13-102364Plumbing
Community & Ems,. S ices 5
33325 8th Ave S Permit #: 13 -102364 -00 -PL
-
Federal Way, WA 98003
Ph: (253) 835-2607 Fax. (253) 835-2609 tb' L' Y -- Inspection Request Line: (253) 835-3050
Project Name: THE PARK AT DASH POINT BLDG D
Project Address: 4905 SW 319TH LN Bldg D Parcel Number: 112103 9129
Project Description: Replace domestic water lines throughout building
Owner
Annlicant
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 Wednesday, November 27, 2013
Permit Issued on Friday, May 31, 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
Seen pp1ic� 1bry.
Owner or agent Date:
:IIAY 31 RECD
• THIS CARD IS TO MAIN ON-SITE
��� Construction In ection Record
Federal Way INSPECTION REQ TS: (253) 835-3050
PERMIT #: 13 -102364 -00 -PL Address: 4905 SW 319TH LN Bldg D
Project: 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.
Final - Plumbing (4075)
Approved
By Q •.� Date
Plumbing Groundwork (4190)
Rough Plumbing (4230)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 Q •.� Date
Rough Electrical
Approved
Final Electrical
Approved
1:1Approved
Right of Way
By
Date
By
Date
By
Date
MmOF,1A PERMITPPLN
Federal Way ��:�-c
M
AY 3 0 2013 01
PERMIT NUMBER I _ C/ / �l/ — �✓OF FEDERAL WAY
TARGET DATE
SITE ADDRESS
SUITE/UNIT B
49 ,NT %^'A
I I1 tAYV i
PROJECT VALUATION
$ 1 -4 0 09
ZONING
ASSESSOR'S TAR/PARCEL /
1 1 0-5 -9k-I 2 -
TYPE OF PERMIT
❑ BUILDING PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
Jftc 5
PRIMARY PHONE
MAILING ADD S
3 O ottl�p r 5 �4G
E-MAIL
TY
STATE
ZIP
NAME, C
-
03-
�'j1E-MAIL
MAILING ADDRESS _
LAr �� E'
CONTRACTOR
CITY Y
STATE
ZIp w
FAX
0
N ex Am baiek—
VA
Lf
WA STATE CONTRA ,1
R'8 LICENSE EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE M
NAME _
PRIMARY PHONE
MAILING ADDRESS _
1�50Oce h P\, (\,\-\ �—
E-MAIL
APPLICANT
C TY
STATE
ZIP
FAX
QN 0 .. i
PROJECT CONTACT
!NA\ME..
3� !
PRIMARY PHONE
-3-
MAILING ADDRESS
E-MAIL
') L&81
(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
(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.
` S
SIGNATURE: �� +, DATE
PRINT NAME: A),-?
Bulletin #100 {anuary 1, 201 3 Pace I of k:Ahandouts\Permit Application