08-103134..A RECEJ/
Fe` I Way �'ERMIT �y���
COMMUM7YD2VRWPM8NrSZRVIC83 JUN 3 0 244 SF MF GME EL PL DE EN FP
33325 8m AVENUE SOU17I • PO BOX 9718 ���' �� AT I O N � �
FEWRAL WAY, WA 98063.9718
253.835-2607• FAX 253. 135- 2�Qg,� g
tuwur.ad�uBedrM W.aw ( rra�yy 4
The folioudng is required informdt &San incomplete application will not be accepted. Please print legibly (in ink) or type.
PROPERTY •- •
SITE ADDRESS 2'N SUITE /UNIT 9
ASSES60R'S TAX /PARCEL 9 S L 3 - C� O LOT SIZE (sp
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) S EIP- %1j fl C_)4 _ j*3 S )4 6 E -r
r
PROJECT INFORMATION
TYPE OF PERMIT "UILDING 'PLUMBING MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work inckuded on this permit onkul
6>e>t0;)o sf TeH .-••1fi f-o -- a use.
PROJECT NAME (Name of Business or Owner Last Name) N `� S �l O re �Ci I �q�� *Q I'la ,--Q war'V T I
PEOPLE •- •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAME
t%v i A;& Fed-f w-m I Ala L LC Cl- A L.
PRIMARY PHONE
(zap) (079
MAILING ADDRESS
.o. 16•�;AK $ I tom
CITY, STATE, ZIP
ITA1,omej t ZA 41$419
E -MAIL ADDRESS
via( c0, -"e#-@ evowniF•
COMPANY NAME
O nes- %ui Ic1er
APPLICANT NAME
OFFICE PHONE
( ) _
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
FAX NUMBER
CONTRACTOR'S REGUrMATION NUMBER EXPMATION DATE
E-MAIL ADDRESS
C
t4v ,4'S
E
L)A\AA Hoek
OFFICE PHONE
-
MAILING ADDRESS
f?O• E ovx 0!(04
CITY, STATE, ZIP
�wcvrtia ln�A °J�419
CELL PHONE
20(p (d!9
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent "ther
(ZD6 ) 417 - •� (!o
NAME PRIMARY PHONE E-MAIL ADDRESS
I�av►d e k 11X4 61-) - Sh(o avid,,corhPr- etomtarf.
NAME
Per RCW 19.27.095.
Lender information is required ifproject value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
EXISTING ASSESSED /APPRAISED VALUE
SPRINKLERED BUILDING? ❑ YES *40 FIRE
WATER SERVICE PROVIDER )[ LAKEHAVEN ❑ HIGHLINE
SEWER SERVICE PROVIDER X LAKEHAVEN 13 HIGHLINE
PC
VALUE OF PROPOSED WORK
❑ TACOMA ❑ PRIVATE (WELL)
❑ PRIVATE (SEPTIC)
n
oaf'
,. ♦ & DSSCRIPTION
EXISTING
8 . FT.
PROPOSED
S . FT.
TOTAL
S . FT.
BASEMENT N/A
a YES o NO
BOILERS
FIREPLACE INSERTS
FIRST
FURNACES
DUCTS
Q
SECOND N/A
o NO
BATHTUBS (or Tab /sh.— comeo�
2 LAVS Is.mmom shiltd
THIRD N/A
RAINWATER SYST
DRINKING FOUNTAINS
SHOWERS
ADDITIONAL FLOORS (DESCRIBE) u A
SINKS
HOSE BIBBS
SUMPS
DECK (❑ COVERED OR ❑ UNCOVERED ?) S /JA
GARAGE ❑ CARPORT ❑ O /A
NUMBER OF FLOORS
ffiBTAe
I
PROPOSED
TOTAL
TOTAL EaenNO Sr
TOTAL PROPOSED By
TOTAL sr
"NEWHOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fucture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
Value of Mechanical Work $ COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS
EVAPORATIVE COOLERS
o REPAIR o. TENANT IMPROVEMENT
FANS
BBQS
a YES o NO
BOILERS
FIREPLACE INSERTS
COMPRESSORS
FURNACES
DUCTS
GAS LOG SETS
G
o NO
BATHTUBS (or Tab /sh.— comeo�
2 LAVS Is.mmom shiltd
DISHWASHERS
RAINWATER SYST
DRINKING FOUNTAINS
SHOWERS
ELECTRIC WATER HEATERS
SINKS
HOSE BIBBS
SUMPS
GAS PIPE OUTLETS WOODSTOVES
GAS WATER HEATERS MISC (Describe)
HOODS Ic mmancM
RANGES
REFRIO. SYSTEMS
URINALS MISC (Describe)
VACUUM BREAKERS
Z WATER CLOSETS froneq
WASHING MACHINES .
I certify under penalty of perjury that I am the property owner or authorised agent of the property owner. I certify that to the best of my
knowledge, the trL&rmation submittal in support c f 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 owner's responsibility for compliance with local, state, or federal laws regulating conduction 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 clabN, which may be made by any person, including the undersigned, and filed against the city, but only
where such claim arises out of the retip" of the ci , including its officers and employees, upon the accuracy of the infbrrnation supplied to
the city as apart of this application. ///
SIGNATURE.
4 x-7_6 8
o NEW a ADDITION
o ALTERATION
o REPAIR o. TENANT IMPROVEMENT
BUILDING SHELL ONLY?
a YES o NO
BASIC PLAN? o. YES
o NO
ZONING DESIGNATION
CHANGE OF USE? o YES
o NO
NEW ADDRESS REQUIRED?
o YES o NO
UP /SEPA /SU? a YES
o NO
PLATTED LOT?
o YES o NO
DEMO PERMIT REQUIRED? o YES
o NO
Bulletin #100 — January 1, 2008 Page 2 of 4 MandoutsTermit Application
` %y of Fe eral Way
~community Development Services
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609
t
Build& - Commercial Permit 608- 103134 -00 -CO ,
Project Name: NORTHSHORE VILLAGE ACE HARDWARE
Project Address: 35419 21ST AVE SW
Line: (253) 835 -3050
Parcel,IVumber: 252103 9002
Project Description: TI - Demising 12000sq /ft to 9000sq /ft and 3000sq /ft of space, constructing partition walls,
(2) restrooms, (1) storage room and (1) office in the 9000 sq /ft space. Mechanical and
Plumbing included
Owner
Applicant
Contractor
Lender
DAVID HOEK
DAVID HOEK
DAVID'S FEDERAL WAY LLC
DAVID HOEK
DAVID'S FEDERAL WAY LLC
DAVID'S FEDERAL WAY LLC
PO BOX 8164
DAVID'S FEDERAL WAY LLC
PO BOX 8164
PO BOX 8164
TACOMA WA 98418
PO BOX 8164
TACOMA WA 98418
TACOMA WA 98418
TACOMA WA 98418
Census Category: 437 - Commercial alt / add / conversion
Existing Sprinkler System in Building ? .................No Mechanical to be Included? ................................... Yes
Number of Stories .................... ..............................1 Permit for Building Shell Only ?............................ No
Plumbing to be Included ? .......... ............................Yes New / Additional Sq. Feet - Total.......................... 0
Occupancy #1 - Use ...................... .........................Sales Room Zoning Designation ............................................... OP -1
Mechanical Fixtures
Ducts............... ............................... 1 Fans................. ............................... 2
Rlurk(ng Vturs
Drinking Fountains ........................ 1 Lavatories........ ............................... 2 Sinks.... ........... ........ 1
Water Closets .. ............................... 2 r; .. � . At
CONDITIONS: - N
A SEPARATE ELECTRICAL PERMIT IS REQUIRED FROM CITY OF FEDERAL WAYS
PERMIT EXPIRES Monday, January 26, 2009 IQ
Permit Issued on Wednesday, July 30, 2008
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the se 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:
Ah
DATE
' O'
AREA AND TYPE OF INsPECTION
wa " A r Ace ftr r
10 r 7�1 Uhf
3
r A ce, a wine S�^ C�
ti THIS'CARD IS TO ON -SITE -T CITY OF Community Developm OmAIN
t Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 08- 103134 -00 -CO
Owner: DAVID HOEK
Address: 35419 21 STAVE SW
FEDERAL WAY, WA 98023 -3058
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.
❑
Footings /Setback (4110)
❑ Gypsum Wallboard Nailing (4130)
❑
Re -steel (4215)
❑
Plumbing Groundwork (4190)
Approved to install mud & tape
Approved to place concrete
Approved to drop tile
By
Approved to place concrete or grout
By
Date / _ 02
Approved to cover
By
Date
Final - Fire Department (4060)
By
Date
By
Date
Final - Mechanical (4065)
Approved
❑
Approved
❑
By
Underfloor Framing (4285)
❑
Slab /Concrete Floor (4255)
Floor Sheathing (4105)
Date
Approved to place concrete
Approved to sheath floor
Approved to install flooring
By
Date
By
Date
By
Date
❑
❑
❑
Rough Plumbing (4230)
Mechanical Rough -in (4165)
Gas Piping (4125)
Approved
Approved
Approved to release test
By
Date
By c--- LA_�) Date j!$.
By
Date
❑ Fire/Draft Stops (4095) TE: Prior to scheduling a Framing (4120) Framing (4120)
Approved inspection; Electrical, Plumbing & Mechanical Approved to insulate
[NO
ough -in and Fire/Draft Stop inspections must be f By Date gned -off and approved. IBC 109.3.4/UBC 108.5.4 By /6/ Date
❑
Insulation (4150)
❑ Gypsum Wallboard Nailing (4130)
❑
Suspended Ceiling Grid (4265)
Approved to install wallboard
Approved to install mud & tape
Approved to drop tile
By
Date
By
Date / _ 02
B
C Date 1l�
❑
Final - Fire Department (4060)
❑
Final - Planning (4070)
❑
Final - Mechanical (4065)
Approved
Approved
Approved
By
Date
By
Date
By
Date
❑ Final - Plumbing (4075)
Approved
By Date
❑ Final - Building (4050)
Approved
By ;� Date A/
For inspector reference o-
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date