10-105287'3uilding - Counpnergial
Cfty of Bo 9718 y FILE
CommunNDevelopmentservices Permit #: 10- 1052$7 -60 -CO
P.O. Box 9718
Federal Way, WA 98063 -9716 Inspection Request Line: 253 835 -3050
Ph:(253)835 -2607 Fax:(253)835 -2609 P 4 ( )
Project Name: POVERTY BAY COFFEE CO
Project Address: 1108 S 322ND PL Unit A Parcel Number: 150260 0040
Project Description: TI - Interior upgrades to existing space and expansion into adjacent vacant space; includes
plumbing and some mechanical. * " *RIEVISM 7118/11 TO ADD w6vc �
Owner
Aool cai n
Contractor
Lende[
POVERTY BAY COFFEE CO
EARTH TECH INDUSTRIES LLC
EARTH TECH INDUSTRIES LLC
POVERTY BAY COFFEE CO
1108 SW 322ND PL
1911 SW CAMPUS DR SUITE 288
EARTHT1929BD (1/4/12)
1108 SW 322ND PL
FEDERAL WAY WA 98003
FEDERAL WAY WA 98023
1911 SW CAMPUS DR SUITE 288
FEDERAL WAY WA 98003
FEDERAL WAY WA 98023
Includes:
Census Category: 437 - Commercial alt / add / conversion
#1
#2 1 #3
#4
Fibbl' "Area.(sq. ft.) 1 2,666 1 0 1 0 1 0
Building Pre -con. Meeting Required? ' ............No
AuHti
Mechanical to be Included? ........ ............................Yes
Permit for Building Shell Only? .............................No
Special Inspection(s) Required? .............................No
Occupancy #1 - Use .......................... .....................Restaurant
'°.:.. lK`?i �t
Zoning Designation ..................... ...........................CC
-F
Existing Sprinkler System in Building? .................. Nd" '
Number of Stories ..................... ..............................1
Plumbing to be Included ? ........... ............................Yes
New / Additional Sq. Feet - Total .......................... 0
Sensitive Areas? (Wetlands/Slopes, etc) ...........:....No
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington
�r and the City of Federal Wa
Owner or agent: �r r-, Date: q- /
viwat¢A 9,*/n
AuHti
'°.:.. lK`?i �t
.. 'a%h 'r�e�'...,v^a ^"s .,°;$+�,u�.
Fans................. ...............................
1 Gas Piping....... ...............................
1
r�:
TS�{% tR�4 � @fie" ��iP
� .�
`
..
Dishwashers .... ...............................
1 Drains.............. ...............................
1 Lavatories........ ...............................
1
Other Plumbing Fixtures ................
1 Sinks................ ...............................
1 Urinals............. ...............................
1
Water Closets .. ...............................
1 Water Heaters.. ...............................
1
PERMIT EXPIRES Sunday, July 10, 2011
Permit Issued on Tuesday, January 11, 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
�r and the City of Federal Wa
Owner or agent: �r r-, Date: q- /
viwat¢A 9,*/n
• - luildiing5- com "e r0al�
City of Fedesal Way z Q�'�' (fin
Community Development Services Permit #. 10 -1052V 1 -W/ -VO
P.O. Box 9718
Federal Way, WA 98063 -9718 Inspection Request Line: 253 835 -3050
Ph:(253)836 -2607 Fax:(253)835 -2609 p q
Project Name: POVERTY BAY COFFEE CO
Project Address: 1108 S 322ND PL Unit A Parcel Number: 150260 0040
Project Description: TI - Interior upgrades to existing space and expansion into adjacent vacant space; includes
plumbing and some mechanical.
Census Category: 437 - Commercial alt / add / conversion
Includes: 1 #1 1 #2 1 #3 1 #4
_B
Load:
0
Fans................. ............................... 1 Gas Piping....... ............................... 1
Dishwashers .... ............................... 1 Drains.............. ............................... 1 Lavatories............... ?..................... 1
Other Plumbing Fixtures ................ 1 Sinks................ ............................... 1 Urinals .......................... i................. 1
Water Closets .. ............................... 1
PERMIT EXPIRES Sunday, July 10, 2011
Permit Issued on Tuesday, January 11, 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 i rdance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: Date:
Owner
Applicant
Contractor
Lender
POVERTY BAY COFFEE CO
EARTH TECH INDUSTRIES LLC
EARTH TECH INDUSTRIES LLC
POVERTY BAY COFFEE CO
1108 SW 322ND PL
1911 SW CAMPUS DR SUITE 288
EARTHT1929BD (1/4/12)
1108 SW 322ND PL
FEDERAL WAY WA 98003
FEDERAL WAY WA 98023
1911 SW CAMPUS DR SUITE 288
FEDERAL WAY WA 98003
FEDERAL WAY WA 98023
Census Category: 437 - Commercial alt / add / conversion
Includes: 1 #1 1 #2 1 #3 1 #4
_B
Load:
0
Fans................. ............................... 1 Gas Piping....... ............................... 1
Dishwashers .... ............................... 1 Drains.............. ............................... 1 Lavatories............... ?..................... 1
Other Plumbing Fixtures ................ 1 Sinks................ ............................... 1 Urinals .......................... i................. 1
Water Closets .. ............................... 1
PERMIT EXPIRES Sunday, July 10, 2011
Permit Issued on Tuesday, January 11, 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 i rdance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: Date:
DD. TI•:
INSPEC1 Ok
XVD-fN 1)v O1 �SI)FC FION
rz
� O ,kIN
s
IMF
crrraF a + 4,
Fedee'aE'�{Vay,
TAIS.CARD IS TO REMAIN QN -SIT,E
Construction I )ection Record
INSPECTION REQUESTS: (253) 835 -3050
PERMIT #: 10- 105287 -00 -CO .Address: 1108 S 322ND PL Unit A__
Project: POVERTY BAY COFFEE CO FEDERAL WAY, WA 93
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 bottq4 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)
Approved to place concrete or gout
By Date
Underfloor Framing (4285)
Approved to sheath floor
By Date
Mechanical Rough -in (4165)
Approved
By Date
Interim Erosion Control (4370)
Approved
By Date
:Insulation (4150)
Approved to install wallboard
By Date
Final - Fire Department (4060)
Approved
By Date 7 /y //%
rl Final- Mechanical(4065)
Approved
By Date, ?
Plumbing Groundwork (4190)
Approved to cover
B Date I'
Floor Sheathing (4105)
Approved to install flooring
By Date
Gas Pipi
Approved to
Date V � ( (9--
test
Prior to scheduling a Framing inspection;
Electrical, Plumbing & Mechanical Rough-in amid
Fire/Dr,g,ft Stop inspections must be signed -oft and
approved. IBC 1093.4
Gypsum Wallboard Nai6ni
Approved to install mud & tape
Date
r'inal I rla
Approved
By Date
Final - Plumbing (4075)
Approved
By `l4 Date
11
SWM Precon Site Mtg (4400)
❑
Initial Erosion Control (4365)
Approved to place concrete
Footings/Setback (4110)
By
Approved
By
To be done prior to breaking ground
Approved to place concrete
By
Date
By
Date
By
Date
Re -steel (4215)
Approved to place concrete or gout
By Date
Underfloor Framing (4285)
Approved to sheath floor
By Date
Mechanical Rough -in (4165)
Approved
By Date
Interim Erosion Control (4370)
Approved
By Date
:Insulation (4150)
Approved to install wallboard
By Date
Final - Fire Department (4060)
Approved
By Date 7 /y //%
rl Final- Mechanical(4065)
Approved
By Date, ?
Plumbing Groundwork (4190)
Approved to cover
B Date I'
Floor Sheathing (4105)
Approved to install flooring
By Date
Gas Pipi
Approved to
Date V � ( (9--
test
Prior to scheduling a Framing inspection;
Electrical, Plumbing & Mechanical Rough-in amid
Fire/Dr,g,ft Stop inspections must be signed -oft and
approved. IBC 1093.4
Gypsum Wallboard Nai6ni
Approved to install mud & tape
Date
r'inal I rla
Approved
By Date
Final - Plumbing (4075)
Approved
By `l4 Date
11
Slab /Concrete Floor (4255)
Approved to place concrete
By
Date
By
Date
By
Rough Plumbing (4230)
By
Approved
By
Date
Fire/Draft Stops (4095)
Approved
By
I Date
Framing (4120)
Approved to nsnlate
By
Dsi1e — Fs
0 Suspended Ceiling Grid (4265)
Approved to drop the
By Date
Final Erosion Control (4375)
Approved
By Date
Final - Building (4050)
Approved
By Date
o
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
Feder i
E� PERMIT
co', C R.
25,3-835 -2607- FdX � APPLICATION
253 -8 35 -2609
n7gc•!;94 °Gof ^r1--- - --: ^r rDEC 2O
w 1 �nl &r
MF CO E PL DE EN FP
SITE ADDRESS
I
� � Z id§
SUITE /UNIT M ,.,
PROJECT VALUATION
$
7nv*1iri I
ASSESSOR'S T ARCEL N
I —/ -f D a a
TYPE OF PERMIT
l6 BUILDING I PLUMBING ECHANICAL
❑ DEMOLITION D ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
jrenantName/ Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
v n t• ' t "� 1 tl c C
II
0. -
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS
E -MAIL
CITY
STATE
ZIP
NABIE .
�or �Ec �t� �,.z L
PHONE
/ -
MAILING ADDHESS
5
B -MAIL .
CONTRACTOR
CITY
F� til 1
STA
�
e&
FAX
STATE CONTRACTORStiCENSZ it
9z. 'D
EXPIRATION DATE
, i
FEDERAL WAY BUSINESS LICENSE E
A Ie -
NAME
PHONE
+�.
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
(The individual to receive and
N A
PHONE
MAULING ADDRESS
2 '} 0�
E-VAIL
w v l
respond to all correspondence
this application)
CITY
R�-Lj t +
SATE
1(7�
Z�
FAX
ALTERNATE CONTACT
i�
PRO"
. AQ
E -MAIL
PROJECT FINANCING
NAME
OWNER - FINANCED
Required value of $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 bast
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 taws regulating
construction or environmental laws.
I further agree to hold harmless the Ci of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in
the Investigation and defe of such cla ,which may be made by any person, including the undersigned, and filed against the city,
but only where such c es out of reliance of the city, including its officers and employees, upon the accura of the
informati on supplied tot as a part th application.
SIGNATURE: DATE I� /
PRINT NAME: t �J
Bulletin #100— April 14, 2010 Page 1 of 3 k:\Handouts\Perrnit Application
�l�t Sq 14 bt
{ 1 ' ;.
VALUE OF MzcFfwLL WORK $ I
V f L
(a copy of bid or estimate must be provided)
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.
AIR HANDLING UNITS
PANS
GAS PIPE OUTLETS OTHER (Describe( -,
_ AIR CONDITIONER
FIREPLACE INSERTS
HOODSIcommerdy
BOILERS
FURNACES
HOT WATER TANKS (G.)
_
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING —L—
GAS PIPING
WOODSTOVES
Indicate how many of each type of fracture to be installed or relocated as part of this project. Do not include existing futures to remain.
BATHTUBS (or Tub /show comb)
Area Occupancy Groupie)
LAVS (HmdSinla)
1 TOILETS
WATER PIPING
1 DISHWASHERS
RAINWATER SYSTEMS
I URINALS
OTHER (Describe)
DRAINS
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A i , r`.: : 'i�: i.
SHOWERS
VACUUM BREAKERS
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DRINKING FOUNTAINS
�_
SINKS (rAchen /ua"
WATER HEATERS (mectric)
Si�o-,S�w�i
$ `Ir$ ` f� . `.i�. 'i ii.: $ $::: ' :y' }
HOSE BIBBS
SUMPS
WASHING MACHINES
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Bulletin #100 — April 14, 2010 Page 2 of 3 kMiandoutsTermit Application
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Additional Information
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Bulletin #100 — April 14, 2010 Page 2 of 3 kMiandoutsTermit Application