05-103697 •
citycity of Federal Way Plumbing Permit #: 05 - 1036 - Ga - PL
o F Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: FEDERAL WAY HIGH SCHOOL FOOD LAB
Project Address: 30611 16TH S Parcel Number: 082104 9001
Project Description: Remodel of cooking lab; adding(1)sink and(1)drain
Owner Applicant Contractor
FEDERAL WAY SCHOOL DISTRICT GREENE GASAWAY ARCHITECTS *CAL MOUNTAIN CONSTRUCTION
1066 S 320TH PO BOX 4158 7457 S MADISON ST
TACOMA WA 98409
\FEDERAL WAY WA 98003 \FEDERAL WAY WA 98063 (253)474-5281
Plumbing Fixtures
Description Quantity Description Quantity Description Quantity
Drains 1 Sinks 1
CONDITIONS:
This parcel islocated within a Wellhead Protection Area(Capture Zone 10)and must comply with FWCC,Chapter 22,
Article XIV"Critical Areas" and fill out..a Hazardous Materials Inventory Statement,ifapplicable.
�
i PERMIT EX IFS ust 2007
Permit issued ugust ,20r,
° E
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 accor ce wthe laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: Date:
THIS CARD IS TO MAIN ON-SITE
•
CITY OF litommunity Developm nt Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-103697-00-PL
Owner: FEDERAL WAY SCHOOL DISTRICT
Address: 30611 16TH AVE S
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.
•
..❑ Plumbing Groundwork(4190) • �❑ Rough Plumbing(4230) ❑ Gas Piping(4125)
Approved to cover Approved Approved to release test
Byc S Date/ — 7 J By Date By Date
El Final-Plumbing(4075)JJJJ
Approved
By fi,.
Date </7
RECEIVED_
S
a!!''' RECEEC_ .G a ..7
Federal Way YERMIT -- - -
CaMAfUM7YUEVElAFdlL+NTSERVICES JUL 2 SF MF CO ME EI( DE EN FP
333458TMAVENUE5aA771•PO97187
PLICATION
FEDERAL WAY,WA 98063-9718 p
253-835 Y607•FAX853-833-4609 ir /
l/l /Y'/V/� / 6'5—
"mAtilYo/Iederal"Y.com CITY OF FEDERAL WAY
DIN tj c
The oilou/i • is re•uirekYI n o on-an inco •lete • ••Iication will not be acce.ted. Please •rtnt le,ibi in i or
•
IIIPROPERTY INFORMATION .
SITE ADDRESS Fi Y )Q4z. WA i•('-f( ScHilo L 30411 16 TN AV S SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# O$ .Z Q tl.-goo) FaydriC# c_ IVAl Y IVA ?telt 3
—A3 — — — LOT SIZE(sf7
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) NE O.TA. OF TuK:Ng Writ'Q O 1= Sere,II't Tw f 2-114,1614G-it ss•y f sy
(Attach sepameFagetarlenethYlegald"a4'6°1l 1N Kt Wer CouNT IA/ASH!AIG-ro+4
• PROJECT INFORMATION
TYPE OF PERMIT10264ipp3----1ftiallgaier -
0 DEMOLITION 0 ELECTRICAL 0 ENGIN -+, = = RE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onli,
ftc-M c1D L e..o o.14-I r4 G- s_if b 1 4.00 SF
•
-DV crALL. /s1 JD `z°L 4-Gtr'iiV -4 CeV) /9pi/{ ✓l• It/•7'/<' �/di s P�1v444/i✓-,,--
PROJECT NAME(Name of Business or Owner Last Name) Foo] L Aj , tt P 6-1Z.41)61S Ft 7CAL l ify t-IGG� Seffoet.
• PEOPLE INFORMATION l
PROPERTY NAME
PRIMARY PHONE
OWNER Ft De.toiI. W14Y FL)61-ic Se-Hovi.. 5 (213 ) 445 -5935
MAILING ADDRESS CITY,STATE,ZIP
10 44 S 3coTtt Fe3) -7Zv{V w,ty WA 98'6o3
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
( )
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
CITY OF FEDERAL (' ) -
• WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
/ / ( ) -
-s L
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each applcatioa( EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
GC-4 Cmt..vir4 GASAw,4y (21.3) i `r( -`fq37
MAILING ADDRESS CITY,STATE,ZIP - CELL PHONE
pa SOX 4-1St r.---L-r)Le 2 A t_ w/4 Y (.206 ) 21 r--Stfrt,6
RELATIONSHIP TO PROJECT Witt 18'063 FAX NUMBER
%Architect ❑Tenant 0 Agent 0 Other(Describe) (2.‘3 ) 9 4-[--57 2-2-
CONTACT
2-
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
C141-VIN G1AS/4-w4 y (2(3) (it f'( - it Cj 3 7 cat vin&r; 990.rid%ifa
LENDER .)_,7 :4,1,,, ,,'4f.a1�1 'Y-1Yrd rnfTh
3`r ' NAME ,e C¢ X
•( 0
MAILING ADDRESS
CITY,STATE,ZIP
■ DETAILED BUILDING INFORMATION
EXISTING USE GOO k t NG- I-itte PROPOSED USE CO o/t.1 JUG L/} 26
EXISTING ASSESSED/APPRAISED VALUE (;' 1(°. g
MM.G 1.+.". i VALUE OF PROPOSED WORK $ 2y Q�
SPRINKLERED BUILDING? X YES ❑NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES a NO
WATER SERVICE PROVIDER XLAKEHAVEN a HIGHLINE ❑TACOMA ❑PRIVATE(WELL)
SEWER SERVICE PROVIDER X LAKEHAVEN a IIIGHLINE 0 PRIVATE(SEPTIC)
•
•
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. ______q9.-FT.
BASEMENT
---
FIRST ------�
SECOND
-
THIRD
FOURTH .
ADDITIONAL FLOORS(DESCRIBE) •
DECK(COVERED?)
GARAGE 0 CARPORT 0
E1Q8TBfO PROPOSED 2OTAL a 'k.-....Y.z4._4.. ' a,�,. RO w 6�'d- ," *IPM
yr°:,
NUMBER OF FLOG r: . € I
**NEWHO • ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
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.
afE
CKANICAL {I
Value of Mechanical Work $ 1iI DOG
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(co, reies WOODSTOVES
BOILERS ,.. FIREPLACE INSERTS 2.Ili RANGES MISC(Describe)
COMPRESSORS FURNACES OAS WATER HEATERS
_____L__ DUCTS OAS PIPE OUTLETS
PLUMBING
BATHTUBS(orTub/Shower Combo) /1'� SHOWERS WATER CLOSETS(rotes MISC(Describe)
V
DISHWASHERS I SINKS 1liV DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bothroomsinlc, VACUUM BREAKERS ELECTRIC WATER HEATERS
`' DISCLAIMER/SIGNATURE BLOCK
•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 a,, claim(including costs, expenses, and attorneys'fees incurred in the investigation and defense of
such claim),which • " •r-e: y • on,including the undersigned,and filed against the City of Federal Way,but only where such claim
arises out of the reli• c o , ci'! Inc •ing its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
i IrNAME/TITLE A c4•fi'd" DATE 2-7l7 `i) 5-----
(Sign
is ure) W (Title)
RELATIONSHIP • PROJ ❑ •MT 0 Agent o Contractor ❑ Architect 0 Other
fI P ' xi:®fit (f'(e)Z( '�e,1m°'.,�Al (e «.,:, .�� '� I, 1 11i iiei,)-Ye)tiD)'i-,..0'`.`
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t e`y a 4 �; ro t � i : � } �.
[fir+fe is sd. _ ,.._ .,,j0i(c,)I:,?..1;42;1 ki,t.
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Bulletin#100—.January 7,2005 Page 2 of 4 k\Handouts\Permit Application