12-104323*Building - Commercial
City Federal Way
Communi ty & & Econ. Dev. Services Permit #: 12- 104323 -00 -CO
33325 8th Ave S
Federal Way, WA 98003 Inspection Request Line: 253 835 -3050
Ph: (253) 835 -2607 Fax: (253) 835 -2609 p q
Project Name: MY LIFE VITA
Project Address: 1928 S COMMONS UNIT B-2 Parcel Number. 762240 0010
Project Description: TI - Interior modifications for new tenant including partition wall & finish work. No
plumbing or mechanical.
Owner
ARRlicant
Contractor
Lender
STEADFAST COMMONS LLC
KI NAM
PRIME CONSTRUCTION &
ROBERT KIM
1928 S COMMONS
KI NAM ARCHITECT
DEVELOPMENT
MY LIFE, INC
FEDERAL WAY WA 98003 -6013
29605 MILITARY RD S
PRIMECD925RK (12/12/12)
DBA MY LIFE VITA
20
FEDERAL WAY WA 98003
22720 HWY 99 SUITE A
34911 57TH AVE S
Floor Areas . ft.
519
EDMONDS WA 98026
AUBURN WA 98001
Census Category: 437 - Commercial alt / add / conversion
Includes:
#1
#2
#3
#4
Occupancy Class:
M
B
Construction Type,
Type V - B
Occupancy Load
20
18
Floor Areas . ft.
519
1 1,731
1 0
0
Existing Sprinkler System in Building? .................Yes
Number of Stories ................... ..............................1
Plumbing to be Included? ......... .............................No
Zoning Designation ..................... ...........................CC -C
Mechanical to be Included? ...... .............................No
Permit for Building Shell Only9 .............................No
Occupancy # 1 -Use ................. ............................... Sales Room
CONDITIONS:
Subject to field inspection with plans.
PERMIT EXPIRES Saturday, March 23, 2013
Permit Issued on Monday, September 24, 2012
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 th ity of Federal Way. /
Owner or agent: Date:
RNA q /c: /fit
City of Federal Way 'W
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 110.2 of the International Building Code certifying that
at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building
construction or use. This certificate is valid ONLY when endorsed by City staff.
Tenant Name: MY LIFE VITA
Address: 1928 S COMMONS UNITB -2
Permit #: 12- 104323 -00-CO
Includes:
#1
#2
#3
#4
Occupancy Class:
M
B
Construction Type:
Type V - B
Occupancy Load
20
18
Floor Area (s q. ft.)
1 519
1,731
1 0
0
Owner Name: STEADFAST COMMONS LLC
Owner Address: 1928 S COMMONS
FEDERAL WAY WA 98003 -6013
Lem- L 41Z /2.
Buildin fficial Da
h eview and inspection made by the City prior to issuance of this Certificate was on those matters which
experience has shown most sevedy affect the health and safety of the general public. Although the City has made as complete a
review and inspection as is reasonably possible (within budgetary time and personnel limitations), the City neither guarantees nor
warrants to the owner / occupant or to any other person that this Certificate evidences strict compliance with each and every
ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon
which it is situated. Such compliance is the responsibility of the owner and / or occupant of the premises.
CITY OF
Federal Way
• THIS CARD IS TO ON -SITE
Construction In ecti4 Record
INSPECTION REQ TS: (253) 835 -3050
PERMIT #: 12- 104323 -00 -CO Address: 1928 S COMMONS UNIT B -2
Project: STEADFAST COMMONS LLC FEDERAL WAY, WA 98003
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.
Re -steel (4215) Slab /Concrete Floor (4255) Underfloor Framing (4285)
Approved to place concrete or grout Approved to place concrete Approved to sheath floor
By Date By Date By Date
Floor Sheathing (4105) Fire/Draft Stops (4095) Interim Erosion Control (4370)
Approved to install flooring Approved Approved
By Date By Date By Date
EElectrical, duling a Framing inspection; Framing (4120) Insulation (4150)
bing &Mechanical Rough -in and App roved to insulate Approved to install wallboard
nspections must be signed -off and roved. IBC 109.3.4 By Date Z / By Date
Gypsum Wallboard Nailing (4130) Suspended Ceiling Grid (4265) ❑ Final - Fire Departm nt (4060)
Approved to nstaV d & tape Approved to drop tile Approved
B ��� ate � q�L By Date By Date
Y
Final - Planning E] Final Erosion Control (4375) Final - Building (4050)
Approved Approved Approved
By Date By Date By Date —�
SWM Precon Site Mtg (4400)
Initial Erosion Control (4365)
❑
Footings /Setback (4110)
By
Approved
By
To be done prior to breaking ground
By
Approved to place concrete
By
Date
By
Date
By
Date
Re -steel (4215) Slab /Concrete Floor (4255) Underfloor Framing (4285)
Approved to place concrete or grout Approved to place concrete Approved to sheath floor
By Date By Date By Date
Floor Sheathing (4105) Fire/Draft Stops (4095) Interim Erosion Control (4370)
Approved to install flooring Approved Approved
By Date By Date By Date
EElectrical, duling a Framing inspection; Framing (4120) Insulation (4150)
bing &Mechanical Rough -in and App roved to insulate Approved to install wallboard
nspections must be signed -off and roved. IBC 109.3.4 By Date Z / By Date
Gypsum Wallboard Nailing (4130) Suspended Ceiling Grid (4265) ❑ Final - Fire Departm nt (4060)
Approved to nstaV d & tape Approved to drop tile Approved
B ��� ate � q�L By Date By Date
Y
Final - Planning E] Final Erosion Control (4375) Final - Building (4050)
Approved Approved Approved
By Date By Date By Date —�
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
OF n,of i ERM T
Federal Way RECEIV
COMMUNITY DEVELOPMENT SERVICES P L I C A'I' ION
253- 835 -2607• FAX 253- 835 -2609
m ±t�m_riE�_vdervluaLon� � p 21202
I�- � S d- M CO PL DE EN FP
O TC
SITE ADDRESS
�DS
SUITE /UNIT #
6
PRO) T VALUATION
ZONING
ASSESSOR'S TAX /PARCEL #
$ ;,7 p v o C3
�2— !2— C - �/� �� -Z Z?
TYPE OF PERMIT
BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name /Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
&L4,/
be included on this permit only
PROPERTY OWNER
NAME
PRIMARY PHONE
MAILING ADDRESS ^
-°,/ 2 *fF
E-MAIL
CITY
STATE
ZIP
NAME r
46le- Cv�ts�vu� -� ��i ��►L
PHONE
MAILING AdDRESS
E-MAIL
CONTRACTOR
CITY
SIT/jA,TE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PHOIfE
MAILING ADDRESS
.�7 & 0 7 INS I i —�
MAIL gyp,
? m fiJ l'(,ti�Cj 7 "
APPLICANT
CITY
Sr TATS
ZIP �u J3
FAX ---,[ ✓j�ji / n r
Al 6
PROJECT CONTACT
NAME
PHONE
(The individual to receive and
MAILING ADDRESS
E -MAIL
respond to all correspondence
concerning this application)
CITY
STATE
ZIP
FAX
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
PROJECT FINANCING
NAME
Y�
OWNER- FINANCE]'1
Required value of $5,000 or more
l I
MAILING
6 2 ADDRESS. v CITY STAT,�,1ZIP � � IY
^ , ONE
(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 1 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
PRINT NAME:
Bulletin #100 — January 1, 2011 Page i of 3 k: flandoutsTermit Application
♦ 1
VALUE OFMECHAMCAL WORK $ l Vl q J (a copy of bid or estimate must be provided)
Indic ow many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HAN'MWQ UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (Commercial)
BOILERS CES HOT WATER TANKS (c —)
COMPRESSORS GAS LOG SET REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATH qb /Shower Combo)
LAVS (Hand Sinks) _ /
TOILETS
WATER PIPING
DISH WASHER S
RAINWATER SY'1E/
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
reher, /uriii_) T
WATER HEATERS (Electric)
HOSE BIBBS
SUMPS
WASHING MACHINES
FLEW
CRITICAL AREAS O PROPER
k CL-
EXISTING /PREVI US USE
WATER PURVEYOR
Lx 0
LOT SIZE (In Square Feet)
SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
�U 0
EXISTING FI SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
Yes ❑ No ❑ Yes u-<0
AREA DESCRIPTION (in square feet) I EXISTING I PROPOSED I TOTAL FOR OFFICE
FIRST FLOOR (or Mobile Home)
COVERED ENTRY
GARAGE ❑ CARPORT ❑
Area
SELLING PRICE
PROPOSED ) TOTAL