07-102729 •
City of Federal Way * PlumbinPer, #: 07-102729-00-P L
Community Development Services bQ
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: OH'S FAMILY CHIROPRACTIC CENTER, PS
Project Address: 1520 S DASH POINT RD Parcel Number: 052104 9158
Project Description: Complete plumbing installation of developer(for x-ray machine) and sink
Owner Applicant Contractor
OH'S PROPERTIES LLC OH'S PROPERTIES LLC OH'S PROPERTIES LLC
2936 S 381ST WAY 2936 S 381ST WAY 2936 S 381ST WAY
AUBURN WA 98001 AUBURN WA 98001 AUBURN WA 98001
Plumbing Fixtures
Other Plumbing Fixtures. 1
PERMIT EXPIRES Sunday, May 17, 2009
Permit Issued on Friday, May 18, 2007
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: -V-4)77/2
THIS CARD IS TO WAIN ON-SITE
CITY OF •ommunityDevelopmMt Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 07-102729-00-PL
Owner: OH'S PROPERTIES LLC
Address: 1520 S DASH POINT RD
FEDERAL WAY, WA 98003-3753
This card is part of your required inspection documents. 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.
O Plumbing Groundwork(4190) 0 Rough Plumbing (4230) ❑ Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date By ,—�i'�� Date 5/i '/o) By Date
❑ Final-Plumbing (4075)
Approved
•
By i Date 00-2
For inspector reference only
0 Rough Electrical 0 FINAL -Electrical
Approved Approved
By Date By Date
4
4- _ t (,) , 7 ta_ i
Federal Way RECEIVEPERMIT �+
COMMUNITY DEVELOPMENT SERVICES SF MF CO ME EL a DE EN FP
33325 8TH AVENUE SOUTH•PO DOX 9718
FEDERAL WAY,WA 98063-9718 MAY 1 8 APPLICATION TD JJJ
253-835-2607.FAX 253-ti cum 09 "'�— /
ma:u;.ciluaf(edert?ltva U.cum �-J� (`/{ /
CITY or rcoEFIAL WAY
The following is required infornv3tpep an incomplete application will not be accepted. Please print legibly(in ink)or type.
� �j �J^ 0 PROPERTY INFORMATION_ F
- J
SITE ADDRESS / .-)-c S . 1.3-0 CSG P0�./ le/ SUITE/UNIT#_
ASSESSOR'S TAX/PARCEL# 0 o- ( /0 9" - 9 / LOT SIZE (sf)
LEGAL DESCRIPTION (e.g.Acme Estates, Lot 1) o h F;,./,,74 CA r YDer�G f-,G Y, tos
(Attach separate page for lengthy legal desrnp(ion)
IN PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING I PLUMBING 0 MECHANICAL
0 DEMOLITION ,K ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(� (Provide detailed description of work included on this permit only)
1^SA l S,,--k c ,( C G .Q.v(2,61,,, ' -7L.- , '7���J •
PROJECT NAME(Name of Business or Owner Last Name) 0I( f '4--44,7147 C/777)•- _e_ iG ��."e o-
• IN PEOPLE INFORMATION /
PROPERTY NAME �/t 1,¢, n _ PRIMARY PHONE
O I
OWNER 195— I� Y
Ure '1/25, L Lc_ (2t-3 )31--6-s-347
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
2-9 3 6 .0- .3.c?-/ /L / /1-7— .v-"- G.-34 9s-a ee/ d r�t.'e546.y''`',.l Leg-,
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
c J (
MAILING ADDRESS CITY,STATE,ZIP - - CELL PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMB ER
( ) -
COPY of card required CONTRACTORS REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
with each application I
APPLICANT COMPANYAME APPLICANT NAME OFFICE PHONE
MAILINGS A�'DDR S - CITY,STATE,ZIP �ELL PHONE
(
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect ❑ Tenant ❑Agent 0 Other ( ) -
PROJECT NAMEPRIMARY PHONE E-MAIL ADDRESS
CONTACT Sia_) ( ) -
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( ) -
• '.■. DETAILED BUILDING INFORMATION • ,
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE 0 TACOMA 0 PRIVATE (WELL)
SEWER SERVICE PROVIDER O LAKEHAVEN 0 HIGHLINE O PRIVATE(SEPTIC)
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.F. SQ. FT. SQ. FT.
BASEMENT '
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR ❑ UNCOVERED?)
GARAGE 0 CARPORT ❑
LXISTINO PROPOSED TOTAL TOTAL=STING Sr TOTAL PROPOSED Sr TOTAL Sr
NUMBER OF FLOORS
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
•• • • ■ FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(comoerei4
COMPRESSORS FURNACES RANGES
DUCTS • GAS LOG SETS REFRIG.SYSTEMS
PLUMBING 2iro
BATHTUBS URINALS -'3'" / MISC(Describe)
Tub/Shower Combo) LAYS(Bathroom Sinks( ( )
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(Touey
ELECTRIC WATER HEATERS I SINKS WASHING MACHINES
HOSE BIBBS SUMPS
• SIGNATURE
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 the permit application is made. 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 of Federal Way,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. -
NAME/TITLE • DATE yc/(cP/0 /
(Signature) (Title)
RELATIONSHIP TO PROJECT Owner 0 Agent ❑ Contractor ❑ Architect 0 Other
o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? - o YES o NO BASIC PLAN? o YES n NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES o NO
PLATTED LOT? o YES ❑NO DEMO PERMIT REQUIRED? o YES o NO
•
Bulletin#100—April 2,2007 . Page 2 of 4 k\Handouts\Permit Application