07-102207 •City of Federal Way
Community Development Services
Plumbing Perm •#• 07-102207-00-lP L
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: GOLDENSTONE SUITE 114
Project Address: 33400 9TH AVE S Suite 114 Parcel Number: 926501 0060
Project Description: Install sink-trim-out only,existing rough-in.
Owner Applicant Contractor
GOLDENSTONE LLC VERN HUBER HUBER'S PLUMBING CO
320 106TH AVE NE SUITE 100 HUBER'S PLUMBING CO HUBERP*042M2(7/6/08)
FEDERAL WAY WA 98004 3420 C ST NE 3420 C ST NE
AUBURN WA 98002 AUBURN WA 98002
Plumbing Fixtures
Sinks 1
PERMIT EXPIRES Thursday, April 23, 2009
Permit Issued on Tuesday, April 24, 2007
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 ith the laws, rules and regulations of the State of Washington
� d ,rCity of Federal Way.
Owner or agent -�%; / ----- Date: G,//.-fi
92J,--k-C) eo. co—a S ern c +4---i
THIS CARD IS TO MAIN ON-SITE
CITY OF tommuntY Development
Inspection
n Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 07-102207-00-PL
Owner: GOLDENSTONE LLC
Address: 33400 9TH AVE S Suite 114
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) ❑ Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date ByDate Z 07 By Date
❑ Final-Plumbing(4075)
Approved
By cDate 55. -�
,�® • •
2 4 Zpp�Federal PERMIT SF MF CO ME EL PL a E EN FP
_CCY75 8 C !8"TM A VENUE SOU1H•POS
FECB 0
AL WAY.WA 963-9718 APPLICATION RD ,
253$,35.2607•FAX 253-835-2609 405
BIALOI
The following is required information-an incomplete application will not be accep•-.. Please print ,. , y(in ink)or type.
S PROPERTY INFORMATION j
SITE ADDRESS 3.3 4/0094 Y/f =' a 0 SUITE/UNIT#_/.7
ASSESSOR'S TAX/PARCEL# ! 2 69 J /-0 - 0 (,/ 6' LOT SIZE(sf
LEGAL DESCRIPTION(e.g.Aare Estates,Lot I) Sr /7. / '7
1
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEEIUNG 0 FIRE PREVENTION SYSTEM
PROJECT D RIP TI (Provid detailed de rel,of work included pn permit onhi)
f¢/As it 7/9 OaT_ciibe
PROJECT NAME(Name of Business or Owner Last Nalnel 0 (4 tit/`Srd — SNAA , 1 1 4
U PEOPLE INFORMATION
OWNERPROPERTY NAME d /j$�%,c 21 C / PRIMARY PHONE
MAILING ADDRESS 1 CTN.ST,TE.
3 /OJ �T/,`/fy,t yes �/ ' / 6(/'-i / ' " J9' EMAIL ADDRESS
CONTRACTOR COMP E APP NAME P� OFFICE PHONE
, � .�L� b/�i (�a /'/e/nA . �✓�',��!',e (S'3) Ess 3 Soft
MAILING ADDRESSSC 1E.ZIP CELL PHONE
3 v.2 C1 c TAT A' ',hell moi/ 9M ' (20--f )s/()_3oE;
env OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION S1ATE FAX NUMBER
,W-Oo /CO/,v(7-o(7.6" , /2 �/ c> ' ( )
corr.t.m CONiRAACCTO REGISTR�A/TION NUMBER � sON DATE E-MAIL
E-MAIL ADDRESS
vim gm*applientiss C /fes' �� / 7��/ .c..' L7�� !�/ �.?"
APPLICANT COMPANY NAME / APPLICANT NAME // OFFICE PHONE
Sfi,94ah, ( ) -
MAILING ADDRESS - CITY.STATE.ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant 0 Agent ❑ Other ( ) -
PROJECT NAME f r PRIMARY PHONE E-MAIL ADDRESS
CONTACT 7r,4.41/1 .1/4.
(feltj ) ,I >I - 30c?
LENDER NAME Per RCW 19.27.095:
Lender irlfortaation is required(fproject value exceeds$5,000
MAILING ADDRESS CITY.STATE.ZIP PHONE
( ) -
I DETAILED BUILDING INFORM.\1 ION
EXISTING USE ("/17;C,( SeG'Cft'/? PROPOSED USE .57a C,E
EXISTING ASSESSED/APPRAISED VALUE$ _ __ _ _VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ':!YES n NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? YES 0 NO
WATER SERVICE PROVIDER 'LAKERAVEN 0 HIGHLINE ❑ TACOMA u PRIVATE(WELL)
SEWER SERVICE PROVIDER XLASffiAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
ARRA DESCREMlON EXISTING I PROPOSED TOTAL
SQ.FT. SQ.FT. S FT.
BASEMENT
1•TtO I
(24Z/ //-
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT 0
=MEW T ssOPOs® TOTAL _ TOTAL azerr'mc:SF TOTAL~POWER® voila NI
NUMBER OF FLOORS
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MItCSANICAL
Value of Mechanical Work$ (A COPY OF BID OR ES7TMA7E MUST BE INCLUDED WITH APPIJCATTON)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODSLcor
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS dor Tub/rower CARP.) LAYS(Bathroom Sokol URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS )
ELECTRIC WATER HEATERS / SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE FF
I certify under penalty of perjury that the information 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 premises to perform the work for which the permit application is made. 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 of Federal Way,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.
NAME/TITLE �. DATE
,C2/7/0 X(
fStgne 1 L, ), (Me)
RELATIONSHIP TO PROJECT 0 Owner 0 Agent 'Contractor 0 Architect 0 Other
FOR OFFICE USE ONLY
-NEW ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? a YES c NO
ZONING DESIGNATION CHANGE OF USE? ❑YES c NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? ❑YES c NO
PLATTED LOT? o YES NO DEMO PERMIT REQUIRED? a YES NO
Bulletin#100—April 2,2007 Page 2 of 4 k\Handouts Permit Application