21-104409-Building Permit Application41k
CITY OF
Federal Way
PERMIT NUMBER 21
PERMIT APPLICATION
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
_ 104409 _ CO
— TARGET DATE
SITE ADDRESS
SUITE/UNIT #
34520 16th Ave S
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$ 250,000.00
2 1 2 1 0 4 _ 9 0 1 0
TYPE OF PERMIT
IN BUILDING IN PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
Walmart Restroom Remodel
Remodel customer restrooms including fixtures, finishes, and lighting
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
Walmart Real Estate Business Trust
479-273-4000
PROPERTY OWNER
MAILING ADDRESS
2914 SE I St
E-MAIL
kristen.din er@walmart.co
CITY
Bentonville
STATE
AR
ZIP
72712
NAME
Sletten Construction
PHONE
800-483-2557
MAILING ADDRESS
E-MAIL
CONTRACTOR
1000 25th Street North
CITY
Great Falls
STATE
MT
ZIP
58401
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
UBI #
NAME
Heather Edmiston, pb2 architecture + engineering
PRIMARY PHONE
479-878-3530
APPLICANT
MAILING ADDRESS
2809 Ajax Ave, Ste 100
E-MAIL
heather.edmiston@pb2ae.com
CITY
STATE
ZIP
FAX
Rogers
AR
72758
NAME
PRIMARY PHONE
PROJECT CONTACT
Heather Edmiston, pb2 architecture + engineering
479-878-3530
MAILING ADDRESS
2809 Ajax Ave, Ste 100
E-MAIL
heather.edmiston@pb2ae.com
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
Rogers
AR
72758
PROJECT FINANCING
NAME
❑x OWNER -FINANCED
When value is $5, 000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best
of my knowledge, the information 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 authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's 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 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,
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.
SIGNATURE: DATE 10-21-2021
PRINT NAME: Heather Edmiston
Bulletin #100 — February 19, 2020 Page 1 of 2 k:AHandouts\Permit Application
MECHANICAL PERMIT
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existin fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial)
BOILERS FURNACES HOT WATER TANKS (Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
PLUMBING PERMIT
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS (or Tub/shower combo) LAVS (Hand sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS (Kitchen/utility) WATER HEATERS (Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
N Yes - No
❑ Yes w No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
...............................................................................................................................
FIRST FLOOR (or Mobile Home)
...............................................................................................................................
SECOND FLOOR
...............................................................................................................................
COVERED ENTRY
DECK
...............................................................................................................................
GARAGE ❑ CARPORT ❑
...............................................................................................................................
OTHER (describe)
...............................................................................................................................
Area Totals EXISTING PROPOSED TOTAL
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE $ 1 # OF BEDROOMS
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
NEW BUILDING
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
TOTAL BUILDING
203,818
M
VB
1
TENANT AREA ONLY
PROJECT AREA ONLY
1,395
M
VB
1
Bulletin #100 — February 19, 2020 Page 2 of 2 k:\Handouts\Permit Application