07-104851a
City of Federal Way
,ommunity Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253)835-2607'Fax: (253)835-2609
Plumbing Permit #: 07-104851-00-l"L
Project Name: VALLEY MEAT
Project Address: 28855 MILITARY RD S
Project Description: Gas pipe outlets to range, fryer an gr'
Inspection Request Line: (253) 835-3050
t
L` Parcel Number: 042104 9037
FY
Owner
A licant
Contractor
EXECUTIVE HOUSE INC
TE FI OTECTION & S
TEGA FIRE PROTECTION & SVC
;'TEGA
7517 GREENWOOD AVE N
GA P TION ER
ORTEGFP997PJ 2/8/08
SEATTLE WA 98103
5134 UC
FIRE PROTECTION AND SERVICES 11
SEATTLE 1 -2 1
5134 S LUCILE ST
SEATTLE WA 98118-2531
PERMIT EXPIRES Thursday, September 3, 2009
Permit Issued on Tuesday, September 4, 2007
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:_
THIS CARD IS TO REMAIN ON-SITE
cir., OF,Av Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 07 -104851 -00 -PL
Owner: EXECUTIVE HOUSE INC
Address: 28855 MILITARY RD S .
FEDERAL WAY, WA 98003-7912
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) ❑ Rough Plumbing (4230) ❑ Gas Piping (4125)
Approved to cover Approved Approved to release test
By Date By Date B Date
❑ Final - Plumbing (4075)
Approved
By Date
For inspector reference only
O Rough Electrical 0 FINAL - Electrical
Approved Approved
By Date By Date
ariaFaderalWay
200 PERMIT
CoaaWNff ava0j'M xrSMWres SF MF CO ME E(PL DE EN FP
33325dnAV¢M/Y,Wl171•P BOX -9718 1a SEP PLICATION
FEDERAL WAY, WA 98063-971 d
2S3 -d352607• FAX 2S3-8359609
lV�u�r.aaa g•rom r BUILD NG DEPT•
The following is required information - an incomplete application will not be accepted Please print.legibly (in ink) or type.
PROPERTY•• •
SITE ADDRESS __ 119 , yyy7_e,- SUITE/UNIT 9
ASSESSOR'S TAX/PARCEL * LOT SIZE (sj)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
■ PROJECT INFOMIATION
TYPE OF PERMIT ❑ BUILDING J(PLUMBING. . ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ .FIRE PREVENTION SYSTEM
PROJECT DEES�CRIPTION (Provide detailed description of work included on this permit onlu)
QZ 4)e—G1►c�F—�dl�iI�
PROJECT. NAME (Name of Business or Owner Last Namel PEOPLE INFORMATION
•• •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAME
PRIMARY PHONE _
MAILING ADDRESS
ITY, STATE, ZIP
MAIL ADDRESS
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
'
k
(266)
'zt!"-;,'
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
-
�3
OF FEDERAL WAY BUSINESS LICENSE NUMB&R
EXPIRATION DATE
FAX NUMBER
)
CONTRACTOR18 REOIBTRATION NUMB
ERP TION DATE
E-MAIL ADDRESS
PT
02-09-L
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other CGv,jv-4 '•-
NAME PRIMARY PHONE E-MAIL ADDRESS
_ 2
NAME
Per RCW 19.27.095t
Lender iq formation is required i f project value exceeds $5,000 .
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $VALUE OF PROPOSED WORK
SPRINKLERED BUILDING? ❑ YES ❑ NO
FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 4 YES
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE
❑ TACOMA ❑ PRIVATE (WELL)
❑ PRIVATE (SEPTIC)
❑ NO
PROJECT •••
AREA DESCRIPTION
AREAS
o REPAIR a TENANT IMPROVEMENT
E%ISTINO
So. FT.
PROPOSED
SQ.FT.
TOTAL
SO. FT.
BASEMENT
o NO
ZONING DESIGNATION
CHANGE OF USE?
o YES
o NO
NEW ADDRESS REQUIRED?
SECOND
UP/SEPA/SU?
o YES
o NO
THIRD
o YES o NO
DEMO PERMIT REQUIRED?
o YES
ADDITIONAL FLOORS (DESCRIBE)
DECK (0 COVERED OR 0 UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
MEMO
TOTN.
°'6j'"sxMV=1O1J
"rarauroesaall
Torncsr
**NEWHOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
Value of Mechanical Work
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
BATHTUBS (oriub/sho combq
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
(ACOP OF BID OR ESTIMATE MUST BE INCLUDED WITHAPPLICATIONJ
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS LOG SETS
LAVS Mw-. sink,)
RAINWATER SYST
SHOWERS
SINKS
SUMPS
_ OAS PIPE OUTLETS
GAS WATER HEATERS
HOODS �commud,q
RANGES
REFRIG. SYSTEMS
URINALS
VACUUM BREAKERS
WATER CLOSETS rrwkq
WASHING MACHINES
WOODSTOVES
T M1SC (Describe)
MISC (Describe)
I cert(jg under penalty of perjury that I am the property owner or authorised agent of the property owner. I cenVy that to the best of my
knowledge, the information submitted to support of this permit application is true and correct. I eertVy that I will comply with all applicable
City of Federal Way regulations pertaining to the work authorised 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 c/almh which may be made by any person, including the undersigned, and flied against the city, but only
where such claim artses 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. A
SIGNATURE:
Owner
9- /( `',a
o NEW o ADDITION
o. ALTERATION
o REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY?
o YES. D NO
BASIC PLAN?
o YES
o NO
ZONING DESIGNATION
CHANGE OF USE?
o YES
o NO
NEW ADDRESS REQUIRED?
o YES o NO
UP/SEPA/SU?
o YES
o NO
PLATTED LOT?
o YES o NO
DEMO PERMIT REQUIRED?
o YES
a NO
Bulletin #100 -August l6, 2007 Page 2 of 4 . k\Handouts\Permit Application