09-104978 w 'Plumbing
City of Federal Way {.�
Community Development Services Permit #: 09-104978-00-PL
LE
P.O.Box 9718 '
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: CHEVRON#206851
Project Address: 1650 SW DASH POINT RD Parcel Number: 122103 9069
Project Description: Plumbing for soda machine and coffee maker.
•
Owner Applicant Contractor
M G INVESTORS LLC J&S MECHANICAL J&S MECHANICAL
1650 SW DASH POINT RD 1108 YUMA ST JSMECSM928OK(9/12/10)
FEDERAL WAY WA 98023 MILTON WA 98354 1108 YUMA ST
MILTON WA 98354
Other Plumbing Fixtures 2
PERMIT EXPIRES Sunday, June 20, 2010
Permit Issued on Tuesday, December 22, 2009
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 oft
Feederal Way.
grOwner or agent: �� -� Date: a-- 0 9
eifaM
THIS CARD IS TO REMAIN ON-SITE
411/111
Federal Way - 4111 Construction I> ction,Record
INSPECTION REQ TS: (253)835-3050
PERMIT#: 09-104978-00-PL Address: 1650 SW DASH POINT RD
Owner: M G INVESTORS LLC 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.
0 Plumbing Groundwork(4190) 0 Rough Plumbing(4230) ❑ Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date `By 34,4.--.
/ -. "Date /Z L/,3.of/Alf
.By Date .
El Final-Plumbing(4075)
Approved
By 5 Datet2_31--1°-(
El Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
., RECEI4E gip - _yo L-7 -7
Peder ERMIT SF MF CO ME ELODE
EN FP
Federal Way DEC' 2 2 200p
COMMUNITY DEV A MENT SERVICES
253-8352607•FAX 253-835-2609 � LI
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SITEADDRESS
C heve-on Ek/ra nide, !(off) S W Dash Ooin f xi Feral k'Ay, wA
SUITS/UNIT C ZONINGASSESSOR'S TAX/PARCEL C
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( of PROJECT '�.; Cl/let/rail f� -1')'10 4
(Tenant or Homeowner Name) 1'1
❑BUILDING X PLUMBING 0 MECHANICAL
TYPE OF PERMIT
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION
gou.9k•in and 4+1rn 4 r plu ,b;h61.1,5460-1 RIStrbomS'((do(.44C,1.aftel Sin V-
PROJECT DESCRIPTION 9
Detnilpd description of work to n /���
be included on this permit only Ki)�;r w&-I-e^r e Sada mach we tatul GePPce /, kor- /ii j-J I
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NAME PRIMARY PHONE
PROPERTY OWNER kith“ lj/rN``�J(t (70&W76-77 /Y
MAILING ADDRESS.QTY.STATE.ZIP 110.4.0.- E-MAIL
/072c 3_6'. z'-( . ggo31
OWNER IS ALSO: 0 CONTRACTOR ❑ APPLICAPiT (a PROJECT CONTACT
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NAME PRIMARY PHONE
Ja6k Erv/�er� _F 4 S (253) 9r
& 9 v30
co
MAILING ADDRESS,CITY,STATE,ZIP , FAX
1/08 'urna f'¢' , /hl/n/ Wf `l 983ce1 ( Z$3) 517 - 715 7
vl1/44)
WA STATE CONTRACTOR'S LICENSE• EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE C
Jsl'ncsm928�k e /d—'/ a
NAME i APPLICANT /_rn'`C- l- _ ( )PRIMARYPHGNE
MAILING ADDRESS,CITY,STATE.ZIP FAX
( ) -
PROJECT CONTACT NAME
1 . PRIMARY PHONE 1 /-.
(The individual to receive and J 6t( ' — 1 \''\ h (es-)6 C/�l C,l-' <"---
respond
respond to all correspondence MAILING ADDRESS,�CITTY,STATE,ZIP FAX
concerning this application) //C�? b i/f !Li St- lj/ /°i l (2s-5) sit- i t --1
ALTERNATE CONTACT NAME: PRIMARY PHONE E-MAIL
( )
PROJECT FINANCING NAME
❑ OWNER-FINANCED
Required for projects with
value of$5,000 or more MAILING ADDRESS,CTM STATE,ZIP PRIMARY PHONE
(RCW 19.27.095) ( ) -
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the
best of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply
with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit.I understand that
the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
Ifurther agree to hold harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred
in the investigation and defense of such claim),which may be made by any person, including the undersigned, and filed against the
city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of this application.
SIGNATURE: A— DATE L _Z2---0 e/
PRINT NAME: ,14 ck Ei-L'itil
Bulletin#100-4/21/2009 Page 1 of 4 k:\Handouts\Pemrit Application
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MECHANICAL FIXTURES
yob e of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE PROVIDED)
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(Commercial)
BOILERS FURNACES HOT WATER TANKS(cas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
PLUMBING FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not inch trip tiny fixtures to remain.
BATHTUBS(or Tub/Shower Combo) LAVS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SY&1'b.MS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS isiwnen/uuiity) WATER HEATERS(Eketin ' My7'4)l '14-ef
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
PROJECT VALUATION 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
RESIDENTIAL
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL
FOR OFFICE USE
BASEMENT ----...---.......___....._._._.......__.._...._._._..._......_...._............_..........._..---....—_......_
FIRST FLOOR(or Mobile Home)
SECONDFLOOR .__..._.__._......._.._...........__...---.....—_�...—.. _.___._._—
COVERED ENTRY
DECK
GARAGE 0 CARPORT 0
OTHER(describe)
WSTmo PROPOSED TOTAL
Area Totals
"NEW HOMES ONLY"
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction 4 of Additional Information
in Square Feet Type Stories
NEW BUILDING
ADDITION
COMMERCIAL -REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area in Square Feet Occupancy Group(s) Construction Stories Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100-4/21/2009 Page 2 of 4 k:\Handouts\Pennit Application