16-105919 r
Plumbing
City of Federal Way • •
C Devel eat 3F 1 r Permit #.16-105919-00—PL
ry � �
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax(253)835-2609
Project Name: VILLAGE GREEN HEARTHSIDE AND GARDENS
Project Address: 35419 1ST AVE S Parcel Number:302104 9024
Project Description: Install(1)sink,(1)floor sink and(2)coffee makers.
•
Owner Applicant C• ractor
VILLAGE GREEN FEDERAL WAY HOWARD H FERGUSONHOWARD'S H o'S PLUMBING
PO BOX 98309 PLUMBING ' .""•884RM(12/14/18)
DES MOINES WA 98198 PO BOX 53
ENUMCLAW WA 98022 PO BOX 53
ENUMCLAW WA 98022
Other Plumbing Fixtures 2 Sinks
PERMIT EXPIRES Monday, IL) ne,2017
Permit Issued on Wednesday, ber 14,2016
I hereby certify that the above information is correct an• - e construction on the above described property
and the occupancy and the use will be in accordanc= r the laws,rules and regulations of the State of
Washington and C, of Federal Way.
Owner or agent: cf/ C.t�iAo V' . (es /Zod rDate: l d �d fJ 00
•
ismi —
THIS CARD IS TO REMAIN ON-SITE
FederalY Construction Inspection Record
INSPECTION REQUESTS:(253)835-3050
PERMIT#: 16 105919 00 Address: 35419 1ST AVE S
•
Project: VILLAGE GREEN FEDERAL WAY FEDERAL WAY WA 98003
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 my of the inspections or the inspection sequence. On-going inspections are logged on the back of this card.
Plumbing Groundwork(4190) 13 Rough Plumbing(4230) 0 Final-Plumbing(4075)
Approved to cover Approved Approved
By Date By _ • Date . ,,,I _ By Date
0 Rough Electrical 0 Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
RJOEIVE® PERM IPAPPLICATION
CITY OF
1 2016 PERMIT CENTER + 33325 811, Avenue South + Federal Way, WA 98003-6325
Federal Way DEC 253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
PERMIT NUMBER I (�o _
CITY OF FEDERAL WAY
® TARGET DATE
SITE ADDRESS
SUITE/UNIT #
3,'c I ► ST a v e v'l
ROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$3..00
TYPE OF PERMIT
❑ BUILDING PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
V I L L 081 --C{ rJ& Ls
PROJECT DESCRIPTION
T -t l "i
Detailed description of work to
I / �Lo it
Bak C
be included on this permit only
N
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,S-
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
NAME
PHONE
ADDRESS
E-MAIL
CONTRACTOR
VOLING
w 1 43 CV1U 1
CITY
STATE
ZIP
FAX
9. G LCA w
w
7 ::)1 -
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
4, L o
MAILING ADDRESS
O 8 0
E-MAIL
APPLICANT-
CITY
STATE
ZIP
FAX
'
b 14WG
lv
2�
NAME
PRIMARY PHONE
PROJECT CONTACT
d L✓ M Y' Funo
MAILING ADDRESS J
flo
E-MAIL
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
@ (4 G
fit/
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
When value is $5,000 or more
(RCW 19.27.095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
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 apart of this application.
SIGNATURE: DATE
PRINT NAME: ijOlnZ a dt/
Bulletin #100 — January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application
'N
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how many o each tjype offixture to be installed or relocated as part of this Project. Do not include existing res to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial)
BOILERS FURNACES HOT WATER TANKS pas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR -
VALUE OF PLUMBING WORK
PLUMBING PERMIT
-a
.___.....___....._..___.__--._.___ ._—.._____.._.... ..—........ —_
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
$ 37692
Indicate how many o each type offixture
to be installed or relocated as
part o this project. Do not include existin rest remain.
BATHTUBS (or Tub/shower combo)
LAVS (Hand Sinks)
TOILETS
cL *WLTR Wplri G
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
7 --Ca f lr10
DRINKING FOUNTAINS
�` SINKS xtchenxtility)
WATER HEATERS (Electric)
) ' ✓►�-t i'ts✓
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR -
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
-a
.___.....___....._..___.__--._.___ ._—.._____.._.... ..—........ —_
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
r
❑ Yes ❑ No
❑ Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet) EXISTING PROPOSED
TOTAL
FOR OFFICE USE
•,,;: +;,, ; ,� �. .a xlhv ��• Y t t ,.h�}.
-a
.___.....___....._..___.__--._.___ ._—.._____.._.... ..—........ —_
FIRST FLOOR (or Mobile Home)
r
_.............. _... ----..... ----_...__............... __............
'46
COVERED ENTRY
k.
p.41't.
. .....
GARAGE ❑ CARPORT ❑
Area Totals EMSTING PROPOSED
TOTAL
y
0111 V)
ESTIMATED SELLING PRICE $
# OF BEDROOMS
Bulletin #100 — January 29, 2016 Page 2 of 2 k:\Handouts\Permit Application