05-100712 . .
�;tyofFederal Way Plumbing Permit #: os - �00�12 - oo - PL
Co:nmunity Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-305a
Project Name: TUESDAY MORNING
Project Address: 2200 S 314TH Parcel Number: 092104 9053
Project Description: Install plumbing for two new restrooms and employee breakroom kitchen
Owner Applicant Contractor
HILLSIDE PLAZA ASSOCIATES RAY'S PLUMBING AND HEATING RAY'S PLUMBING AND HEATING
PO BOX 5003 PO BOX 2272 PO BOX 2272
BELLEVUE WA 98009 REDMOND WA 98073 REDMOND WA 98073
(425)868-2032
Plumbing Fixtures
yl r Descri tion Q n i I __ Descri tion Quanti ^
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Descri tion IiQuantit �_�
�Lavatones 2 � Sinks l� 4 �I� Water Closets 2 1
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Water Heaters �� 2 J
i :� �
�� PERMIT EXPIRES March 1,2007.
Permit issued on March 1,2005
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: ��� �C'�
' � � TffiS CARD IS TO�.MAIN ON-SITE � •
��floF �-� �;ommunity DevelopmC��t Inspection Record
Federal 1lVay IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-100712-00-PL
Owner: HILLSIDE PLAZA ASSOCIATES
Address: 2200 S 314TH ST
FEDERAL WAY, WA 98003-5475
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.
Inspec[ions are listed as close to sequential order as possible(read lef[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.
❑ Plumbing Groundwork(4190) ❑ Rough Plumbing (4230) ❑ Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date By ��j��- Date .3 "z-�:-�J By Date
❑ Final-Plumbing(4075)
Approved
By � Date� Z C�
1
` . .. .. • � � � P � -_3 i_,....
Fede lar Way ' � �" `. �
PERMIT SF MF CO ME EL PL E EN FP
� COMMf/NRY DEVEfAPMENT SERYICES
� 33825 8TM AVENUE SOU7N•PO BOX 9718 - ��p p L I C A T I O N
£EDERAL WAY,WA 98 063-9 718 � ' � � ^ / / //��
253-835-2607•fAX 253-835-2609 1 � / /� �
www.a(uof(ederalway.mm � � V
, The ollowi is re uired in orntation-an inco lete a lication will not be acce ted. Pleacse rint le ibi (in in or
- • • � • - , • •
SITE ADDRESS �!-� �� �(1 G�� �J �.C�� SUITE/UNIT#
ASSESSOR'S TAX/PARCEL N � � � � � �- � � � � LOT SIZE(s�
LEGAL DESCRIPTION(e.g.Acme Estafes,Lot 1 J
(Atta�sepa�a[e page fw ierhthy Iegai desuiptionJ
' • 1 � ' •
TYPE OF PERMIT O BUILDING �P�UMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPT ON(Provide detailed description o work induded on this permit onlu)
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PROJECT NAME(Name of Business or Owner Last Name)
• • � � - , � •
PROPERTY NAj`'� � � PRIMARY PHONE
OWNER � J j " � �S� D �-F � � -
MA NGOADD SS CITY STATE,ZlP
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CONTRACTOR COMPANY NAME APPUCANT NAME OFFICE PHONE
f� �s Pl� � � ,l �� ' c�t-s�� �G -z ��
MAI G ADDR I , AT ZIP C�3 CELL PHONE
d �Ok L Z 2 � ,,� ,�,{ ° cY�� �-�d -���-J
� C[TY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DA E FAX NUMBER
�-.C��L �c�7�� _- B L ��-- � �t �c.� cs�ZS���e - ���c
CONTRACTORS REGISTRATION NUMBER(copy of eud reqnired with each applicatioa) EXPIRATION DATE
� Y .� p �-�1 S �' �'1 � Z y� ��c�'
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
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MA[L G ADDRESS C�� T � �� �z3 �yzPs�N�F a �Q �U
/�o �3 227-L
RELATIONSH[P TO PROJECT FAX NUMBER
❑ Architect o Tenant ❑Agent ❑ Other(Describe) (S,r LS� �`� 's�/7 f'
CONTACT NAME PRIMARY PHONE E-MAIL DDRESS
�.- 1 J z � o - ��<i l.� �, 1 ��
LENDER Per RC 19.27.095: Lender lnformation is':�` NAME
required if project value exceeds�5,000 ,»;{r
MAILING ADURESS CITY,STATE,ZIP
� � : 1 � 1 1 • ' •
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK �
SPRINKLERED BUII,DING? O YES ❑ NO FIRE SUPPRFSSION SYSTEM PROPOSED/RF,QUIRED? ❑ YFS ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑TACOMN ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTICi
- . . . -
AREA DESCRIPTION EXISTING PROPOSED TOTAL
S . F'T. S .F'T. S . F'I'.
BASEMENT
FIRST
SECOND
THIRD
FOURTH .
ADDITIONAL FLOORS{DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT O
L7�SCING PROPOSED TOTAL . TOiAL CXiSTtPG SF SOTAL PROPOSED 9F �TOtAL SF
C
NUMBER OF FLOORS
••NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
✓ � -
Indicate number of each type of fi.xture to be insta(!ed or relocated as part of this project. Do not include exisfing fixtures fo remain.
MECHAHI(.AL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
B BQS FANS HOO DS�comm«d�� W OODSTO V ES
BO[LERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUlYIBING
BATHTUBS�o�rub/snow«comno� SHOWERS � WATER CLOSEI'S Roa<q MISC,(Describe)
D[SHWASHERS �_ SINKS DRINKING FOUNTAINS i ,, !
GAS PIPE OUTC.ETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
Z LAVS�sau,room sinks) VACUUM BREAKERS 2� ELECTRIC WATER HEATERS
� I�il •
I certify under penaity of perjury that the injormation furnished by me is true and correct to the best of my knowiedge, and further, that I
am authortzed 6y the owner oj the above premises to perform the work for which the permit appiication ts made. I further agree to hold
icarniiess the City oj Federal Way as to any claim(including costs, expenses, and attorneys'fees tncurred tn the investigation and defense of
such ciaimJ, which may be made by any person,including the undersigned,and filed agatnst the City of Federal Way,but only where such claim
arises out ojthe reliance of the city,inciuding its ojficers and empioyees,upon the accuracy of the information supplied fo the city as a part oJ
thts application.
' NAME/TITLE (/ DATE ���[/�
(Signature) (Title)
RELATIONSHIP T PROJECT ❑ Owner ❑ Agent pYe"ontractor ❑ Architect ❑ Other
� ;�-�� ,� _.._ .�:. . . � ; ,.:.
" �FOR�OFFICE USE ONLY,; -;;�,;
� „ ar.... _ _.,.., ,
o�NEW. ❑ADDITION '❑ALTERATION ❑REPAIR ❑TENANT IMPROVEMENT
� -BUII,DING SHELL ONLY? o YES ❑NO BASIC PLAN? '' , . ,' ❑YES a NO
}
� `ZOriING'DESIGNATION:':. CHANGE OF USE?. ❑YES ❑NO ''
°FNEW ADDRFSS,RF.QUIRED? a YES ❑NO ` UP/SEPA/SU? o YFS a NO
�PLATTED,LOT?<� . ��: � r�� �.:o YES��'�,n NO���=� �� DEMO PEKMIT REQUIRED?������ :,a YES�� �_�n NO�� _;��:�,��
Bulletin#100—January 7,2005 Page 2 of 4 k�E3andouts�I'ermit Application