07-102211 City of Federal Way Plumbing Per #• 07-102211 -00-PLCommunity Development Services •
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 118
Project Address: 33400 9TH AVE S Suite 118 Parcel Number: 926501 0060
Project Description: Install coffee sink.
Owner Applicant Contractor
GOLDEN STONE LLC VERN HUBER HUBER'S PLUMBING CO
33400 9TH AVE S HUBER'S PLUMBING CO HUBERP*042M2(7/6/08)
FEDERAL WAY WA 98003 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 with the laws, rules and regulations of the State of Washington
a d t y , Federal Way.
Owner or agent: ��;� Date: �0� G� `/
THIS CARD IS TO.MAIN ON-SITE ,
CITY OF - ommuntY Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 07-102211-00-PL
Owner: GOLDEN STONE LLC
Address: 33400 9TH AVE S Suite 118
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) ❑ Rough Plumbing(4230) ❑ Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date By , Date 572/ 7 - By Date
❑ Final-Plumbing (4075)
Approved
ByL.'
3&--; Date b L.-05-:�
, 0
P ....,.....4. Niek et, 19 7_ i D 0)--01-1 1
IR
"S PERMIT SF MF CO ME EL DE EN FP
CO MIJAWY DEVELOPMENT SERVICES
(10
3.3325 8n.AVENUE SOUTH•PO BOX 9718
FEDERAL WAY.AX 253.'3980&335-2609 r`-9718 A 112 4 2ALICATIONIMIIMMII
253-835-2607•FAX ��� +P_
The following is,-e � lrt-an Incomplete application will not be accepted. . print ,'' ig(in Ink)or type.
/� • PROPERTY INFORMATION
SITE ADDRESS_ 2 3 7 2O 9,9dir g'ci gg 0 SUITE/UNIT#_ 1/ ? iQ
ASSESSOR'S TAX/PARCEL# 2 Q J /0 - O 6 (2 LOT SIZE Isf) AO)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot I) `j F / 7. .2/ Lil
(Attach sePrrcte Pag.Ia kr.fihY k4 descriptk
S PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING Lr1 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on thisrmit only)
0 /I/„ e T1/� __ 1;/74;£ .C./ A /.✓✓n.5TA/ j/8'
PROJECT NAME(Name of Business or Owner Last Name) ( 0 v\W`-y \`'i� I
5 PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER /,!J/a -57-/04x 116: ( )
MAILING ADDRESS CITY.STS ZIP E-MAIL ADDRESS
CONTRACTOR COMP ► +E .' / APPLI NAME �j / OFFICE PHONE
/ ,eS GG!/Il�//.'i Ci° if/'n> //✓e.e/rX ( 5-3) F13 3 - 5-M//
MAILING ADDRESSC STATE,ZIP CELL PHONE
3 7, 0 C 7"S'7 /1//f 41Aell /719Z—J.1.2- (2o-i )- /0-3.°6'
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
,2e)-U0 /dO/TOO--(2C7 G /2 3/ !� 7 ( )
CONTRACTORN REGISTRATION NUMBER ON DATE E-MAIL ADDRESS
CO!!e[cud� �/
with each ® b ,e �7F0 4 oO0r
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 ( ) -
PROJECTr PRIMARY PHONE E-MAIL ADDRESS
CONTACT NAME , ". //2Z1/f///2Z1/f/ (2 061 .ri I't/T� - 30c?
LENDER NAME Per RCW 19.27.095:
Lender in ormation is required if project value exceeds$5.000
MAILING ADDRESS CITY.STATE.ZIP PHONE
( ) -
• DETAILED BUILDING IvFORMATION
EXISTING USE (9/7 C/ ;GVC/1 PROPOSED USE S'/ 2 C,1
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPPRJNK EKED BUILDING? `AYES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? )'YES 0 NO
WATER SERVICE PROVIDER VfLAHEHAVEN 0 HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER XLAKEHAVEN 0 HIGELINE o PRIVATE(SEPTIC)
t,". ■ PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SO.FT. SQ.FT. Sg.FT.
1 BASEMENT
-
FIRST
7, ( W/4/
SECOND
'THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(D COVERED OR D UNCOVERED?)
GARAGE 0 CARPORT ❑
lIZOITING PROPOS® TOTAL TOTAL SOWING sr TOTAL rTIWO®9F TOTAL s►
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.
MECHANICAL
Value of Mechanical Work$ (A COPY OF'BID OR ESTIMATE MUST BE INCLUDED wan APPLICATION)
AIR HANDLING UNTIS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(Corm..rctai)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SEIb REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/Shower Combo) LAVS(BatmoomS)nI URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS roc)
ELECTRIC WATER HEATERS / SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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 authorised 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 ,i' and employees,upon the accuracy of the information supplied to the city as a part of
this application.
e/ ,
NAME/TITLE �� DATE C9 0G 3 l77.
(Signa re) (Title) ���///
RELATIONSHIP TO PROJECT 0 Owner o Agent 'Contractor 0 Architect ❑ Other
)
FOR OFFICE USE ONLY
NEW u ADDITION ❑ALTERATION REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES ❑NO BASIC PLAN? o YES ❑NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES ❑NO UP/SEPA/SU? ❑YES o NO
PLATTED LOT? a YES o NO DEMO PERMIT REQUIRED? o YES o NO
Bulletin#100—April 2,2007 Page 2 of 4 k\Handouts\Permit Application