12-100193 r , t Plumbing
City of Federal Way
Community&Econ.Dev.Services Pert #: 1 2-14601-93-00-PL
33325 8th Ave S
Federal Way,WA 98003
Ph (253)835-2607 Fax:(253)835-2609 Inspection Request Line: (2
53)835-3050
Project Name: FEDERAL WAY QUALITY CARE AFH
Project Address: 31205 8TH AVE S Parcel Number: 858800 0005
Project Description: Installation of bathroom fixtures in existing room,previously roughed-in.
Owner Applicant Contractor
KILCHA SEKYRA KILCHA SEKYRA OWNER IS CONTRACTOR
31205 8TH AVE S 31205 8TH AVE S
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
Lavatories 1 Showers 1 Water Closets 1
PERMIT EXPIRES Tuesday, July 10, 2012
Permit Issued on Thursday, January 12, 2012
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the us will be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: f .,1� Date: //� —//
® THIS CARD IS TO REMAIN ON-SITE
A.
IP Construction TSdogRecordCITY OF ,
Federal WayINSPECTION
PERMIT#: 12-100193-00-PL Address: 31205 8TH AVE S
Projee"I - KILCHA SEKYRA FEDERAL WAY, WA 98003-5301
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) ❑ Rough Plumbing(4230) El Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date By Date By Date
❑ Final-Plumbing(4075)
Approved
B Date _ ' /0�
JJ ( `
0 Rough Electrical Final Electrical CI Right of Way
Approved Approved Approved
By Date By Date By Date
w _
ap - ± o 0 �
Federal Way
ERMIT slIPAF CO ME PL 9E EN FP
OMMI%N/TY T/E E„1PMF,TSERUCES N, ' ' ± o 0 7 r- ...."'
253-835-2607.F FAX 25.3-835-2609 ERP
GjctICi FCD
SITE ADDRESS SUITE/UNIT#
c �
PROJECT—YALUATION ZONING ASSESSOR'S TAX/PARCEL# /
TYPE OF PERMIT ❑ BUILDING LUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJE , . l
(Tenant Name/Homeowne ast Name) FW c„,,,,,_.. A R u
( J
i
PROJECT DESCRIPTION
(' .� ( 1 ,.1. .t4..,_
I' 1'ti-0 r 1c
oj
Detailed description of work to
be included on this permit only
NAME / PRIMARY PHONE
PROPERTY OWNER A / /( 'Lc. ,c. yrs –
MAILING ADDRESS / E-MAIL
3/)c.S- h'_O/G2 S.
CITY /STATE 7.
STATE
NAME G/ / PHONE
C -
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
AME... //�/ HONE
l ^� a1 S 3) 381 - 7 o 9e
APPLICANT MAILING ADDRESS E-MAIL -
CITY' STAGE FAX
PROJECT CONTACT NAME PHONE
(The individual to receive and
respond to all correspondence MAILING_. DRESS E-MAIL
concerning this application)
QITY ATE ZIP FAX
ALTERNATE CONTACT NAME: PHONE
k.
PROJECT FIN NAME 0 OWNER-FINANCED
Required value of ,000 or more
(RCW 19. .095) ING ADDRESS , ATE,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.
1 further agree to hold harmless the City of Federal Way as to arty 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 of this application.
s�
SIGNATURE: 7/-17/7;(- Z L �L
DATE / '—la–
,
PRINT NAME: X-7/7" /ti _____C- /y4---/k--
Bulletin
/ /L-/l_.
Bulletin#100—January I,2011 Page 1 of 3 k:\Handouts\Permit Application
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f 2_ 31: ' - ' ,, '41S l Y ,aap "o q ! S
3L zks 4r% C ,, ,,s3 ., w^w.- h,, " _ ., .
VALUE OF MECHANICAL WORK $ - . .py of bid or estimate must be provided)
Indicate how many of each type of fixture to be installed • elocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER F P- •LACE INSERTS HOODS(commerrial(
BOILERS FURNACES HOT WATER TANKS(Gas(
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
- . �- � ...mr,. �sro: n.�.�^ as �:� .� s.?..9,.a�x�.„ , �.,,,.� a
Indicate how many of each type of fvctture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo) I LAVS Wand silks), ( TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS ` SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Ki,ehen/uti itvl WATER HEATERS(elecv;c(
HOSE BIBBS SUMPS WASHING MACHINES TOOEIl1RTITR ":°',
_=3
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes ■ No ❑Yes ❑ No
fir., '" a .� �': w, 'x `R ',--,- :.r z., & _ t.
AREA DESCRIPTION(in square feet) EXISTING PROPOSE A TOTAL FOR OFFICE USE
" ,:-.4::4,44';,....;der 4, r1" a
o
' r% .'i '' . ^*`°4 : Kms' %i..
FIRST FLOOR (or .site Home) -___.._.
. or.^ a „ oxo 40 , �'�... l
, IL .
COVERED ENTRYI__._._
' 11im
� g ,tom;
GARAGE
❑ CARPORT ❑ _-_-
<y
a,
PROPOSED TOTAL
Area Totals Ak
ESTIMATED SELLING PRICE$ , # OF BEDROOMS
AREA DESCRIPTION r Occupancy croups) Construction St ries Additional Information
`€- `=ate ,y "fes �T'`a^ w '� . 'a a � 4.!:,i'
s4t�4' �. #`' i any � �k'`-
�� "'''a,. �.a� �a�,^, e Frac,.::, S/,� :����""�'�,.y d' �. '�K� `Se� '�^° ,sores.. "o ` �
ADDITIONAi
_
>«r .3,,,,,,,,::,',.. .,-,',!'„7.1,.i. 2 .+Iy. ' , S ib rGI i 7:1 e � .. '' :�.` a q,'; ,
Construction # of
AREA DESC' PTIONFEW' Occupancy Group(s) a Stories Additional Information
, ? 3 ^«ate :,; s < "�.s ; �s % �
TENANT AREA ONLY
Ez w, ���r P cTAREAOBLY E � '
Bulletin#100 January 1,2011 Page 2 of3 k:AHandouts\Permit Application