10-103058 r
Plumbing
City of Federal Way
Community Development Services Permit #: 10-103058-00-PL
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: CHURCH OF BLESSING
Project Address: 1430 S 330TH ST Parcel Number: 172104 9045
Project Description: Adding(1)Lay to childcare area on 1st floor
Owner Applicant Contractor
CHURCH OF BLESSING C N C PLUMBING C N C PLUMBING
1430 S 330TH ST 33324 ELKHOLM DR SE CNCPL**982PZ (10/9/10)
FEDERAL WAY WA 98003 AUBURN WA 98092 33324 ELKHOLM DR SE
AUBURN WA 98092
11
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Lavatories 1
PERMIT EXPIRES Saturday, January 15, 2011
Permit Issued on Monday, July 19, 2010
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 Feder I Way.
Owner or agent - �- � Date: 7"r
11 //5/10
•
' THIS CARD IS TO REMAIN ON-SITE .
CITY OF' Construction Inction Record
Federal Way • INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 10-103058-00-PL Address: 1430 S 330TH ST
Owner: CHURCH OF BLESSING FEDERAL WAY, WA 98003-6302
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.
O Plumbing Groundwork(4190) D Rough Plumbing(4230) ElGas Piping(4125)
Approved to cover Approved Approved to release test
By Date By ill (,- Date 1^2 _�v By Date
o Final-Plumbing(4075)
Approved
'By - ,-� Date .l 1.—‘5-1 .
LI Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
'PERMIT
Federal Way 411 --F CO ME /PL DE EN FP
COIL MNITY DEVELOPMENT SERVICES APPLICATION 7
253-835.2607•PAX 253-835-2609 /�
'nuaa cih:r.;;sdsra3i.;,y.crm �� / ®
SITE ADDRESS JUL 9 z0+9I1 SUITE/UNIT#
/9/36 :tOp J
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL �Q
$ fDA ' ,S
TYPE OF PERMIT CIBUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) /24 e /z-zrrjin
PROJECT DESCRIPTION /� '� O
Detailed description o work to [— C, dCaa V, 1
be included on this permit only
NAME
j� (I l C PRIMARY PHONE
PROPERTY OWNER
y 43-6-4J-(
MAILING ADDRESS - E-MAIL
CITY STATE ZIP
NAME J PHONE
ADDRESS�� {-/ /Cs-" ...4) -~.13/-/ci `"y
MAILING E-MAIL •
CONTRACTOR £ 1•' �� ^
CIT! STA ZIP 1 f7 FAX
WA STATE CTOR' LICENSE# E>65cIRATION DATE FEDERAL WAY BUSINESS LICENSE#
PXP
Z, 9 "11 Z... / /
NAME l
� PHONE
/49. Dr6erfh
APPLICANT MAILING ADDRESS E-MAIL
-CITY97 ,4 /`-f--
CITY
STATE ZIP FAX
PROJECT CONTACT NAME PHONE
(The individual to receive and
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application)
CITY STATE ZIP FAX
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME
0 OWNER-FINANCED
Required value of$5,000 or more
(RCW 19.27.095) MAILING ADDRESS,CITY,STATE,ZIP PHONE
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
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,
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.
SIGNATURE: —�/� �J �' DATE
piramp
PRINT NAME: ,�/'-`iF�_ • �'
Bulletin#100—April 14,2010 Page 1 of 3 k:\Handouts\Permit Application
•
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VALUE OF MECHANICAL WORK $ (a copy of bid or estimate must be provided)
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commerciap_
BOILERS FURNACES HOT WATER TANKS(Gas(
COMPRESSORS GAS LOG SETS REFRIGERATION SYST •
DUCTING GAS PIPING WOODSTOVES
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Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo) / LAVS(Rand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Ekchic)
HOSE BIBBS SUMPS WASHING MACHINES # •0.t. i ,g ,`••?ii•iii:
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CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes❑ No ❑ Yes ❑ No
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AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
FIRST FLOOR(or Mobile Home)
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COVERED ENTRY
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GARAGE ❑ CARPORT 0
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EXISTING PROPOSED TOTAL
Area Totals
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ESTIMATED SELLING PRICE$ # OF BEDROOMS
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Area Construction #of
AREA DESCRIPTION Occupancy Group(s) Additional Information
in Square Feet Type Stories
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ADDITION
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Area....................................P........y...........p( ;. . .
Construction #of
AREA DESCRIPTION Occu anc Grou s Additional Information
in Square Feet Type Stories
TENANT AREA ONLY
.................................
Bulletin#100—April 14,2010 Page 2 of 3 k:\Handouts\Perrnit Application