14-104623City of Federal Way
Community & Eoon. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
%.Plumbing
Permit #: 14 -104623 -00 -PL
Inspection Request Line: (253) 835-3050
Project Name: FEDERAL WAY HIGH SCHOOL - TEMPORARY PORTABLE T-4
Project Address: 30611 16TH AVE S Parcel Number. 082104 9001
Project Description: Connect domestic water supply to portable structure.
Owner
FEDERAL WAY PUBLIC SCHOOLS
A1212lecant
LLOYD ENTERPRISES INC
Contractor
LLOYD ENTERPRISES INC
33330 8TH AVE S
PO BOX 3889
LLOYDI*238QB (4115115)
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: I I Iff Date:
CITY CW
A
FedW
PERMIT #:
Project:
THIS CARD IS TO MAIN ON-SITE
Construction In ection Record '
INSPECTION REQ TS: (253) 835-3050
14 -104623 -00 -PL Address: 30611 16TH AVE S
FEDERAL WAY PUBLIC SCHOOLS FEDERAL WAY, WA 98003-4903
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.
Final - Plumbing (4075)
Approved
By 0 Date
Plumbing Groundwork (4190)
❑
Rough Plumbing ( 230)Gas
Final Electrical
Approved
Piping (4125)
1:1Approved
Approved to cover
By
Approved
Approved to release test
By
Date
By
Date
By
Date
Final - Plumbing (4075)
Approved
By 0 Date
Rough Electrical
Approved
Final Electrical
Approved
1:1Approved
Right of Way
By
Date
By
Date
By
Date
At
OCEIVE® 0
Cl" OF ;�... PERMIT APPLICATION
Federal Way SEP 0 8 2014
CITY OF FEDERAL
/
PERMIT NUMBER
TARGET DATE /� r
SITE ADDRESS
SUITE/UNIT li
30 6 t( PPe tf� i �,s
I
PROJECT VALUATION
ZO G
ASSESSOR'S T /PARCEL #
$ 0 . ct�
-
TYPE OF PERMIT
❑ BUILDING kl PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
�� c- W (c d -scko _. t 12)2a%�'� � . fildj) 14 � /�'J/'2 UA` <
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME/I `` � //''�� //
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PRIMARY PHONE
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NAME
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EMAIL
CONTRACTOR
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ZIP
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FAX
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WA STATE CONTRACTOR'S LICENSE R
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EXPIRATION DATE
4-/ rS� ��
FEDERAL WAY BUSINESS LICENSE N
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NAME
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PRIMARY PHONE
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MAILING ADDRESS
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E-MAIL i t�
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APPLICANT
CITY / STATS
ZIP
FAX
NAME
PRRY PHONE
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27
PROJECT CONTACT
c��i
MAILING ADDRESS
3,5>eM�
EMAIL I
10 r� 42 t 1 t'o
(The individual to receive and
respond to all correspondence
l-fc�j (jJ�L
STATE
O'
ZIP
0 6 3
FAX 9
2:3'`'0,3 k e' 13
concerning this application)CIT}
PROJECT FINANCING
NAME
OWNER -FINANCED
❑
Required value of $),000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
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 as a p 'rt of this application.
city
SIGNATURE: DATE
PRINT NAME: ���� ✓ til
Bulletin #100 —January 1, 2013 Page I of 3 k:ANandouts\Permit Application
1C. � i
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GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
# of
LO'
in Square Feet
Type
$ O
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Do not inctude existing fixtures to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS
OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS
HOODS Ic—rc,ail
OTHER (Describe)
BOILERS
FURNACES
HOT WATER TANKS (Gast
AREA DESCRIPTION
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
# of
DUCTING
GAS PIPING
WOODSTOVES
TOTAL FDtTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING PERMIT
# of
LO'
in Square Feet
Type
$ ;�vp ,
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Do not include existing fixtures to remain.
BATHTUBS (or Tub/ Shower combo)
LAVS (Ha d Sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
AREA DESCRIPTION
DRINKING FOUNTAINS
SINKS Xtchen/Utility)
WATER HEATERS (E(«triq
# of
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FDtTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
# of
LO'
in Square Feet
Type
Stories
$ haute-
EXISTING/PREVIOUS USE
LOT SIZE )In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
-
❑ Yesj?'iVo
❑ Yes g No
RESIDENTIAL -NEW OR ADDITION
AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASENIENT
FIRST FLOOR (or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT 11
OTHER (describe)
EXISTING PROPOS® TOTAL
Area Totals
**NEW HOMES ONLY*
ESTIMATED SELLING PRICE $ # OF BEDROOMS
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION
Area
Occupancy Group(s)
Construction
# of
Additional Information
in Square Feet
Type
Stories
NEW BUILDING
-
ADDITION
COMMERCIAL — REMODEUTENANT IMPROVEMENTS
AREA DESCRIPTION
Area
Occupancy Group(s)
Construction
# of
Additional Information
in Square Feet
Type
Stories
TOTAL BUILDING
TENANT AK@;A ONLY
PROJECT ARFA ONLY
Bulletin #100 —January 1, 2013 Page 2 of 3 k:\Handouts\Permit Application