19-105390 •
Plumbing
City of Federal way Permit #:19-105390-00-PL
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: CAFE NOIR
Project Address: 33304 PACIFIC HWY S Parcel Number: 797820 0025
Project Description: Installing a grease trap.
Owner Applicant Contractor
ARTHUR&SHIRLEY INC ARTHUR&SHIRLEY INC CAFE NOIR
PO BOX 3858 PO BOX 3858 N/A
FEDERAL WAY WA 98063 FEDERAL WAY WA 98063 33304 PACIFIC HWY S STE#301
FEDERAL WAY WA 98003-7810
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Other Plumbing Fixtures I
PERMIT EXPIRES Wednesday,6 May,2020
Permit Issued on Friday,November 8,2019
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. ///
l 4 /
Owner or agent: / fr. Date: I I 1
.
• THIS CARD IS TO REMAIN ON-SITE
CITY OP Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 105390 00 Address: 33304 PACIFIC HWY S Unit 301
Project: ARTHUR& SHIRLEY INC 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 any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card.
El Plumbing Groundwork(4190) 0 Rough Plumbing(4230) Final-Plumbing(4075)
Approved to cover 9 Approved Approved
.By Date By Date By A d Date 0 1 9
•
Rough Electrical 0 Final ElectricalElRight of Way
Approved Approved Approved
By Date By Date By Date
�� RECEIVED PERMIT APPLICATION
CITY OF IIIP"''"1111%./
Federal Way NOVERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325
`� 0 S 2019 253-835-2607 + FAX 253-835-2609 +permitcenter@cityoffederalway.com
CITY OF FEDERAL WAY
,'OMM ITY pZ___PERMI
T NUMBER-/q TARGET DATE
SITE ADDRESS / tr S00.,4- U /�( ' I /CegoOS SUITE/UNIT#
3-3304( P4 )14
c 4 c I��ZONING S.
ASSESSOR'S R,S L1e # WIC W
PROJECT VALUATION /
$ 3 SOO. (✓v �C1iNfv��'fGI —
TYPE OF PERMIT ❑ BUILDING PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT C treet T Cct-( CI'air
PROJECT DESCRIPTION
syks l 6 reits..e TKi&f)
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
A-r4cktr S11iVIe Tor, as 3 -- g3s - CoR 0
PROPERTY OWNER MAILING RESS y E-MAIL
3ao Pari-Cc v./ S . 41 (OX s k'NwNey�nc I.cowr
Qclt r'� wA� ZIP
YO0,2
AME �„t�n/�� Cir_� PHONE 5-714/0S-
MAILING
0[-MAILING ADDR d ' .•(/`, I r E-MAIL
CONTRACTOR 100 9 r'
CITY = ZIP /� FAX
WQC°O✓v1 CA. WA' ' 61"IJ
STATE CONT, OR' LICENSE# E IRATIOi1 4'E FEDERAL WAY BUSINESS LICENSE#
HONE
AME
6-'IA
0," PRIMARY4,10 o- l 1 - cat-l'-7
MAILING ADDRESS E-MAIL
E-MAIL I
APPLICANT- . 3 do �eA 'r1 ,C �I S - ot �OO sLAk�,IW\( y1M01:l'CC✓ 1
STATE ZIP FAX
C
ede Li w W7 9 2 Uo 3
NAMEtt PRIMARY PHONE
PROJECT CONTACT -Ci-A 1� Kcc ex()11- ellQ( - _4d-1r/7
MAILING ADDRESS - E-MAIL
(The individual to receive and �J (� +,� i
respond to all correspondence 333.)o at^c.1 t r- T \1r- J .. ' 0I(3 StA e t( i w, ®/ ��,\'a 1'
concerning this application) CITY I TATE ZIP FAX
Fae_r'J tAdiv\/ w A- 2 U0-3
NAME
PROJECT FINANCING OWNER-FINANCED
When value is$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(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 a part this p lication.
SIGNATURE. •
i1 i DATE A /161,
PRINT NAME: SI/, k K/
V'i�
Bulletin#100-January 29,2046 Page 1 of 2 k:\Handouts\Permit Application