-835-2609 + peiinitcenter@cityoffederalway.com COMMUNITY DEVELOPMENT 7 tt e ( 0 i q / -7 PERMIT NUMBER -_ - / TARGET DATE SITE ADDRESS SUITE/UNIT# 9.61 l O -PCI c U F v . I i ,�-- PROJECrTs VALUATION ZONIN ASSESSOR'S TAXI PARCEL# ` - TYPE OF PERMIT /❑ BUILDING PPLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT1 Y/U /)I'vt) . /r1.5 tc,�(. 5'i/1 1G S re.,z7 f, f/. IJ '' PROJECT DESCRIPTION i Detailed description of work to 1( u f/Y I/ / �O�v" SYS kJ be included on this permit only NAME PRIMARY PHONE `k. (n O 1 b ( t' Z0 u'ra'Y c,) )5--) ,)-' 29 i PROPERTY OWNER MAILING ADDRESS 7 //qqV�� ` ! E-MAIL i CITY41H14-n- " � 40 Z? STATE 1 GIZI( rck S:� AM -r 4 '�- L'1) , 1'\- cl y 0.3 a'— r y ` PHONE N E V N 12— M MAILING ADDRESS E-MAIL CONTRACTOR M' A N.0 de t'i l a(03A,N i(v to t)MC%1.t' CITY STATE ZIP FAX WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# / / PRIMARY PHONE �r NAME �- r j!f," i,. 3_) APPLICANT MAIMG ADDRESS E-MAIL i7©t3 M /' ) -IC' : rc) CITY STATE ZIP FAX NAME �., - PRIMARY PHONE PROJECT CONTACT C4 L 1 C1 1.- Zu Y'/Or. � (?. 3) 327 /Z3 MAILING ADDRESS E-MAIL(The individual to receive and respond to all correspondence ,92 0 c'> rf+4 t`Or'-1CI fes/ .(„t concerning this application) CITY STATE ZIP FAX (, ./f Lv (t" `)bC J 2 • NAME PROJECT FINANCING 12/ OWNER-FINANCED When value is$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: ��D ('jr ,Gl rr--a'1 DATE /i 7/i l PRINT NAME: I. GsrvJ Bulletin#100-January 29,2016 Page 1 of 2 k:AI-Iandouts\Permit Application VALUE OF MECHANICAL WORK MECHANICAL PERMIT Indicate how many of each type offixture 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 I TiAlLUE OF 4 LUIVLOING'WORK PLUMBING PERMIT Indicate how many of each type of facture 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 WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS(Kitchen/Uulity) 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 Li No ❑ Yes ❑ No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT FIRST FLOOR(or Mobile Home) ISFCOND FLOOR COVERED ENTRY DECK GARAGE ❑ CARPORT ❑ OTHER(describe) EXISTING PROPOSED TOTAL Area Totals **NEW HOMES ONLY** ESTIMATED SELLING PRICE$ _ # OF BEDROOMS COMMERCIAL-NEW/ADDITION Area in Construction # of AREA DESCRIPTION Bourne FeetOccupancy Group(s) r.,.o Stories Additional Information NEW BUILDING ADDITION COMMERCIAL-REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area in Construction # of Square Feet Occupancy Groups) Type Stories Additional Information TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin#100—January 29,2016 Page 2 of 2 k:\I-Iandouts\Permit Application Plumbing City of Federal WayFILEPermit #:17-104824-00-PL Community Development Dept. 33325 8th Ave S Federal Way,WA 98003 Inspection Request Line: (253)835-3050 Ph:(253)835-2607 Fax (253)835-2609 Project Name: MINISUPER LA FAMILIAR Project Address: 29100 PACIFIC HWY S Parcel Number:042104 9073 Project Description: ALT-Plumbing in newly added deli to include installing(1)hand sink,(1)prep sink,(3) compartment sinks and(1)floor sink.Plumbing in future meat department to include installing (1)hand sink,(1)prep sink,(1)grease trap and(1)floor sink.In the restroom,replace the existing water tank. Owner Applicant Contractor PABLO LIZARRARASMINISUPER LA PABLO LIZARRARASMINISUPER LA OWNER IS CONTRACTOR FAMILIAR FAMILIAR 27023 MILITARY RD S 27023 MILITARY RD S KENT WA 98032 KENT WA 98032 r, Phs 3 1 /. 3 1 l�31 �,. Fit nbing Fixtures141 /ANt�aA? J33 Sinks 7 Waste Interceptors 1 Water Heaters 1 PERMIT EXPIRES Saturday,7 April,2018 Permit Issued on Monday, October 9,2017 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: �� 1 d,V u'�U1 Date: '♦ THIS CARD IS TO REMAIN ON-SITE Construction Inspection Record 4•, CITY OF �•,` Federal Way INSPECTION REQUESTS: (253)835-3050 PERMIT#: 17 104824 00 Address: 29100 PACIFIC HWY S Unit 1 Project: PABLO LIZARRARAS FEDERAL WAY WA 98003 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) ® Final-Plumbing(4075) Approved to cover Approved / Approved By Date ''/Z4-117 By Date I°/ t4 I;`7 By Date OK — A rJ 10/16. . , 111 Rough Electrical El Final ElectricalCIRight of Way Approved Approved Approved By Date By Date By Date