21-101267City of ROM Way
Community rievelop pleat [kpt.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: LIFEWAY CHURCH
Project Address: 5015 SW DASH POINT RD
Plumbing
Permit #:21-101267-00-PL
Inspection Request Line: (253) 835-3050
Parcel Number: 112103 9102
Project Description: Installation of a new 1-1/211 Pex material water service, approximately 450' from meter to
church.
Owner
LIFEWAY CHURCH
5015 SW DASH POINT RD
FEDERAL WAY WA 98023
Other Plumbing Fixtures
Applicant
COLTON BILDERBACKPLATINUM FULL
SERVICE PLUMBING
439 E 63RD ST
TACOMA WA 98404
Plumbing Fixtures
Contractor
PLATINUM FULL SERVICE PLUMBING
PLATIFS804BP (1/17/22)
439 E 63RD ST
TACOMA WA 98404
PERMIT EXPIRES Tuesday, 28 September, 2021
Permit Issued on Thursday, April 1, 2021
I hereby certify that the above information is correct and that the construction on the above described property
acid the occupancy and the use will he in accordance with the laws, rules and regulations of the State of
Washington a d.1he City of Federal Way.
Owner or agent: Date:
As�
CITY OF
Federal Way
THIS CARD IS TO REMAIN ON -SITE
COINSPECTInINREQ�UCS eCtZa $ Record
PERMIT #: 21 101267 00 Address: 5015 SW DASH POINT RD
Project: LIFEWAY CHURCH
FEDERAL WAY WA 98023-2041
Scheduled inspections may be failed if this card is not on -site. I)0 tiO"1' 1.OSi:'I'llIS 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.
Rough Plumbing (4230) ® Final - Plumbing (4075)
Q Plumbing Groundwork (4190) ❑ g Approved
Approved to cover Approved
By Date By
Date By Date '�.
Final Electrical ❑ Right of Way
r-Rough Electrical rBy
ApprovedApproved
Approved
Date
Date By Date
RECEIVE®
4%
crry MAR 31 2021 PERMIT APPLICATION
FederaWayCITY OF FEDERAL WAY PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
COMMUNITY DEVELOPMENT 253-835-2607 + FAX 253-835-2609 + permitcenter[a,,cityoffederahvay.com
PERMIT NUMBER -0� / - —2 -0j -07 '�7 _ -P L 9 J .5L-ZTARGET DATE 1
SITE ADDRESS SUITE/UNIT #
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL #
1V i 000. 22 4� 1 2 1 Q - q- 0 1-
TYPE OF PERMIT
❑ BUILDING APLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRF, PREVENTION
NAME OF PROJECT
t9J(�+e( S� ire- PC0 �9'ci
PROJECT DESCRIPTIOPi
Detailed description of work to
be included on this permit only
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NAME �, ire, c�Gy Church
PRIMARY5 3 � PHONE�
PROPERTY OWNER
MAILING ADDRESS
506 Caw OashQoi'�
E-11AIL
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CITY �P>aC.It STATE ZIP
W i O 2'�
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NAME 1 .,
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PHONE
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MAIi.IIBG ADDRESS
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E-MAIL
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CONTRACTOR
STATE
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FAX
WA STATE CONTRACTOR'S LICENSE #
i/RA1 I�
IIBI #
1/JC1 �O ®LA - 5 (0� - � r - 5
LEA
/
NAME Sec ' rib`►n
PRIMARY PHONE
200 -rs Octco
MAILING ADDRESS
E-MAIL
APPLICANT
CITY-rAC�+l�0.
TE
W
Z�IS )a a
FAX
NAME �1 0 D� ' /� + t&P61 _
IV 11V. 1VY�`L k
PRi cp - PHONE
zo � - 44-15 - oc� td
PROJECT CONTACT
MAILING ADDRESS r e �Q7J`�l CA Gt
"( 1
E-MAIL
(The individual to receive and
respond to all correspondence
concerning this application)
1
CITY
Tacor%
SrAM
I w�
ZIP
I ss d
FAX
J0 -
-
PROJECT FINANCING
NAME Ji/r)
OWNER -FINANCED
When value is .$5, 000 or more
MAILING ADDRESS, CITY, STATE. ZIP
PHONE
(RCW 19.27 095)
I certify under penalty ofpedury that I am the property owner or authorized agent of the property owner. I certify that to the best
of my knowledge, the igorrnation 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 authorised by the issuance of a permit. I understand that the
issuance of this permit does not remove the owners 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 any claim (including costa, expenses, and attorneys' fees incurred in
the investigation and defense of such claim), which may be made by any person, including the undersigned, and fated 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 apart of this application.
SIGNATURE: DATE gl-7,�, -
�r
PRINT NAME:,Q
U
NrI
:.c
Bulletin 4100 - Fetmlary 19. 2020 Paee I of 2 1clHandouts\Permit Amlication
MECH;WCAL PERMIT
Indicate hour many of each qjee YfixMre to be &LstaUed or relocated as part of this pjntect Do not include e*#ggfm1ures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS po,—r w)
BOILERS FURNACES HOT WATER TANKS (u�)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OFPLUMDING WORK
PLUMBING PERMIT
$ Z0, coo .
Indicate horn miariff pf eaah type offatLire
to be installed or relocated as
part pf this projed. Do not include existing adores to remain.
BATHTUBS (or -Mb/Shoiver Combo)
LAVS [H—dSin]-)
TOILETS
x WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (xtcb—/uahty)
WATER HEATERS (Ekarm)
HOSE BIBBS
SUMPS
WASHING MACHINES
t TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEWR
SEWER PURVZWR
VALUE OF EMS-nNG IMPROVEMENTS
ERISTMG/PREVIOUS USE
LOT SIZE (In Square Feet)
ERISTRgG FIRE SPRINKLER SYSTEMV
❑ Yes ❑ No
PROPOSED FIRE SUPPRESSION SYSTEM?
[,Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EHISTING
PROPOSED
TOTAL
FOR OFFICE USE
FIRST FLOOR (or Mobile Home)
COVERED ENTRY
['�i[NEti �!
I
-..ice--.•
.
-
GARAGE ❑ CARPORT ❑
-
_
Area Totals
moraaen
SOT.1L
ESTIMATED SELLING PRICE S
# OF BEDROOMS
COMMERCIAL - NEw/ADDITION
AREA DESCRIPTION Area In
I
Occupancy Groupjs)
tion
Construction
�.,.:
of
Stories
—
Additional Information
-
- - r-- ---- - Share eet
1
�'QE'�9'•''•!:tTILAItdC'
ADDITION
COMMERCIAL - ]REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
Feet
Occupancy Group(s)8
Construction
# of
Stories
Additional Information
'$C73i:Ir?iI'{ •ef r�::!,'i'c .�47,i
oars
S"M�' :t:v — -- ---
_
—-':`c�'�...:_ �ri���ri:' yy
_
:x,
TENANT AREA ONLY
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Bulletin 4100 - Febntary 19 2090 Pine 2 of 2 k-\F-TandnnLs\Pemlif. Annlicafion