13-102171City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Plumbing
Permit #: 13 -102171 -00 -PL
i Inspection Request Line: (253) 835-3050
Project Name: THE PARK AT DASH POINT BLDG V
Project Address: 31710 50TH LN SW Bldg V
Project Description: Replace domestic water lines throughout building
Parcel Number: 112103 9129
Owner
Applicant
Contractor
K N L VISION WA LLC
PLUMBING EXPRESS SAGEWATER
PLUMBING EXPRESS SAGEWATER
3709 CONVOY ST SUITE 300
450-C S PICKETT ST
PLUMBES922JC (6/20/13)
SAN DIEGO, CA 92111
ALEXANDRIA VA 22304
450-C S PICKETT ST
ALEXANDRIA VA 22304
Plumbing Fixtures
Other Plumbing Fixtures ............... 14
PERMIT EXPIRES Tuesday, November 12, 2013
Permit Issued on Thursday, May 16, 2013
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: .A, Date:
CITY. -.A '
Federal Way
PERMIT #:
Project:
THIS CARD IS TO MAIN ON-SITE
Construction In ection Record
INSPECTION REQ TS: (253) 835-3050
13 -102171 -00 -PL Address: 31710 50TH LN SW Bldg V
K N L VISION WA LLC FEDERAL WAY, WA 98023
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)
0
Rough Plumbing (4 )Gas
Final Electrical
Approved
Piping (4125)
Approved to cover
By
Approved
Approved to release test
By
Date
B
Date
By
Date
Final - Plumbing (4075)
Approved
By\� Date
Y�
Rough Electrical
Approved1:1
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
Cm OF Tll�
Federal Way
CEIVED
MAY 16 202
CITY OF FEDERAL WAY
CDS
PERM IT*APPLICATION
PERMIT NumBER _/� _ /6 c� / 7 / — L�9 L
�obSK
TARGET DATE
SITE ADDRESS
SUITEJUNIT #
air. LP� 5 Q 423-55
1* y wulps
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL # 3 -
TYPE OF PERMIT
❑ BUILDING PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT',
^ 5
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME PRIMARY PHONE
5
MAILING ADDRESS
373 0CoNVo i 5 j00
E-MAIL
CITY STATE ZIP
S I e- d �- ( i
NAME
PHONE
N—
MAILING ADDRESS _
�i
EMAIL
CONTRACTOR
CITY
STATE'ypp
/n� L.f
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME_
PRIMARY PHONE
((��
e- V\\Q-o-
MAILING ADDRESS
d�\�1�\C, S2\
EMAIL
APPLICANT
CITY
STATE
ZIP
FAX
I� (� 0
I 1 . C
NAME..
SN
VS
PRIMARY PHONE
/
PROJECT CONTACT
�
MAILING ADDRESS
EMAIL
(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
fRCW 19.27.0951
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 part of this application.
SIGNATURE:-'� f- DATE A�
PRINT NAME:
Bulletin #100- .1anuary 1. 201.1 Page 1 of 3 k:AIfandowsAPermit Application