14-104620Plumbing
City ofFederal Way
Community & Econ. Mv. Services Permit #: 14 -104620 -00 -PL
33325 8th Ave S
Federal Way, WA 98003 253 Ins tion Re uest Line:
Ph: (253) 835-2607 Fax: (253) 835-2609 p 4 () 835-3060
Project Name: FEDERAL WAY HIGH SCHOOL - TEMPORARY PORTABLE T-1
Project Address: 30611 16TH AVE S Parcel Number: 082104 9001
Project Description: Connect domestic water supply to portable structure.
Owner
FEDERAL WAY PUBLIC SCHOOLS
ApRilcant
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: Date:
FILE
CITY OFV&
4
Federal Way
PERMIT #:
14 -104620 -00 -PL
THIS CARD IS TO MAIN ON-SITE
Construction In ection Record
INSPECTION REQ TS: (253) 835-3050
Address: 30611 16TH AVE S
Project: 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.
0
Plumbing Groundwork (4190)
❑
Rough Plumbing (4230)
Final Electrical
Approved
Gas Piping (4125)
11
Approved to cover
By
Approved
Approved to release test
By
Date
By
Date
By
Date
Final - Plumbing (4075)
Approved
By Date `
Rough Electrical
Approved
Final Electrical
Approved
11
Right of Way
Approved
By
Date
By
Date
By
Date
'LL)
SEP 0 2014
CITY OF
Federal way CITY OF FEDERAL WAY
CDS
PERMIT NUMBER I Y _ / 0 y � ;� V _
PERMITOAPPLICATION
TARGET DATE
SITE ADDRESS
SUITE/UNIT#
PROJECT VALUATION
ZO *G
ASSESSOR'S T /PARCEL #
$
TYPE OF PERMIT
❑ BUILDING � PLUNIBING ❑ MECHANICAL ❑ DEMOLITION ❑ FNGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
�� L ( 1: l (G % S(��jL ! ���%C� fi ID , � �llZ AC S
C,,-n�W c etc'wYr ° d I i ��� j AC
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER(?
NAME /�
C�1!
PRIMARY PHONE
MAILING ADDRESS
44 3333o
E-MAIL
gwdor
CITY f�
STA'L�rt
Zip 6oc
NAME/
L l � 6/
PHONE
2!S- '� - 1-7
MAILING ADDRESS
G
E-MAIL
CONTRACTOR
CITY
re-j"�,, �
STATS
L
ZIP
99C/ (, 3
FAX
Z5"� -- 33�-2 tG 3
WA STATE CONTRACTOR'S LICENSE #
LLtaYu� 23°
EXP_ IRATION DATE
�f� 15_
FEDERAL WAY BUSINESS LICENSE #
jn2)39-cO
_
PRIMARY PHONE
2,
MAILING ADDRESS
Poo &-x 3b2O
E-MAIL
k< wt l(�Tb c)qA n5RI l
APPLICANT
CITY'e �ca/I V'�
STATES
LL,'✓✓/I
ZIP C G/l/� J
FAX 2h
2'Sl Z
NA/MLLE
PRIMARY PHONE
PROJECT CONTACT
MAILING ADDRESS /
E-MAI`L. I
(The individual to receive and
respond to all correspondence
CI
Tpie ,� U�z�
STATE
ZIP
FAX 7
z�3-�3�-�t�>3
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)
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 city as a p 'rt of this application.
SIGNATURE- _DATE
i
PRINT NAME: ti(
Bulletin #100 —January 1, 2013 Page I of 3 k,AHandouts\Permit Application
,)C. C C51
C-� CC'/Y
e
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
FOR OFFICE USE
Lv%)
NEW BUILDING
$ U
Indicate how many of each type offixture
to be installed or relocated as part
of this project. Do not include
existing fixtures to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS
OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS
HOODS Commercial
DRAINS
BOILERS
FURNACES
HOT WATER TANKS (call
DRINKING FOUNTAINS
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
HOSE BIBBS
DUCTING
GAS PIPING
WOODSTOVES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING PERMIT
FOR OFFICE USE
Lv%)
NEW BUILDING
$ ; 00'
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 (H—dSlnka)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DECD
DRINKING FOUNTAINS
SINKS (Kitchen/Utility(
WATER HEATERS (Eleatr;cl
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
FOR OFFICE USE
Lv%)
NEW BUILDING
FIRST FLOOR (or Mobile Home)
$ hm4e_
EXISTING/PREVIOUS USE
LOT SIZE (In Squ— Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ONo
❑ Yes ie No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
BASEMENT
NEW BUILDING
FIRST FLOOR (or Mobile Home)
ADDITION
SECOND FLOOR
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
COVERED ENTRY
Occupancy Group(s)
Construction
a
# of
Stories
Additional Information
DECD
GARAGE ❑ CARPORT ❑
TENANT ARh:,I ONLY
OTHER (describe)
PROJECT AK EA ONLY
Area Totals
EXISTING
PROPOSID
TOTAL
*`NEW HOMES ONLY**
ESTIMATED SELLING PRICE -$
I # OF BEDROOMS
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION
Area
in Square Feet
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
NEW BUILDING
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area
in Square Feet
Occupancy Group(s)
Construction
a
# of
Stories
Additional Information
TOTAL, BUILDING
TENANT ARh:,I ONLY
PROJECT AK EA ONLY
Bulletin #100—January 1, 2013
Page 2 of 3
k:\Handouts\Permit Application