12-100844Plum-birig
City of ay
Community& Econ. Services Permit #: 12 -100844 -00 -PL
33325 8th Ave S
Federal Way, WA 98003
FILE
Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (2
53) 835-3050
Project Name: D AND A AFRICAN INTERNATIONAL MARKET
Project Address: 29100 PACIFIC HWY S Unit 9 Parcel Number: 042104 9073
Project Description: Adding new plumbing fixtures. /%,
Owner ARRIlican &fConfiractor
BEATRICE A RHODES SILVER 2 GOLD PLUMBING LLC IL R LD PLUMBING LLC
1000 TOWNCENTER NE 1419 49TH ST VE2G893ME 7/5/13
TACOMA, WA 98422 TACOMA WA 98409 ` 1419 49TH ST
TACOMA WA 98409
Plumbing Fixtur
Lavatories ....................................... 2 Sinks...................................... .... 2 Water Heaters................................. 1
Subject to field inspection without plans.
ow
PERMIT
I hereby certify that the above infor�Fn 'on is rrect and tt
the occupancy and the use will bei co ance with the
.� and theZ1 of
Owner or agent:
moo?
,,JWst 21, 2012
wary 23, 2012
(construction on the above described property and
rules and regulations of the State of Washington
al Way.
Date:
4%� CITY OF
Federal Way
PERMIT #:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
12 -100844 -00 -PL Address: 29100 PACIFIC HWY S Unit 9
Project: BEATRICE A RHODES FEDERAL WAY, WA 98003-3877
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)
E] Final - Plumbing (4075)
Approved to cover
Approved
Approved
By Date 3- !z" /z.By
Date
By Date
Rough Electrical
Approved
Final Electrical
Approved
1:1Approved
Right of Way
By
Date
By
Date
By
Date
400e
n„°, Federal Wa ERMIT
COMMUNITY DEVELOPME APPLICATION
'
253-835 2607 FAX 253609
wwww.ahloffederalwny.cout
FEB 4_A, NAY
rd
f
11-1
V
a
L _LQQg�±-�L
0 MF CO ME ODE EN FP
SITE ADDRESS L t�, -- " SUITE/UNIT#
lb
PR CT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL ;
W
TYPE OF PERMIT
❑ BUILDING( PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
enant Name/Homeowner Last Name
�' �
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME (
) e'l
PRIMARY PHONE
• 7r-") =� �
MAILING AMDE-MAIL4�
CITYF/�.t� `
Y
ZIP
/
` V ! t
NAME
PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE M
5IL.VE 8_h>ME
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE N
N`�,L V L f Z(-- - t _
PHONE `
APPLICANT
MAILING ADDRESS
1
L" ! S Ll �Z�h �ree
y�
E.L
1�jlL,kjef-LGcui
CITYSTATE
Gti[ei���
ZIP
`1-. L, L
FAX
?J -C 0
PROJECT CONTACT
NAME
PHONE
(The individual to receive and
respond to all correspondence
MAtLn�G AD° vl i7 L iftti ��
C? t4ATE
it -NAM
concerning this application)
j��C-bye
,61�
ZIP
�
FAX
ALTERNATE CONTACT NAME:,J
st�LL.{ s /t i C�' ��.
PHOffi_
'5? (> r1��
Z -MAIL
PROJECT FINANCING
AME
OWNER -FINANCED
Required value of $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
I cert(& under penalty of perjury that I am the property owner or authorized agent of the property owner. I cert(& 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 apart of this application.
SIGNATURE: DATE
PRINT NAME: ! L•
Bulletin #100 —January 1, 2091
Page 1 of 3
k:\Handouts\Permit Application
M
VALUE OF MECHANICAL WORK "`. ,_, (a copy of bid or ate must be provided)
Indicate how many of each type of fixture to be installed or relocateda—p'art of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
IN
AIR CONDITIONER FIREPLACE-ERTS HOODS (Commercial)
BOILERS _ ,FA:, -MACES HOT WATER TANKS (Gila)
COMPRESSORS GAS LOG SETS -REFRIGERATION SYST
DUCTING �''s GAS PIPING WOOMSTOVES
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) r
LAVS (HandSinka)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
I"1 C j �j� ry l� wrci
DRINKING FOUNTAINS
SINKS (Kitch—/Utility)
WATER HEATERS (Ei-tic)
HOSE BIBBS
SUMPS
WASHING MACHINES,
Bulletin #100— January 1, 2011 Page 2 of 3 k:\Handouts\Permit Application