04-102726 •
,may of Federal way Plumbing Permit #:04 - 102726 - 00
Community Development Services
33530 ist Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: FEDERAL WAY YOUTH DEVELOPMENT CENTER
Project Address: 31455 28TH S Parcel Number: 092104 9054
Project Description: TI-Install new plumbing for men's/women's bathroom,kitchen sink,drinking fountain and floor drains.
PLUMBING ONLY.
Owner Applicant Contractor
FEDERAL WAY PUBLIC SCHOOL DEBOLTE PLUMBING AND HEATING DEBOLTE PLUMBING AND HEATING
31405 18TH AVE S DEBOLTE PLUMBING AND HEATING DEBOLTE PLUMBING AND HEATING
FEDERAL WAY WA PO BOX 909 PO BOX 909
98003-5433 FALL CITY WA 98024 (425)451-7173
Plumbing Fixtures
Description ,Quantity Description ;Quantityl Description 1Quantityi
Dishwashers II 1 1 I Drains Y 8 Drinking Fountains 1
Gas Pipe Outlets6 Laundry Washer Outlets f_7 1 Lavatories $
Other Plumbing Fixtures 4 Rain Water Systems T1
Sinks 1
Urinals ! 2 Water Closets 7 Water Heaters 1
PERMIT EXPIRES January 5,2005.
Permit issued on July 9,2004
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: Date: `0 0 rI
•
INSPECTION LOG
DATE INSPECTOR OK CORR/REJ AREA AND TYPE OF INSPECTION
VghtiAr-/- wirer +1- rotyk outn f io
p1 11 9n - e $ D rs)�
THIS CARD IS TO REMAIN ON-SITE
•
CITY OF .de community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04-102726-00-PL
Owner:
Address: 31455 28TH AVE S
FEDERAL WAY, WA 98003-5003
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) 0 Rough Plumbing (4230) ❑ Gas Piping(4125)
Approved to cover Approved Approved to release test
By 11,1 Date 7//6/x'` By /'L f Date "Abie By Date /1//6/0�
►�) Final-Plumbing(4075)
Approved
By VIII Date 4 ap ��
_ 102 2. ,
Federal Way PERMIT All-
COMMUNITY DEVELOPMENTSERVIC ECR V � vIF CO ME EL PL DE EN FP
33530 FIRSTDEKA WAY SOUTH. 6.BOX 9718 _APPLICATION
FEDERAL WAY,WA 98063-9718 TD /
253-6614115 FAX 253-6614129 J 1 ,l_ 019 7f-
The
f-
www.dtyojjederdwa4.eon, U �i
The ollowin. is re.uired in ormation-an inco •fete a.•Iication will not be acce.ted. Please •rint le.ibi (in ink)or . .
PROPERTY INFORMATION •
SITE ADDRESS � � 8 at SC)u,T ft SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal desoiproo)
PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING 0 MECHANICAL
0 DEMOLITION ❑ ELECTRICAL 0 ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
FAIISA4 A L1i2 2N 14 P(L4+44 _/�llt /1 S L, Kit-,134(-)-Ae• S
AerrP-4,6ntS ,Q L 4[2 J`i.Z iv 2it/ K • /)1 A. Air =mac vv'Y/Wiry
11- 6L t) - p LtAe‹.
PROJECT NAME(Name of Business or Owner Last Name) /'L 1)ee.A t_ VV YCLAT!'l 1)L i'e (/)
PEOPLE INFORMATION
PROPERTY NAME �/ PRIMARY PHONE
OWNER f)3 y� A Al vr(;L'� CLLA J� Kt'ie col-�.n(�'y (
MAILING ADDRESS CITY,STATE,ZIP
60 3 i e fez lis, I*3c ) 5esrty...E Wry 98/01
CONTRACTOR COMPANY N ME APPLICANT NAME OFFICE PHONE
D I3V C. lr itkimative, b r TN�2srini K.IC��-,� (`!LS 1 L/.rj j0,3
MAILINGnAjD✓D RESS �� CITY,STATE,ZIP ) fai y�/ CELL
PPHONE
CITY 10, FE FRAC WAY BUSINESS`' LICENSE NUMBER MLL (Try
EXPIRATION DATES° i (AX NUMBER
6 —ZS+7
_ B L / (4ns ) ZZ2.- 96-0
CONTRACTORS REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
Q_ a t2g P B L k t D L 031 05 / 06.
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
C0Air ait ) -
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect ❑ Tenant 0 Agent ❑ Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
l � -
LENDER Per RCW 19.27.095: Lender information is NAME
required if project value exceeds$5,000'
MAILING ADDRESS CITY,STATE,ZIP
DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN o HIGHLINE ❑ PRIVATE(SEPTIC)
PROJECT FLOOR AREAS •
AREA DESCRIPTION EXISTING SQ.FT. PRO• QED SQ. FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
**NEW HOMES 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.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(Commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING �y p
BATHTUBS(or Tub/Shower Combo) SHOWERS / WATER CLOSETS(roue) p MISC(Describe)
/ DISHWASHERS tai SINKS / DRINKING FOUNTAINS re
6 GAS PIPE OUTLETS SUMPS / RAINWATER SYST
/ WASHING MACHINES Z URINALS 4/ HOSE BIBBS
LAVS(Bathroom Sinks) 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 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 /' s c..c 1111-7V-, DATE 0'? b 7 CI Al
(Signature) (Title)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent ❑ Contractor ❑ Architect ❑ Other
FOR OFFICE USE ONLY
❑NEW a ADDITION a ALTERATION ❑ REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES ❑NO BASIC PLAN? a YES a NO
ZONING DESIGNATION CHANGE OF USE? ❑YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a YES a NO
PLATTED LOT? a YES o NO DEMO PERMIT REQUIRED? a YES a NO
Bulletin#100—March 30,2004 Page 2 of 4 k\Handouts—Revised\Permit Application