13-105419• t
City of Federal way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003 v
Ph: (253) 835-2607 Fax (253) 835-2609'
k -8
Project Name: 7-11
Project Address: 28719 AHLITARY RD S
Project Description: Replace existing drain lines
Plumbing
Permit #: 13 -105419 -00 -PL
Inspection Request Line: (253) 835-3050
Parcel Number: 332204 9161
Owner
ARRlicant
Contractor
CGL PACIFIC LLC
LIBERTY PLACE VENTURER LLC
LIBERTY PLACE VENTURER LLC
376 EL EDCANTO DR
2918 SE LIBERTY PL
LIBERPV%7R7 (12/27/14)
PASADENA, CA 91107
GRESHAM OR 97080
2918 SE LIBERTY PL
GRESHAM OR 97080
Plumbing Fixtures
Drains............................................. 1 ti
PERMIT EXPIRES Tuesday, Ju ,2
Permit Issued on Thursday, Dep er�i;;r 013
I hereby certify that the above information is correct and that the ction on the above described property and
the occupancy and the use will be in accordance with the laws,es and reg ons of the State of Washington
and the City of F ral Way.
Owner or agent
THIS CARD IS TO REMAIN ON-SITE '
CITY CWConstruction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 13 -105419 -00 -PL Address: 28719 MILITARY RD S
Project: THE SOUTHLAND CORPORATION FEDERAL WAY, WA 98003-3332
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)
Final Electrical
Final - Plumbing (4075)
Approved to cover
By
Approved
Approved
By
JM6 Date
By
V-4 Date I 6
By
Date
Rough Electrical
Approved
1:1Approved
Final Electrical
Right of Way
Approved
By
Date
By
Date
By
Date
AL.
Clri OF
Federal Way
PERMIT NUMBER I
9 PERMIAAPPL�YATA'qN
- I (D 5-.j ( 9 - F`�'L
DEC 0 5 2013
TARGET DATE CITY OF FEDERAL. WAY
CDS
SITE ADDRESS
SUITE/UNIT M
C(!j 2d S
PROJECT VALUATION
ZONING
ASSESSOR'S C� a O 4 -
TYPE OF PERMIT
❑ BUILDING k YLUMBING ❑ MECHANICAL ❑ DEMOLMON ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION
aZAIAl
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME I
l�J
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
CITY
STATE
j
ZD'
NAME
/PHONE
C9— �
MAHdNG ADDRESS
LC
EMAIL
CONTRACTOR
CITY
o r
STA
d
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE M
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE N
NAEP C/ / n\/G'N
i
PRIMARY PHONE
MAILING ADDRESS rE-MAIL
APPLICANT
CITY
STATE
ZIP
FAX
NAME
PRIMARY PHONE
PROJECT CONTACT
MAILING ADDRESS
E-MAIL
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5, 000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
1 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 suppliiedd to the city as apart of this application.
SIGNATURE: / C DATE/ Z /�3
PRINT NAME: l /
Bulletin #100 — January 1, 2013 Pagel of 3 Uliandouts\Permit Application
AL
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing res to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commerciel)
BOILERS FURNACES HOT WATER TANKS (c.)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING PERMIT
Area
Occupancy Group(s)
Construction
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
$
Indicate how many o each type offixture
to be installed or relocated as
part o this project. Do not include existing res to remain.
BATHTUBS (or Tub/slower Combo)
LAVS (Hand sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Kitchen/utaity)
WATER HEATERS (Electric)
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FE[TURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IWROVEMENTS
Area
Occupancy Group(s)
Construction
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
ERISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No
[]Yes ❑ No
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION
Area
Occupancy Group(s)
Construction
# of
Additional Information
in Square Feet
a
Stories
.: ""',
w6k'
7777771!i1�VBUII;AINCf
ADDITION
COMMERCIAL — REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
I AreaOccupancy
Group(s)
Construction
# of
Additional Information
in Sauare Feet
Tvne
Stories
TENANT AREA ONLY
Bulletin #100 — January 1, 2013 Page 2 of 3 kAl-landoutsTermit Application