07-102209 •
•
City of Federal Way PlumbingPerm#: 07-102209-00-PL
Community 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 208
Project Address: 33400 9TH AVE S Suite 208 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
and the city Federal Way.
Owner or agent:_ Date: ,,
- its.
. 44146,
THIS CARD IS TO'' :MAIN ONSITE
CITY OF ` ommunity Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 07-102209-00-PL
Owner:
Address: 33400 9TH AVE S Suite 208
FEDERAL WAY, WA
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 /-4' Date ;,,/, J e I By Date
❑ Final-Plumbing(4075)
Approved
By r,— t` .1 Date t�—�-G..1
r • •
-- yieraiam, RCE�u O "?-- - / o a 0 1
'�"�
PERMIT SF MF CO ME EL op.. EN FP
aoraa xrn IIEVELGP1IEKrsERWCIS
1,'i3?PEDERAFJWAY.WJnl•POBOX 971A 4 Z�'PPLI ATION
PEDIF.RAL WAY.WA 9806.3.9718 tv /� j S-
253-835-2607.FAX 253-8352609 ��JJ /l.lJ'
CITY OF FEDERAL WAY
The following is requilailWarelailiiirr.an incomplete application will not be accepted. Please nt legibly(in ink)or type.
• PROPERTY INFORMATION
, `/ �
SITE ADDRESS .5 ) 4 1 100 4i'//' ..>a SUITE/UNIT r__ �`�("2 6 5
ll !
ASSESSOR'S TAR/PARCEL 2 (j . - 0 o 6' 0 LOT SIZE lsn td\A1
LEGAL DESCRIPTION te.q.Acme Estates,Lot 1) S 1- /7 ,2/ 4'
(Aum+ pne.for kcal ae
• PROJECT INFORMATION
[1 /
TYPE OF PERMIT BUILDING ?(PLUMBING ❑ MECHANICAL
❑ DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailedtioof work Included ohis it ant )
f d5/--Jr, .1',7,477.4;/./Al'
1-moi/�: d7,'a n n t
S'�. �o
,P,ee � Al/ .__C-7;77 it 07
PROJECT NAME(Name of Business or Owner Last Name) (10t[.k(&,5115 .(2.— 5t l t L 02 0 E'
a PEOPLE INFORMATION
PROPERTY NAME// ///' — PRIMARY PHONE
OWNER ld� fJ-S% f GLC ( ) -
MAILING ADDRESS I CITY.SLATEZIP E-MAIL ADDRESS
gg0C.) /T/lAilil5el If a/ / A,Of
CONTRACTOR COMP NAME APP NAME OFFICE PHONE
6�,F,s L� 6ir1 G'o if/7(7f /%<eit1 (.25-3) x.53 - se10/
MAILING ADDRESS E.ZIP CFLL PHONE
3 V.2 0 C 7-r7-• //f 010.07 l/ri/91DV. (2 )S/0-...?
067
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION RATE FAX NUMBER
.0-OU i00/iOC/-C2(y.z' /eti.1,17e"" 7 ( ) -
r;opv of wa,egoii,<n \\ COMByACTO/R/J$REEGIS7/R/�ATTIO(N NUUMMBEER.[ /� SN DATE E-MAIL
E-MAIL ADDRESS
vita each.application I ✓ f//(Z, / // V / `' - l•'//CLO Q/ (,S d
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY.STATE.ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant 0 Agent ❑ Other ( ) -
PROJECT NAME �/: /. PRIMARY PHONE E-MAIL ADDRESS
CONTACT f,'m'A r/V;h 1 (fob') 'T/O - 30(?
LENDER NAME Per RCW 19.27.095:
Lender information is required If project value ercerds$5,000
MAILING ADDRESS CITY.STATE.ZIP PHONE
( ) -
• DETAILED BUILDING LNFOR4IATION
EXISTING USE (7//C,C $G'C�C ----__--_—_—__-- PROPOSED USE S�or CA
EXISTING ASSESSED/APPRAISED VALUE S VALUE OF PROPOSED WORK S
SPRINHLERED BUILDING? ?YES NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? -,YES 0 NO
WATER SERVICE PROVIDER LAKEHAVEN 0 HIGHLINETACOMA PRIVATE(WELL)
SEWER SERVICE PROVIDER LAHEHAVEN 0 HIGHLINEPRIVATE(SEPTIC)
• PROJECT FLOOR AREA
AREA DESCR11PT1ON EXISTING PROPOSED TOTAL
h SQ.FT. 813.FT. SQ.FT.
BASEMENT
FIRST ----------- - / /
SECOND ri G,C ',f/1,4 _
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT 0
morn - .aa.o® _ TOTAL TOTAL Earmn s Ionic Ivo®• TOTAL s
NUMBER OF FLOORS
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
a 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
Vali e of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPUCAI7ON)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
B8QS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(Commercial)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
AO
BATHTUBS torltin/sna. rCo LAVS(Bathroom&Nal URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS mart)
ELECTRIC WATER HEATERS 4 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 ocers and employees, upon the accuracy of the information supplied to the city as a part of i
g'i
this application.
NAME/TITLE � �'//� DATE __ ice.. �S�////t� ;N
(Signatum f r mile) /
RELATIONSHIP TO PROJECT d'Owuer 0 Agent Ti'C'ontractor 0 Architect ❑ Other
FOR OFFICE USE ONLY
NEW _ ADDITION o ALTERATION o REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? a YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o TES a NO IIP/SEPA/SU? a YES o NO
PLATTED LOT? a TES a NO DEMO PERMIT REQUIRED? a YES a NO
Bulletin#100-April 2,2007 Page 2 of 4 k\Handouts\Permit Application