00-100012 City of Federal Way
Community.iFederal en[Services • Plumbin ermit #:00 - 100012 - 00
33530 1st Way S
Federal Way,WA 98003-6210 Inspection request line: 253.661.4140
)11►, Ph:253.661.4000 Fax:253.661.4129 (3:30pm cut-off for ne y inspections)
Project Name: EVERGREEN LODGE(PLUMB)
Project Address: 31002 14TH S Parcel Number: 082104 9088
Project Description: PLUMB-ADDING TO TWO NEW OUTLETS FOR WASHERS
Owner Applicant Contractor
EVERGREEN LODGE EVERGREEN LODGE RTESY PLUMBING CO
31002 14TH AVE S 31002 14TH AVE S OURTPCO27RT(5/6/00)
FEDERAL WAY WA 98003 FEDERAL WAY WA 94 103 1402 AUBURN WY N,STE.214
AUBURN WA 98002
• _;..
'1 ng t /
Description Quantity Desc uantity Description Quantity
Laundry Washer Outlets 2
j
•
•
110
•
PERMIT EXPIRES July 2,2000,IF NO WORK IS STARTED.
Permit issued on January 04,2000
I hereby c: .` , that the above information is correct and that the construction on the above described property and
the occur and the use will be in accordance with the laws,rules and regulations of the State of Washington and
the Ci ederalWay.
Owner or agent: Date:
• BUILDING DIVISION
cl;o1,r`i • 33530 Fust Way South
ipEz
r �_ Federal Way,WA 98003
V7,27«y (253)661-4000
Fax(253)661-4129
R EC F n i "'"
APPLICATION FOR BUILEAKIG PERMIT
BUILDING�r'
PLEASE PRINT APPLICATION # 0/- ( O�� 12 -�v
......................................................................................
���><��� Site address
:<;;:.;:.;
Ten t name Q Lot # Assessor's Tax #
t. am19Q.Y..2Ir-e,PY,
uildin Owner's Name Address
2,03
u0ir fie" 31 Do Z 14 �Q-U2 S
p 9ROt)3 253. 9 4 i - o , ,
City �p&-I2 I �� State Ll; � Z Phone /
Description of Work p'u,vu 6 ,..-1
.......................................... ...........................................
............................................................................................
Name (F,M,L)
Address
City State Zip
Contact Person Day Phone Other Phone Fax
.................................................................................
.................... ......... ..................................... ...... .....
........ ..............................................................................
kiiiiibi dt hITFA T.O.BO:»': :' Federal Way Business License #
Company Name ,
LOk1-r
C� Sr LktA bit 1 •nri
c Address
i.140 L A.u.A0(4_1(...fip
City 14"tA*Ju.Y'k) State Lk) Zip 'Ot
Co lap•erson Phone Fax
Dv' 253-` �q—37
Contractor's It (carddmust be presented _t_ Expiration Date Verified ❑ Yes CI No
`� 7
C of vC.(0 11 K l
AkC
�����Ei?'<i?miii'i;:i'iii ?[2%ii#'ii'>im% ?s :[:
Name
Address
City .// State Zip
Contact Person /" Phone Fax
.
LEGAL DESCRIPTION
P/ease Compete Reverse Side
f:$T13fIC F .xisting Use •roposed Use ..,---'s/----
.0
/`tr.
Permit includes: ❑ Building Pthmbin 0 Mechanical ❑ Other x
Type of Work: ❑ New ❑ # of bedrooms ❑ Deck
\-..,z, Commercial �'Addition ❑ Garage ❑ Shed
Enter 1st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area sq ft
Water Availability XI Sewer Availability lip On-Site Septic System Availability ❑ Project Valuation $
Zoning I Lot Size Existing Bldg Valuation $
SNIDE :: <:><:>`<«>» `MM:M
.... �:._::::.::::::.::.:::::::.::.:.�::::::.:::::::.:;;;::.;:.:;.>:.>:.::.::<.:.: For new residential only - Proposed selling cost: $
Name Address
City -
State Zip
s>s Ki:
7YkE .�1�:t#Ji+!f:7.L. A1FTk7fi �tT:.:�:::::.w,-�:.:;::.
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes 0 No
•
NIGCt71I11Tf3ACTOR..... .... . .::::
C ntractor Name Address
C v-te s14 ''P1( u im L t✓1, (� Q (� _
City 1(402 IL1 J (�1.) U)! � r f) Zl� /atx tate lt��' Zip , ,_,
Contac
n Phone -`?39'—3?i'c Fax
License # C 91L h Expiration Date Verified 0 Yes ❑ No
PLUM BINE PIXTUFiE`'GO UN.T :
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
.. .. . . . ............................................
Lavatories Washing Machine Drains Total fixture Count
EUKAI ALMNIEU'OUNT:: MECHANICAL EVALUATION ONLY $
Fuel Type (gas/electric/other) Gas Dryer ___.__-__..___--Ai--Handling < --1-O;-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 Burne Duct Work 0-3 Tons Underground
BBQ" Wood Stoves 3-15 Tons TotalUnit 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 investi•ation 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 claim aris- •. o the --fiance of the city,in in_its officers and employees,upon the accuracy of the information supplied to the city as a part of this application.
ner/Agent' , i Date: 0 c r 06
RV1l0NG.APP
REVSrC 5110/95
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POST IN A CONSPICUOUS PLACE
City of Federal Way• Community Development Services Department
INSPECTION REPORT
Date Inspection Type Remarks Inspector
_2,-73-00