11-102952` r Building - Cominercial
City of Federal Way • ,jjjj '
Community Development Services Permit #: 1 1 - 1 02952 -00 -CO
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609 Inspection Request Line: ( 25
3) 835 -3050
Project Name: SAFEWAY STORE
Project Address: 1207 S 320TH ST Parcel Number: 150050 0020
Project Description: TI - Demolition of some existing pharmacy walls, construction of new walls and doors,
interior relites and a new unisex restroom, includes plumbing fixtures. Mechanical work
on separate permit.
Owner
Applicant
Contractor
Lende r
MGP IX SUNSET SQUARE LLC
TRICON ENTERPRISES
TRICON ENTERPRISES
SAFEWAY INC STORE 0477
425 CALIFORNIA ST FLOOR 11TH
108 FAKERS WAY
TRICOEL90209 (9/29/12)
C/O COMPREHENSIVE PROP TAX
SAN FRANCISCO CA 94104
HAMILTON MT 59840
108 FABERS WAY
1371 OAKLAND BLVD SUITE 200
HAMILTON MT 59840
WALNUT CREEK CA 94596 -8408
Census Category: 437 - Commercial alt / add / conversion
Includes: #1 #2 #3 44
Occupancy Class:
Consatction Type:
Occubaticv Load:
0 1 0
CONDITIONS:
This parcel is located within a Wellhead Protection Area (Capture Zone 10) and must comply with FWRC
Chapter 19.185 and fill out a Hazardous Materials Inventory Statement, if applicable.
PERMIT EXPIRES Tuesday, January 31, 2012
Permit Issued on Thursday, August 4, 2011
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
e City of Fed ral Way.
Owner or agent: Date:
�iNa�.l�D �2 /z�i►
CITY OF
Federal Way
PERMIT #:
Project:
THIS CARD IS TO MAIN ON -SITE
Construction I ection Record
INSPECTION REQUE TS: (253) 835 -3050
11- 102952 -00 -CO Address: 1207 S 320TH ST
SAFEWAY INC STORE 0477 FEDERAL WAY, WA 98003 -5339
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.
C]
SWM Precon Site Mtg (4400)
0
Initial Erosion Control (4365)
E]
Footings /Setback (4110)
Slab /Concrete Floor (4255)
Approved
Approved to place concrete or grout
To be done prior to breaking ground
By /- �� Date /(� �(� - /tl
Approved to place concrete
By
Date
By
Date
By
Date
Framing (4120)
Approved to insulate
B C7 Date(,3i ,2
Insulation (4150)
Approved to install wallboard
By Date
Gypsum Wallboard Nailing (4130)
Approved to install mud & tape
B Date '�? 2,1
0 Suspended Ceiling Grid (4265)
Re -steel (4215)
Final - Fire Department (4060)
❑
Plumbing Groundwork (4190)
Approved to drop tile
Slab /Concrete Floor (4255)
Approved
Approved to place concrete or grout
Approved
By /- �� Date /(� �(� - /tl
Approved to cover
/ Date l` _2 3 f/
Approved to place concrete
By
Date
By Date '2� _ ( _ , `
By
Date
0
Final - Plumbing (4075)
Final Erosion Control (4375)
Final - Building (4050)
Approved
Approved
Floor Sheathing (4105)
Rough Plumbing (4230)
E]
Underfloor Framing (4285)
Date
Approved to sheath floor
r Date
Approved to install flooring
Approved
By
Date
By
Date
By
Date
Ei
El
Fire/Draft Stops (4095)
Interim Erosion Control (4370)
Prior to scheduling a Framing inspection;
Approved
Approved
Electrical, Plumbing & Mechanical Rough -in and
By
Date
By
Date
Fire/Draft Stop inspections must be signed-off and
approved. IBC 109.3.4
Framing (4120)
Approved to insulate
B C7 Date(,3i ,2
Insulation (4150)
Approved to install wallboard
By Date
Gypsum Wallboard Nailing (4130)
Approved to install mud & tape
B Date '�? 2,1
0 Suspended Ceiling Grid (4265)
0
Final - Fire Department (4060)
0
Final - Planning
Approved to drop tile
El
Approved
By
Approved
By /- �� Date /(� �(� - /tl
By
/ Date l` _2 3 f/
By
Date
Date
0
0
Final - Plumbing (4075)
Final Erosion Control (4375)
Final - Building (4050)
Approved
Approved
Approved
By Date
By
Date
By
r Date
Rough Electrical
Approved
El
Final Electrical
Approved
El
Right of Way
Approved
By
Date
By
Date
By
Date
cilry Fe e t-VERMIT
Federal a
COMMUNITY DEVELOPMENT 5- 2609EJ L .� 1 '/,�,� P p LI CAT I O N
253 - 835 -26D7• FAX 253 - 835 -2609 �J A L.
u;tuii.ciYyoffedcratwrxu.�nri2
CITY OF FEDERAL WAIF
SF MF CO ME PL DE EN FP
SITE ADDRESS CDS
3 2v St
SUITE /UNIT #
I Z-u'7 S •
PROJECT VALUATION
ZONING
ASSESSOR'S TAX /PARCEL #
$ 7f11 0 C-0
L '5 a L3 $ O- O o 2 0
TYPE OF PERMIT
BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name /Homeoumer Last Name)
M 4 r•
Sr, e w 4 � 1 1/1 -T
(,
►�c:.•t 0 p � C iL. 110 rN W �I t0 t' � u a2S �s tl �t W �, .�,ItC.
PROJECT DESCRIPTION
Detailed description of work to
t
C1 d tIL S i N k rs icr re tkeS G fi. -^ uX
be included on this permit only
PROPERTY OWNER
NAME C
Jc'4wcxt�
PRIMARY PHONE
A-ZS • 201. L}-W
MAILING ADDRESS
E -MAIL
(I Z ( L?-k44- .A--h2 NL'
11; .1-, U I-CA
CITY
r f"
3T
WA
ZIP
Ct
NAME
n i C.ol� E pr 1` e C
PHOYiE`
Ji• 5C/1
Y��,
Mo DMK
is i. U
E-MAIL
CONTRACTOR
CITY
L �
1- &.; 14 C.� \
STATE
I W
ZIP G
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
Ttuc, -eL eiozo5
IZO12,
NAME 16iI1 1
PHONE 2 �Ge, . T323
APPLICANT
MAILING ADD
(loo. 16L.0
E -MAIL
Iotdr a rr� Cr»1ei�e ! ribtS.
CITY
STATE
AA T
ZIP
FAX
PROJECT CONTACT
NAME � t tI R��t1
t
PHONE
•7
('The individual to receive and
MAILING ADDRESS
40 r60 x l�(�n
E
X51
L
{Y +eancr14u uses•
respond to all correspondence
concerning this application)
CITY �tt
STATE
ZIP
FAX
ALTERNATE CONTACT NAME:
PHONE
E -MAIL
PROJECT FINANCING
NAME N 1AV
0 OWNER- FINANCED
Required value of $5,000 or more
(RCW 19.27.095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
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: ! 11 1
Bulletin #100 - January 1, 2011 Page 1 of 3 k:\Handouts\Pennit Application
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ref
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VALUE OF MECHANICAL WORK ti st(mate must be provided)
Indicate how many of each type kfJIxturefo be " d as part of this project. Do not include existing fvdures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER IREPLACE INS RTS HOODS (commercial)
BOILERS 'RN ACES HOT WATER TANKS (cis)
COMPRES GAS LOG SETS REFRIGERATION SYST
D G 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 xtures to remain.
BATHTUBS (or Tut /Shower Combo)
LAVS (Hand Smks)
TOILETS WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Attchen /Utility)
WATER HEATERS (Etectrtcl
HOSE BIBBS
SUMPS
WASHING MACHINES ; "T01r'iiii
Bulletin #100 - January 1, 2011 Page 2 of 3 kMandoutsTermit Application