04-102773y
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v
City of Federal Way
munity Development Services Building - Commercial Permit #: 04 - 102773 - 00 - co
Com
3530 1st Way S
Federal Way, WA 98003 -6210 Inspection request line: 253.835.3050
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Ph: 253.661.4000 Fax: 253.661.4129 h q
Project Name: LIBERTY FITNESS
Project Address. .44929 1ST AVE S SuiteE Parcel Number: 697900 0050
Project Description: TI - Build (2) changing rooms (1) store room and expand bathroom
Owner
Applicant
Contractor
Lender
RESILIENT FLOOR COVERING
SERVICEMARK
SFRVICEMARK
NONE
RESILIENT FLOOR COVERING
SERVICEMARK
SERVIL *984CA 2/3/04
1201 PACIFIC AVE S SUITE 1400
1221 4TH AVE S
SERVICEMARK
TACOMA WA 98402
SEATTLE WA 98101
1221 4TH AVE S
NONE
Includes:
Census category: 437 - Comm
Occupancy Group:
Construction Type:
Occupancy Load:
Floor Area (Silk Ft.): ,
#1 #2 #3 #4
Census Category-... . . ..... ............................. 437 - Commercial alt/add Fire Sprinklers.................... No
Mechanical ................. .......................... No Number of Stores .. ................I
Permit for Building Shell ' Only ......................... —No Plumbing...... ... ....... .... - -. ...... No
PERMIT EXPIRES January 17, 2005.
Permit issued on July 21, 2004
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the usee in accordance with the laws, rules and regulations of the State of Washington and
the City of Federal Way. ,
Owner or agent: %f k2 l, Date: �? y'.--a I ' 0
>< THIS CARD IS TO MAIN -Q;N -SITE
CITY OF fommunity Developm t Inspection Rec a
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 04- 102773 -00 -CO
Owner: RESILIENT FLOOR COVERING
Address: 32729 1ST AVE S Suite E
FEDERAL WAY, WA 98003
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)
❑
Foundation Wall (4115)
❑ Drainage/Downspout (4040)
Approved to place concrete
Approved to place concrete
Approved to backfill
By
Date
By
Date
By Date
❑
❑
Re -steel (4215)
Plumbing Groundwork (4190)
❑ Slab /Concrete Floor (4255)
Approved to place concrete or grout
Approved to cover
Approved to place concrete
By
Date
By
Date
By Date
❑
❑
Underfloor Framing (4285)
Floor Sheathing (4105)
❑ Shear Walls (4245)
Approved to sheath floor
-Approved to install flooring
Approved to install siding
By
Date
By
Date
By Date
❑
❑
Roof Sheathing (4220)
Fire/Draft Stops (4095)
NOTE: Prior t:scheduling (4120)
Approved to install roofing
Approved
inspection; Elec& Mechanical
:aFraming
Rough -in and Firections must be
By
Date
By
Date
signed -off and app3.4/UBC 108.5.4
❑ Framing (4120) ❑ Insulation (4150)
Approved to insulate Approved to install wallboard
By f�T Date By Date
❑ Suspended Ceiling Grid (4265)
Approved to drop tile
By Date
❑ Final - Public Works (4080)
Approved
By Date
❑ Final - Fire Department (4060)
Approved
By Date
❑ Final - Building (4050)
.• Approved
By 4 :__t .J Date 0
❑ Gypsum Wallboard Nailing (4130)
Approved to install mud & tape
By Date
❑ Final - Planning (4070)
Approved
By Date
Federal ayE1V
_ PERMIT
3� 0l2jJ7 WAY SOfT771 •• POSBOX 97i8V L 1 i L O '1'
FEDERAL WAY, FAX 98063 -9718 RPLICATION
253 - 6614715• fAX 253b614129
u,unv- (wffederalwa DE RA
BUILDING DEPT,
The followinq is required information - an incomplete application will not be
4 S MF O L DE EN FP
D
ited. Please print iegibiy (in ink) or type. k 1d
13 1 SITE ADDRESS E :)� / QST V^�- 50 SUITE /UNIT #
ASSESSOR'S TAX/PA RC # . _lD / 7 1 OOO�O //-_W f_s LOT SIZE (sj)
LEGAL DESCRIPTION (.g. Acme Estates, Lot 1) See /' - r -AC(+E l.+
(Attach separate page for lengthy legal dcsv(ptfm)
PROJECT •- •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only/
rJ u•d l 2 C-ka A d t r%G Y'o avvi ez. I S -�o,r e-
PROJECT NAME (Name of Business or Owner Last Name) L-'i -e-Y-4 -y P ) P S S
PEOPLE t • - •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
EXISTING USE
NAME t� PRIMARY PHONE
Fesdl�V\T- t' tm v- L a v e cr i n Cr ( )
MAILING AD15RESS ,/� S-:: CITY, STATE, ZIP ` '
U ' /G�-\ �- %-Uc Q Ta1C -0M CA- q�1�oL
COMPANY NAME 1
Sevvtc-e yv\Ay t�
APPLICANT NAME
APPLICANT NAME
� a W
OFFICE PHONE
(;L64 ) 373 --1 1-1-1
MAILING ADDRESS
122--, y t =�
CELL PHONE
CITY, STATE, ZIP
-t1`�- F- V1l f ft01
CELL PHONE
(go 0 Bab
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
- EXPIRATION DATE
FAX NUMBER
_ -B
L l l
(nob) 3 -73- -11 -73
CONTRACTOR'S REGISTRATION NUMBER (copy of card required with each application(
V.V6+
EXPIRATION DATE
UZ - /U3/ O�
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe)
FAX NUMBER
NAME PRIMARY PHONE E -MAIL ADDRESS
Per RCW 19.27.095: - Lender information is
required if project`value exceeds $5,000
NAME
MAILING ADDRESS
CITY, STATE, ZIP
EXISTING ASSESSED /APPRAISED VALUE $
SPRINKLERED BUILDING? ❑ YES YNO
WATER SERVICE PROVIDER ❑ LAKEHAVEN
SEWER SERVICE PROVIDER ❑ LAKEHAVEN
PROPOSED USE
VALUE OF PROPOSED WORK $ I S,o O O
FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? D YES ❑ NO
❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ HIGHLINE ❑ PRIVATE (SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION
EXISTING S . FT.
PROPOSED S . FT.
TOTAL
BASEMENT
❑ ALTERATION
o REPAIR ❑ TENANT IMPROVEMENT
FIRST
BASIC PLAN? a YES
o NO
SECOND
CHANGE OF USE? ❑ YES
THIRD
NEW ADDRESS REQUIRED? ❑
YES ❑ NO
FOURTH
❑ NO
PLATTED LOT? cl YES ❑ NO
ADDITIONAL FLOORS (DESCRIBE)
o NO
DECK(COVERED ?)
GARAGE /CARPORT
HOW MANY FLOORS?
TOTAL MUSTDNG
TOTAL PROPOSED
TOTAL EXISTING AND PROPOSED
"NEWHOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
Value of Mechanical Work
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
PLVMBING
BATHTUBS (or T,.biSno..orcombo
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINES
LAVS (Bathroom Smkt )
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS PIPE OUTLETS
SHOWERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
GAS LOGS
HOODS (C— e.dat)
RANGES
GAS WATER HEATERS
WATER CLOSETS Toilet
DRINKING FOUNTAINS
RAINWATER SYST
HOSE BIBBS
ELECTRIC WATER HEATERS
REFRIG. SYSTEMS
WOODSTOVES
MISC (Describe)
MISC (Describe)
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 ma a ma a by any person, including the undersigned, and filed against the City of Federal Way, but only where such claim
arises out of the r i e oft e city, including its officers and employees, upon the accuracy of the information supplied to the city as a part of
this application.
NAME /TITLE
RELATIONSHIP TO
Gene
ature) (Title)
C ❑ Owner ❑ Agent ❑ Contractor ❑ Architect Other
TE 1-13 —05�
FOR OFFICE USE ONLY
o NEW ❑ ADDITION
❑ ALTERATION
o REPAIR ❑ TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑ YES o NO
BASIC PLAN? a YES
o NO
ZONING DESIGNATION
CHANGE OF USE? ❑ YES
❑ NO
NEW ADDRESS REQUIRED? ❑
YES ❑ NO
UP /SEPA /SU? ❑ YES
❑ NO
PLATTED LOT? cl YES ❑ NO
DEMO PERMIT REQUIRED? ❑ YES
o NO
Bulletin 4100 — March 30, 2004 Page 2 of 4 k \I landouts — Revised \Permit Application