02-103761 • S
City of F; era1 Way
l;onunmrity Development Services Plumbing Permit #:02 - 103761 - 00- PL
31530 1st Way S
Federal Way,WA 98003-6210
Ph:253 661.4000 Fax:253.661 4129 Inspection request line: 253.835.3050
Project Name: FRED MEYERS
Project Address: 33702 21ST SW Parcel Number: 930100 0010
Project Description: PL-Rough in(3)floor drains and move(1)sink&(1)hot water tank.
Owner Applicant Contractor
FRED MEYER INC BEST PLUMBING BEST PLUMBING
PO BOX 42121 BEST PLUMBING BEST PLUMBING
PORTLAND WA 97242 4129 STONE ST N 4129 STONE ST N
SEATTLE WA 98103 (206)633-1700
Plumbing Fixtures
Descri•tion ;ti.^, e.;,• " "cripIi6 :,Nt ,Quainti Descri tiarr-c- „' y Qi ar
Drains 3 Sinks 1 Water Heaters L I
PERMIT EXPIRES March 10,2003,IF NO WORK IS STARTED.
Permit issued on September 11,2002
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: Date: // /7-631 2'
P0 HIS CARD ON THE FRONT OF BUILD*
ay = BUILDING DIVISION
El:1E1KM_
Nn RV' INSPECTION RECORD
INSPECTION REQUEST PHONE#: 253-835-3050
PERMIT #: 02-103761-00-PL
OWNER'S NAME: FRED MEYER INC
SITE ADDRESS: 33702 21ST SW
( ) FOOTINGS/SETBACKS ( ) FOUNDATION WALL
arlirr : 'ZI1,51707-0,:ttM,K0:1WOWNTLWAIICABOVEIS API*OAIjaW,39ffir :
( ) DRAINAGE: Line ( ) Connection
111111M7 4..1P.F: caLEsraitl.g,77STPRIg—gitEgailOSE:IS AP ROPMErartinr4W,
( ) UNDERFLOOR
( ) ROUGH PLUMBING: DWV Water piping
( ) ROUGH MECHANICAL Gas piping
( ) SHEATHING Roof Floor
( ) SHEAR WALLS
( ) ELECTRICAL ROUGH-IN Ditch Cover
( ) FIRE/DRAFTSTOPS
1111111 SitialEMEMEMIEMEEMER e RIM 0:ER r I UM NM
( ) FRAMING/FIRESTOPPING
1111111111MTOYMAOWW*-VM1RITATiTAWITMEK4WTING Ok$Itift**17402.85-14VVitr
( ) INSULATION: Floors Walls Attic
1111115VMMDAIOVARTStA417:,0-9101, Is. ' AFOPLYING
( ) WALLBOARD NAILING ( ) SUSPENDED CEILING
0511WITWAVY;E:WSTINL7TITOIARMORPTAftsiOJA:11%.{STALIAd:Ot1:1S:dtWAW
( ) ELECTRICAL FINAL
( ) PLANNING FINAL
( ) PUBLIC WORKS FINAL
( ) FIRE FINAL
111115644a.tank, ra.:0074-15,3M—IMEKM*1)19 DP)4001414fki0A-1100444:!Zg
Pl-4-144.01136
( )03UILDING)FINAL ILD - /45 2_.
111FEIN:OA7,0,1(0,0Mtftir$ ii007R:Cirgitihivit;RING*iNgI APPROVED
1
08/29/2002 11:23 FAX 2536814 CITY FEDERALWAY g1001
• lb
��« RECEIVED CONSTRUCTION PERMIT APPLICATION
uV tw APPLICATION NUMBER: Q? - 1_a3 _&_/ - VL__
SEP 0 4 2002 APPLICATION NUMBER: - -
I-IV�C APPLICATION NUMBER: - -
**Thegbn�erm F4 Ald W tnatiori—Please print(in ink)or type**
ILDING DEPT. •
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
-. - - - • . 1:PROPERTY INFORMATION - -
SITE ADDRESS: 331 Qt 4-we.. S,u.� ASSESSOR'S TAX/PARCEL #: 9 3D J 1707 Com")/-3
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
''-'-'''.1.-.1.. . _ . . :;_,_ ".:-.%.1.'PROJECTINFORMATION ' _ .- . : ., -
TYPE OF PROJECT(This application): ❑ BUILDING >i PLUMBING 0 MECHANICAL 0 DEMOLITION
0 ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description):g �Gv. f'/tjo* D11..- LL1v,5 ' 0 5/,I ei_ () kt-s—,,-
PROJECT NAME: /-/2 v ini5a 1301-6
- - - -' : - ''1'PEOPLE INFORMATION . -' -.- , - '-
PROPERTY OWNER: NAME: DAYTIME PHONE:
1:p''2.7n »1 alts p�7 (�;3) -79"7--3S.2S I
T.0 ADDRESS sr4-fill
1 ADDRESS,/l I CITY,STATE,ZIP):il� n 2, l /a y a
CONTRACTOR: NAME: 7 �/ ►CicC>w�eX DAYTIME PHONE.
365r Ph-t iit a/.v1,- (206 ) ,33 —/ lac)
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: I
LI/a.9 Srr.06 AJC: S rcii-'rus WA, 9$/03 ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER.:
- - (Z64) 4.33 -Zzc)z_.
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy a card required) E 5'r Pl 41., '2.3 313 o C I /c;1 / 2-0c)3
3
APPLICANT: NAME: DAYTIME PHONE
0-;WI rn4oaA,1A.Je1 ( z,)3B'3 -/90,3
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP)' EVENING PHONE:
/3-1 r r LI c 1-r 2.cs--io„'I•UAh0 &J4. 982,16-a ( ) -
RELATIONSHIP TO PROJECT' FAX NUMBER:
0 ARCHITECT ❑ TENANT OTHER(DESCRIBE):646Cou7►'L.gc.v-vIL ( ) - 1
E-MAIL ADDRESS: —1
CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER 0 APPLICANT ,, CONTRACTOR I
-' = - - w- - - . 1 DETAILED BUILDING INFORMATION ': .. : , -
•
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ ,
PROPOSED USE: _ PROPOSED VALUATION FOR IMPROVEMENTS: $ %j DC910
'
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES 0 NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN 0 HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
8/29/2002 11:23 FAX 25366141
4
l CITY FEDERALWAY j002
1111,?w -
**NEW RLESIOENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: _ ESTIMATED SELLING PRICE: $
•
- -• ■ PROTECT FLOOR AREAS
_ FLOOR EXISTING SQ.FT.' PROPOSED SQ.FT. TOTAL •
BASEMENT• •• -
FIRST .
• SECOND •
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
' DECK
GARAGE
HOW MANY FLOORS? • .
TOTAL:
■ FIXTURES
- Indicate number of each type of fixture - -
MECHANICAL
• AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSORS) FURNACE(S) -
DUCI(S) GAS PIPE OUTLET(S) HEAT SOURCE: 0 ELECTRIC 0 GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) 1 WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) , ELECTRIC 0 GAS
DRINKING FOUNTAINS) SHOWER(S) WASH MACHINE OUTLETcwt
GAS PIPE OUTLETS) SINK(S) WATER CLOSETS) ' MISCF/
.( D
T itq r
INTERCEPTOR(S) SUMP(S)
•
''■ DISCLAIMER/SIGNATURE BLOCK - '
I certify under penalty of perjury that the Information furnished by one 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 daim(including costs,expenses,and attorneys'fees incurred hi the
investigation and defense of such daim),which may be made by any person,including the undersigned,and filed against the City of
Federal Way,but only where such daim arises out of the reliance of the city,including its officers and employees,upon the accuracy
of the information lied to the dty as a part of this application.
NAME/TITLE: G}DATE: 1 /3 /C)2--
0
❑ PROP WNER fkAPPLICANT 0 CONTRACTOR
r_ i Tib= ::_tr.L1,D•-:;40E. -:''''311 :::W!: --:'la]iixt!,-arra.{ • ,ri -s 1
�� 1-,\':v:,( iS, ,sail:.+}it l'if k~' :G4i- 'i E'a �•_' 7.14:At_,r. ‘-cir ; .b,'
' ;C ls+ ; `'6II ,04 e'v '"�, ,T.� f -, q .
F4 0,111 - L •FtM �, [ rY ii . it'� tfi' t"
d. -iris
kiva3! A' , a_ T iu I�'iv0: .�. j , •� j' 'O";
COMMUNITY DEVELOPMENT SERVICES-33530 FIRST WAY SOUTH•PO sox 971E•FEDERAL WAY,WA 98063-9718.253-661-4000•FAX:253661-4129
www.dtroffederalway.com