12-104033 + r AI
• _ Plumbing
City of FederalWay Permit #: 12-104033-00-PL
Community&Econ.n.Dev.Services
33325 8th Ave S �
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax (253)835-2609 fits
fip q
Project Name: BELLA DENTAL
Project Address: 34410 16TH AVE S Unit 109 Parcel Number: 250090 0040
Project Description: Install new plumbing fixtures for associated tenant improvement work
•
Owner Applicant Contractor
FEDERAL WAY MARKETPLACE CHOI'S PLUMBING CHOI'S PLUMBING
INVESTORS LLC 1632 S 295TH PL CHOISP*953D8(3/28/13)
5743 CORSA AVE SUITE 216 TACOMA WA 98444 1632 S 295TH PL
WEST LAKE VILLAGE CA 91362 TACOMA WA 98444
•
Plumbing Fixtures
Other Plumbing Fixtures 1 Sinks 9 Water Closets 1
Water Heaters 1
PERMIT EXPIRES Wednesday, February 27, 2013
Permit Issued on Friday,August 31, 2012
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: OD 3 1 . C �z
IN.-.a.ao 11 3/171
THIS CARD IS TO MAIN ON-SITE
CITY OF`41A ,
• Construction In ection Record
Federal Way INSPECTION REQ TS: (253)835-3050
PERMIT#: 12-104033-00-PL Address: 34410 16TH AVE S Unit 109
Project: FEDERAL WAY MARKETPLACE IN 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.
n Plumbing Groundwork(4190) 0 Rough Plumbing(4230) ❑ Gas Piping(4125)
A proved to covg Z�2 Approved Approved to release test
B Date 'By 4,..i.....7.
Date y �jg�z ,,By Date
0 Final-Plumbing(40754
�'"
Approved
By 0_, ,, Date 1 —1 3-%s-
❑ Rough ElectricalEl Final Electrical Right of Way
Approved ApprovedEl Approved
By Date By Date By Date
CITY OFd PERMIT . MF CO ME PL IDE EN FP
Federal wECEIVED
COMMUNITY DEVELOPMENT SERVICES APPLICATION
253-835-2607•FAX 253-835-2409 G 31 2012
ww .cit± erieryjwau.-2, ,
WWII,'
MY OF FEDERAL WAY
SITE ADDRESS DS / SUITE/UNIT#
y_,,e/
/ '7/ /e--(k? A 1/41 ,'; ‘.6-7,EiL'-e'22. / )
PROJECT VALUATION ZONING ASSESSORS TAX/PAR EL#$
l�IG (; (: C_ - — — — —
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING 0 MECHANICAL
❑ DEMOLITION 0 ENGINEERING 0 Ff\RE PREVENTION
NAME OF PROJECT p,ip
JJ /( errant Name/Homeowner Last Name) %.La\ `. �--�7/: ') /
PROJECT DESCRIPTION PLV Vt
Detailed description of work to
be included on this permit only
NAME _,�,._ fG1F t,�� ^//�,A PRIMARY PHONE
PROPERTY OWNER ' /�
MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAME
PHONI_
MAILING ADDRESS/0) E-MAIL-1
CONTRACTOR � z h 9 G " ' Lyc.2 7 p/6.,,7$1A/rl 77,ti
CITY STATE ZI FAX /
WA STATE CONTRACTOR'S LICENS$# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
6W67_‘ /2CAS 3 (j -V 4 /,-).1 //;
NAME -- . PHONE
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
PROJECT CONTACT NAME LA, l/ PHONE
(The individual to receive and
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application)
CITY STATE ZIP FAX
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME OWNER-FINANCED
Required value of$5,000 or more
(RCW 19.27.095) MAILING ADDRESS,CITY,STATE,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.
I 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.
SIGNATURE: C' f/L`�' r DATE PW)1 j 1 /�C/Z
PRINT NAME: �7�s//) �� lI E 1---
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Bulletin#100-January 1,2011 Page 1 of 3 k:\Handouts\Permit Application
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VALUE OF MECHANICAL WORK $ (a copy of bid or estimate must be provided)
Indicate how many 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(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
-�s�- '' -t' � �.�"� � ` � � ,�'. � �.>” ��,, . „ate�� �. •� � � .t �' �� ,� s� �,� �� �z S '"�„�� �^>
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Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo) (__' (( LAVS(Hand Sinks) / TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS -? SINKS(Kitchen/utility) / WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES '4-ttJRSy '
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
•
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AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
_;a�> '��S A .� a. ,' -�,� ......— ----------- ----
FIRST FLOOR(or Mobile Home) Ampmi
COVERED ENTRY y _--
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GARAGE 0 CARPORT 0
3, n Y
EXISTIRO PROPOSED TOTAL
Area Totals
;.,..-
ESTIMATED SELLING PRICE$ #OF BEDROOMS
.tet T - yy €.tea• •� z m ' "�.. 3
tF ,gav: dYo" 5. 4`°,47"(17{ Y \\ ., Z t 01:11:11 3� �- '3 '5 a^�.' $mayG:a� '+'•4�,
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AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in S•uare Feet •e Stories
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ADDITION % ■ -
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AREA DESCRIPTIONMEE! Occupancy Group(s) IMRE Stories Additional Information
TENANT AREA ONLY
Bulletin#100—January 1,2011 Page 2 of 3 k:\Handouts\Permit Application