13-102368M
Plumbing
CRY& Community Permit #: 13 -102368 -00 -PL
33325 8th Ave S L+=
Federal way, WA 98003 Inspection Request Line: 253 835-3050
Ph: (253) 835-2807 Fax: (253) 835-2609 � �
Project Name: THE PARK AT DASH POINT BLDG H
Project Address: 4940 SW 3197M LN Bldg H Parcel Number: 112103 9129
Project Description: Replace domestic water lines throughout building
Owner
ARRIlican
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 Fbdures
Other Plumbing Fixtures ............... 13
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 Statebf Washington
Seeand Application the City of Federal Way.
Owner or agent: Date:
MAY 31 wo
FINAUw a/a/�3
CITY OF '400
Federal "Alay
THIS CARD IS TO MAIN ON-SITE of
Construction In ection Record
INSPECTION REQ TS: (253) 835-3050
PERMIT #: 13 -102368 -00 -PL Address: 4940 SW 319TH LN Bldg H
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.
0
Plumbing Groundwork (4 0)
E]
Rough Plumbing (4230)
11
Gas Piping (4125)
Approved to cover
By
Approved
3
Approved to release test
By
Date
By
Date
By
Date
0
Final - Plumbing (4 75)
Approved
By6
Date
Right of Way —^
Approved
By
Date
3
boy � i�3
Date
ZqVl
By
l6,7
❑
Rough Electrical
Approved
Final Electrical
Approved
Right of Way —^
Approved
By
Date
By
Date
By
Date
crffoF APERM ITIPPLICATIO N
Federal Way
RECEIVED ��,��,
MAY 302013 �
PERMIT NIIMBER - _ ` Z (Q g ---2L TARGE; TARGET DATE _ , %V AV
cin M *-)'r- , ---
SITE ADDRESS - SUITE/UNC
L-Mtko 5 LIN.�► 13
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL N
$ (� 0!0 i i2, L 0 3—— 12
TYPE OF PERMIT ❑ BUILDING PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT p rt r r t`t i C1 .� f 1_ �n _ (A ^ t
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OR;NER
AO /✓e_
CONTRACTOR
APPLICANT
PROJECT CONTACT
(The individual to receive and
respond to all correspondence
concerning this application)
(Z L, Ili e-5
NAME
PRIMARY PHONE
k, V50yj
MAILING ADDRESS
E-MAIL
9ITY
STATE
ZIP
_
S e a
�-21
1�1 i
NAME ,
e, 6 es 5
PHONE
'103 -
MAILING ADDRESS
E-MAIL
CITYSTATE
ZI
FAR
;t3Ol
VyAiSTATE N CTOR'S LICENB,&{ M EXPIRATION
n0/I�3/3G
FEDERAL AY BUSINESS L
ICENSE MC2
NAME
PRIMARY PHONE
S e_1e
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
NAME_
'1
PRIMARY PHONE
'3 ` 8 T
MAILING ADDRESS
E-MAIL i �•+ /+,
w 1 1 �/V l 1 t�'•7
CITY
STATE
ZIP
FAX
NAME
PROJECT FINANCING 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 lincluding costs, expenses, and attorneys' fees incurred in
the investigation and defense of such ciainq, 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.
F e}�' 4 i
SIGNATURE: �.> ;a- DATE
t
PRINT NAME: t ty
Bullehn #100 Liiivary 1. _013 Page i of 3 K:AIlaildouts\Permit Application