14-104624City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2807 Fax: (253) 835-2609
Plumbing
Permit #: 14 -104624 -00 -PL
w"
Inspection Request Line: (253) 835-3050
Project Name: FEDERAL WAY HIGH SCHOOL - TEMPORARY PORTABLE T-5
Project Address: 30611 16TH AVE S Parcel Number: 082104 9001
Project Description: Connect domestic water supply to portable structure.
Owner
ARRIIcant
Contractor
FEDERAL WAY PUBLIC SCHOOLS
LLOYD ENTERPRISES INC
LLOYD ENTERPRISES INC
33330 8T11 AVE S
PO BOX 3889
LLOYDI*238QB (4/15/15)
FEDERAL WAY WA 98003
FEDERAL WAY WA 98063-3889
PO BOX 3889
FEDERAL WAY WA 98063-3889
Plumbing Fixtures
Other Plumbing Fixtures ............... 1
PERMIT EXPIRES Sunday, March 8, 2015
Permit Issued on Tuesday, September 9, 2014
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:
A�k I I
CITY OF V
Federal Way
PERMIT #:
Project:
THIS CARD ISTO MAIN ON-SITE
Construction In ection Record
INSPECTION RETS: (253) 835-3050
14 -104624 -00 -PL Address: 30611 16TH AVE S
FEDERAL WAY PUBLIC SCHOOLS FEDERAL WAY, WA 980034903
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.
0 Final - Plumbing (4075)
Approved
By Date
L
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
Plumbing Groundwork (419)
Rough Plumbing (42 0)
Gas Piping (4125)
Approved to cover
Approved
Approved to release test
By
Date
By
Date
By
Date
0 Final - Plumbing (4075)
Approved
By Date
L
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
4
Federal Way
RWEIVED
SEP 0 8 2014
PERMIT APPLICATION
CITY OF FEDERAL VVAY
/ CDS /
PERMIT NUMBER / I _ / 0- y j C-/ _ e L
AOI -13 L, 7-5
TARGET DATE ZC? Y
1
SITE ADDRESS )) )
SUITE/UNIT #
3G � v Pike-tf"t c t s �.Q x
I Lick
PROJECT VALUATION
ZO G
ASSESSOR'S T /PARCEL #
$
TYPE OF PERMIT
❑ BUILDING e PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECTr
_r�Iz c t /yl_ ( W Z,(J Sr�I{ OL Pf1C'�/0-T ` 1?;4)7 1D kyaACL, <
I e ej C,�Mv5dIZc���,
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME t
r�CIO LIC
PRIMARY PHONE
2^Qr1
�
MAILING ADDRESS
E-MAIL
CITYSTA
C
ZIP
NAME
PHONE
MAILING ADDRESS 1 r
UMAIL
CONTRACTOR
CITY
e-je',c,
t p
ZIP
FAX
��—2,30,�-0\63
WA STATE CONTRACTOR'S LICENSE #
Ltelybr
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE M
10 -00--02)39-CO-
NAME
k4ilo
PRIMARY PHONE
L.5'3- $"35- t,(e 1 3
I t
MAILING ADDRESS
3b2fi
E-MAIL
In'b Ft5?S[
APPLICANT
CIT/FAX
/O,Pu �I
G,✓1
3�
i /h — G 3
2-'5^
NAME /
�-
PRI MARY PHONE
27 - U3
PROJECT CONTACT
r 4
MAIIILING ADDRESS
/ G<
E -MARL. I
(The individual to receive and
respond to all correspondence
e�t5,J U�r_L
STATE
ZIP
FAX '
3-03s�- t�'3
concerning this application)CIT
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
Required value of $),000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW ]9.27.095)
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 rt of this application.
�cityasap
fL
SIGNATURE: C-< `' DATE b: / 7 —
PRINT NAME:
Bulletin #100—January 1, 2013
Page I of 3
k:\Handouts\Permit Application
Ic , cc,
C ; k cvy
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OFMECHANICAL WORK
MECHANICAL PERMIT
# of
Stories
LO 'z)
NEW BUILDING
$ U
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Do not include existing tures to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS
OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS
HOODS (cornm—iaq
OTHER (Describe)
BOILERS
FURNACES
HOT WATER TANKS (cast
TOTAL BUILDING
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING
GAS PIPING
WOODSTOVES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING PERMIT
# of
Stories
LO 'z)
NEW BUILDING
$ �,00 , C,Y,
Indicate how many of each type o
Ixture to be installed or relocated as
part of this project. Do not include existing ixtures to remain.
BATHTUBS (or Tub/Snow« combo(
LAVS (Hand sinks(
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
TOTAL BUILDING
DRINKING FOUNTAINS
SINKS (Eimhen/Utility(
WATER HEATERS (Eleario(
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
# of
Stories
LO 'z)
NEW BUILDING
$ hm4e
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes O No
❑ Yes V No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
:BASEMENT
FIRST FLOOR (or Mobile Home)
SECOND FLOG
COVERED ENTRY
DECK
GARAGE ❑ CARPORT 11
OTHER (describe)
EXISTING PROPoSID TOTAL
Area Totals
*"NEW HOMES ONLY"
ESTIMATED SELLING PRICE -$-- it OF BEDROOMS
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION
Area
in Square Feet
Occupancy Group(s)
Construction
Tjpe
# of
Stories
Additional Information
NEW BUILDING
ADDITION
COMMERCIAL — REMODEUTENANT IMPROVEMENTS
AREA DESCRIPTION
Area
in Square Feet
Occupancy Groupls)
Construction
Type
# of
Stories
Additional Information
TOTAL BUILDING
TENANT AkEA ONLY
PROJECT AREA ONLY
Bulletin #100—January 1, 2013 Paue 2 of 3 k:AHandouts\Permit Application