05-103937 • •
ity of Federal Way Plumbing Permit #: 05 - 103931- 00 PL
community Development Services
I P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: TULLY'S COFFEE @ FRED MEYER
Project Address: 33702 21ST SW Parcel Number: 930100 0010
Project Description: Installing(2)new sinks for new coffee stand
Owner Applicant Contractor
FRED MEYER BOO CO CONSTRUCTION LLC BOO CO CONSTRUCTION LLC
3800 22ND AVE 5325 NE 109TH AVE 5325 NE 109TH AVE
PORTLAND OR PORTLAND OR 97220 PORTLAND OR 97220
(503)262-6750
Plumbing Fixtures
Description Quantity Description ;!Quantity Description Quantity
Sinks 2
PERMIT EXPIRES August 23,2007.
Permit issued on August 23,2005
I hereby certify that the above informatio orrect and that the construction on the above described property and
the occupancy and the use will be in ac•ordance ith the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: `—a / -15- _r_ Date: bl/Lyt9
CITY OF THIS CARD IS TEMAIN ON-SITE
tit Development Inspectio •n
n Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-103937-00-PL
Owner: FRED MEYER
Address: 33702 21ST AVE SW
FEDERAL WAY, WA 98023-7762
This card is part of your required inspection documents. 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) n Rough Plumbing(4230) 0 Gas Piping(4125)
Approved to cover Approved Approved to release test
By
Ki/f::--- Date 9/7/0,J— B `►f Date li 3 By Date
0 Final-Plumbing(4075)
Approved
By � ��
</ Date 1/7-/2
/k;
. CITY OF � / • C -17
Federal Way ��� ) J / b 3 7_ '
A PERMIT
t' COMMUNITY DEVELOPMENT SERVICES 7 0 8 200 r S F MF CO M E EL D E EN FP
33325 8Th AVENUE SOUTH•PO BOX 9718
APPLICATION
FEDERAL WAY,WA 530 3,a5V,d,,,)F rp _/ / , , / os_
253-835-2607•FAX 253-835-�/ F�QE� `4s...... ,
`/J�/
www.cityo((ederalway.com LDING,F.Tw„.1V
The ollowi . is re• fired in ormation-an incom.fete a.•lication will not be acce•ted. Please •rant le.ibi (in in or .e.
■ PROPERTY INFORMATION
SITE ADDRESS 33 70 Z 2/s1 e d iA Aoura/Ai:4u �9�: ,g'c SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - _ LOT SIZE(sj7
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal desorption)
■ PROJECT INFORMATION
4
TYPE OF PERMIT 0 BUILDING `Q}\PLUMBING 0 MECHANICAL
❑ DEMOLITION 0 ELECTRICAL 0 ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
. s7�Zi- v1/54; &A /Gage ',vs. /4,.6 .o '4ew o '
( f(ulwlblin� 60(y)
PROJECT NAME(Name of Business or Owner Last Name) /c 1`Y S (. /:::tiesa Meyer--
.
• PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE,�
OWNER GGfGrn.. ( J) G 32"
MAILING ADDRESS ZAP
CITY STATE, I
-; �' ` %r�1'!-- it f:774, laiartoni
CONTRACTOR COMPANY NAME v APPLICANT NAME OFFICE PHONE
EDD !,. ,sA,eth i � � lG/4o2�h1 (f03 ) z - 4761"
MAILING ADDRESS�� /D`9� v� CITY,STATE,ZIP /�/p�J(��J CELLPHONE /%!��
CITY OF FEDERAL WAY BUSINESS LICENSE 41� � az.
DATE (F97//)X E 20/
R
C .2-11 y00 (o_ _-BL iC-- / 3/ / 6S- (55' ) ZZ- - /, /
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each applications EXPIRATION DATE
jsOO6OCC 7yX3 r.' l •- / 0/
APPLICANT COMPNAME n � Y� � ' APPQA:
LICANT NAM��. , OFFICE PHONE
.4&10 (/tv/ 1✓ LX l<<L/ 1.,4-,.. - + 5c,^- (,�`•j 3 ) �'G,z. -lvS?i�MAILING ADDRESS CITE,ZIP CELL PHONE
3 Z.; /Vi:s 10; «74/400 6.— `l1l7- (7 7/ ) 227 - 34,v4
RELATIONSHIP TO PROJECT /) FAX NUMBER
❑ Architect ❑ Tenant o Agent pXOther(Describe) (.i."•Oink-ft i, ( ) -
CONTACT NAME / PRIMARY PHONE E-MAIL ADDRESS
( ) -
LENDERi �t l ! NAME
K 00 � t. ;
MAILING ADDRESS CITY,STATE,ZIP
• • ■ DETAILED BUILDING INFORMATION ' .
EXISTING USE 1-r/ PROPOSED USE T 2 II
EXISTING ASSESSED/APPRAISED VALUE $ A ,J- VALUE OF PROPOSED WORK $ /V 4-
SPRINKLERED BUILDING? ,YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES /(NO
WATER SERVICE PROVIDER LAKEHAVEN 0 HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER frLAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
•
- . i PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
_ SQ.FT. SQ.FT. SQ. FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH .
ADDITIONAL FLOORS(DESCRIBE)
•
DECK(COVERED?)
GARAGE 0 CARPORT 0
EXISTING PROPOSED TOTAL TOT L7¢ IN f .y, I ►ROPOSW!(F y AG`6r�
NUMBER OF FLOORS e,1•••••:
, - -r.'f5 ' a a i :t
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES.
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commereia1) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
/^
f
PLUMBING
BATHTUBS(or Tub/Shower Combo( SHOWERS WATER CLOSETS(rose) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
' DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further, that I
am authorized by the owner of the above premises to perform the work for which the permit application is made. 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 of Federal Way,but only where such claim
arises out of the reliance of the city,inc ding itsNficers and employees,upon the accuracy of the information supplied to the city as a part of
this application. )
e-E
NAME/TITLE (4&---- 6- ec- 41�j 0 DATE R/e/ C'I,S��
(Signature) � (ride) /
RELATIONSHIP TO PROJECT ❑ wner 0 Agent Contractor ❑ Architect 0 Other
C "'�'l""`n.""3° 7^' 7 ^r..� rn ¢ e :"--"'''d—:
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Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application