10-100191 City of Federal Way • .* Numbing
Community Development Services PFILEermit #: 10-100191-00-PL
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: (253)
Ph:(253)835-2607 Fax (253)835-2609 p q 835-3050
Project Name: LA NUEVA LUPITA'S
Project Address: 2124 SW 336TH ST Parcel Number: 132103 9097
Project Description: Installation of hand sink and food prep sink.
Owner Applicants Contractor
BLANCA HERNANDEZ HANARO GENERAL CONTRACTORS HANARO GENERAL CONTRACTORS
LA NUEVA LUPITAS TIENDA 29423 7TH PLACE SOUTH HANARGC065J7(8/8/11)
2124 SW 336TH ST FEDERAL WAY,WA 98003 29423 7TH PLACE SOUTH
FEDERAL WAY WA 98023 FEDERAL WAY,WA 98003
Lavatories 1 Sinks 1
PERMIT EXPIRES Wednesday, July 14, 2010
Permit Issued on Friday, January 15, 2010
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 acc rdance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
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Owner or agent: Date: /"c.
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THIS CARD IS TO IN ON-SITE _,►
CRY OF ` Construction Ins tion Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 10-100191-00-PL Address: 2124 SW 336TH ST
Owner: BLANCA HERNANDEZ 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.
El Plumbing Groundwork(4190) ❑ Rough Plumbing(4230) CI Gas Piping(4125)
Approved to cover Approved Approved to release test
Byl—CC..., Date t__- =Z4,j d By -5 Date(— —70/0 By Date
❑ Final-Plumbing(4075)
Approved
`By a Date n `-)`1
❑ Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
RECTI / O - ( 0 0 /
iVayREIT ''`�, 11F CO ME EL 4;30 DE:„..E ' F':',:'P
COMMIIIVI7Y DEVELORI�NT ES JAN 'APPLICATIONr . .. ._.. : :: ... : .:::::/.::.
2538352607•FAX 253-835-2609
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SITEADDRESS
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SUITE/UNIT# ZONING ASSESSOR'S TAX/PARCEL#
/ 39 ( O3 - 10c7
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NAME OF PROJECT :::. :::::::::::::•i:::.ii
...:..::.......................
(Tenant or Homeowner Name) /\,a- 4/l 6M/� .7 A- S
❑BUILDING )6LUMBING 0 DifECHANICAL.
TYPE OF PERMIT
❑ DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION
tA. .ii.Ct / fitr9, c i 1,_L_G
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME ),"
PRIMARY PHONE
PROPERTY OWNER � -
( DRESS„��TY,STATE ZIP
• � E-MAIL
OWNER IS ALSO: 0 CONTRACTOR 0 APPLICANT 0 PROJECT CONTACT
NAME PRIMARY PHONE
CONTRACTOR / MAILING ADDRESS,CITY,STATE,ZIP FAX
iWA STATE CONTRACTOR'S LiCENSE 0 EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE C
CM...S,. PRIMARY PHONE
APPLICANT V O C C V�...S,. ( ) -
MAIIANG ADDRESS,CITY,STATE,ZIP FAX
( ) -
PROJECT CONTACTNAS PRIMARY PHONE
(771e individual to receive and ( ) -
respond to all correspondence MAILING ADDRESS,CITY,STATE,ZIP
FAX
concerning this application) ( )
-
ALTERNATE CONTACT NAME: PRIMARY PHONE E-MAIL
(
PROJECT FINANCING NAME
El OWNER-FINANCED
Required for projects with
value of$5,000 or more I 0 ADDRESS,CITY,STATE,ZIP P PHONE
a2CW 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 of this applicatioon.
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SIGNATURE: DATE Gi� is — l Z
PRINT NAME: L6 PI, /e(;r/E' 17 6:114/
/27
Bulletin#100—January 1,2010 Page 1 of 4 k:\Handouts\Permit Application