94-101809 c l'Oi e t 9
CITY
335300FirstF DEWay South RAL WAY B U I LD I NG P E R M I T PERISSUED: 09/19/9432
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 03/18/95
ADDRESS:2025 S 341ST PL
NO. : 212104-9048
PROJECT DESCRIPTION:PLUMBING ONLY.
OWNER — CONTRACTOR ===== LENDER ----
F.W. CLINIC BOB PEARSON CONSTRUCTION INC
2025 S. 341ST PL 1401 WILLOWS RD E
FEDERAL WAY WA 98003 FIFE WA 98424
922-3399
BOBPECI093C6
BLD?: MEC?: PLM?:X FLR--EXIST--PROP--- DWELLING UNITS: 0 COMP PLAN •9 FEES:
TYPE OF WORK:? USE:COM 1ST.: 0: O:sf STORIES • 0 REQUIRED PARKING..: 0 SPRINKLERS? •? PLM PRMT ISSUANCE.. $ 20.00
CENSUS CATEGORY •800 2ND.: 0: O:sf HEIGHT • 0.00 ft HAZARD CLASS •? PLUMBING FIXT....93$ $ 35.00
OCCUPANCY GROUP 3RD.: 0: 0:sf VALUATION REQUIRED SETBACKS FIRE FLOW • 0 gpm
:? :? :? :? OTHR: 0: 0:sf EXIST..$: 0 FRONT • 0.00 ft
TYPE OF CONSTRUCTION BSMT: 0: O:sf PROP...$: 0 SIDE • 0.00 ft WATER SERVICE..:?
:? :? :? :? DECK: 0: O:sf REAR • 0.O0:ft SEWER SERVICE..:?
OCCUPANT LOAD GAR.: 0: 0:sf RECEIVED.:09/19/94
0: 0: 0: 0: TOTL: 0: O:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
IliFUEL TYPES.:? ? FANS • 0 BOILERS/COMPRESSORS WATER CLOSETS • 0 URINALS • 0 TOTAL FEES $ 55.00
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 BATH TUBS • 0 DRINKING FOUNT.: 0
FURN<100K..: 0 DUCT WORK • 0 3-15 HP • 0 SHOWERS • 0 SUMPS • 0
GAS NWT • 0 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 0 VAC BREAKERS...: 0
CONY BURNER: 0 FURN>100K • 0 30-50 HP • 0 SINKS • 3 DRAINS • 0
BBQ • 0 MISC • 0 5+ HP • 0 DISH WASHERS • 0 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELEC WTR HEATERS...: 2 OTHER FIXTURES.: 0
RANGE • 0 <_10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS...: 0
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INF TI FURNI D :Y ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT , ; DATE Vffi?"9
FILE COPY
•
City of Federal
a„� GWay
NIN4 APPLICATION FOR BUILDING PERMIT
PLEASE PRINT APPLICATION #: )l Ly-R----c)-7-3p
SITE LOCATION • Address 2625— 34 t 61 (�L
Tenant kno n)t .
Lot # Ass sot's Ta �T�.
0
�c ( . w � rr�c � i L 'B
Building Owner Name Address
wC s be WP,SbE 1-614 345-0-1 T i cF-1c {4Nm 5o
( A s,pp„�"�i StateW� Zip 8pp 3 Phone
Nature of Work �"�
APPLICANT
Name (F,M,L)
L1+--fit PDMS M iNAC2.,At_ LSC_
Addr322-3 —(WtSte' SPr . M`.
City 1.,k3 ref State iikK- Zip ( ""1
tact Person Day Phone Other Phone Fax
7104-., , Hyl t-t-' S -742--Q-7 b cr79 —►(83 74Z--03?
$:UILT NNG•CONTRACTOR
Company Name
Address
City State Zip
Contact Person
Phone Fax
Contractor's # (card must be presented) Expiration Date Verified ❑ Yes 0 No
�RCHTrE'.CT
Name
Address
City
State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
CD0492(Rev 4/93)
TI ng use
•osed Use .4
Permit includes: U Building ❑ Plumbing ❑ Mechanical ❑ Other
Type of Work: ❑ Residential ❑ New ,( Remodel ❑ Number of Units 1 ❑ Deck
Commercial ❑ Addition Cl Garage ❑ Shed ❑ Other
Enter 1st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement q ft Decks� sq ft Garage sq ft Proposed Total Area sq ft
Water Availability Sewer Availability . ksOn-Site Septic System Availability 0 Project Valuation 8
Zoning Lot Size iiUEid.S.tiilg Bldg Va[yation $
E
LENDI ...........:
Name Address
City State Zip
MECHANICALCONTRACTORMiii
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING ONTRACTOR
Contractor NameiQ c n e J i _ 32z3Address `(�� / f�AA
City Ly( 3- -c J/ `�!zL_ State (} zip 91e+03—) /•`
Contact rAll.LlNMS PJ74--62-7 S Fax 71-7i—(=e62—C.
License # WIL.LI1^/1t O(b? Pet Expiration Date/b1-1y- Verified ❑ Yes ❑ No
PLUMBING FIXTURE COUNT see bUY-it -Cb 5L1 4D-Y of ku pUu'h bi w5 -6 x:-1't rF S-
Water Closets Sinks 1) " Urinals Lawn Sprinklers
Bathtubs • Dish Washers Drinking Fountains Other
'�\ Showers Electric Water Heaters 2 Sumps
Lavatories Washing Machine Drains Total Fixtttre;;Cotint ;;.. .
MECHANICAL UNIT COUNT
Fuel Type (electric/other) Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping Range Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUs Gas Log Unit Heater 50+ Tons
Furn >100 BTUs Fans Miscellaneous Fuel Tanks
Gas Hwt Hood Boilers Above Ground
Cony Burner Duct Work 0-3 Tons Underground
.................................................................
..................................................................
BBQ's Wood Stoves 3-15 Tons Total'Untt.Count
DISCLAIMER: I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge and further that I am authorized by the owner
of the above premises to perform the work for which permit application is made.I further agree to save harmless the City of Federal Way as to any claim(including costs,expenses,
and attorneys'fees incurred in investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the City of Federal Way,
but only where such cl • rias out of th. .lie Fe of�. e City,including its officers and employees,upon the accuracy of the information supplied to the City as a part of this
application/,��j / / .�
' Owner/Agent: �f-I__ `��L .•/�P_/ Date: 9//01--
.