03-101162 •
4
City of Federal Way Plumbing Permit #:03 - 101162 - 00 - PL
Community Development Services
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: OHS SANJIVNI LLC
Project Address: 2120 S 314TH Parcel Number: 092104 9053
Project Description: PL-Installing fridge unit,ice machine,hand wash sink,3 complrtment sink and mop sink
Owner Applicant Contractor
ROSEN PROPERTIES GUAREN SOOD GUAREN SOOD
PO BOX 5003 PO BOX 3055 PO BOX 3055
BELLEVUE WA 98009 KENT WA 98032 KENT WA 98032
(206)372-9056
Plumbing Fixtures
Description Quant ', bescription , ;. ]Quaartfity Descrl bo
p i iQuartity
LSinks 3
PERMIT EXPIRES October 6,2003.
Permit issued on April 9,2003
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: Q (oci 4 3
irtei
(/) 'Ti/0 -
//11
® 0 C CONSTRUC PERMIT APPLICATION
C',T Y OF E ` El'
Federal Way R ��v APPLICATION NUMBER: 03 - -/ Di L)Z- 0
Y APPLICATION NUMBER: - -
wiAR 2 5 20a_ APPLICATION NUMBER: - -
"The following is regyjte� nformation-'#Please print(in ink)or type** ��
Please note: Electrical, Fire Prevention Systems))ttand Engineering permits may require a separate application. V '`
- ■ PROPERTY INFORMATION
SITE ADDRESS: 2120 6 314 Si Ftdeuit Way `t8DD3 ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
- ■ PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING o MECHANICAL o DEMOLITION
❑ ELECTRICAL 0 ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
Field/6 c4.ru°t, ,.TC: macluf.,a , 6/-64 lndksA s;i/ct 3 anraninlemt si14, ./790.s/tIk
PROJECT NAME: :� �it,4 CNy Ll. r I k) LLC
a.►
■ PEOPLE INFORMATION
PROPERTY OWNER: NAME:RO`'S PR OPE ?-r,ES' ; DAYTIME PHONE:
(4125 )652- -1623
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
P o Qo) Soo 3
CONTRACTOR: NAME: S p- P
�' DAYTIME PONElit r :MAILI RESS(STREET AA DRESS; Y,STATE.ZIP): EVENING PHONE
i ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: I FAX NUMBER:
i ( )
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) I __ - / /
APPLICANT: NAME: DAYTIME RHONE
AURA Y c (206)3572 - q056
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
I s PO 16e7 055 Kent Wa- g8a3 . (206 ) g72 - c/o%G
I RELATIONSHIP TO PROJECT: j FAX NUMBER:
❑ ARCHITECT o TENANT n OTHER ( DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT a CONTRACTOR /10 3-72-q°56 !co
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? 0 YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES ❑ NO
WATER SERVICE PROVIDER: o LAKEHAVEN o HIGH LINE n TACOMA n PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION Ot * •
ESTIMATED SELLING PRICE: $ _
NUMBER OF BEDROOMS: �
■ PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
• FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) _REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) _ WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) _ MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC o GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) o ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) t>I+* SINK(S) WATER CLOSET(S) _ MISC.( )
INTERCEPTOR(S) SUMP(S)
■ 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 daim(including costs,expenses,and attorneys'fees incurred in the
investigation and defense of such claim),which may beinade by any person,including the undersigned,and filed against the City of
Federal Way,but only where such daim arises out o ' e reliance of the city,induding its officers and employees,upon the accuracy
of the information supplied to the city as a part of A is ication.
NAME/TITLE: .0"• GOO DATE: 3-24-203
❑ PROPERTY OWNER ffvAPPLICANT ❑ C•:\• 02R
I1 ►
FOR OFFICE:USE°ONLY
NEW4.
. O ADDITION.� ALTERATION y▪ t7'REPAIRS � TENANT IMPROVEMENT .
tCENSUS CODE ,. :-tqAQ max * ? ;LOT
ZQNINGDESIGNATION,,, �,,,, BUILDING•SHELL*ONLY?., D YESt_,❑ NO _
COMP PLANDESIGNATION n: ,, :BASIC PLAN?,4WYES ' ❑`,NO„ .
SECTION .TOWNSHIP . `RANGE U 'NEW ADDRESS REQUIRED? .. ❑YES -o
PLATTED LOT? a YES " ;i7 NO r CHANGE OF USE? Cl YES";-=o NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
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