12-101370 •
I • _ 1 0 L3 70
cnroF PERMIT SF MF CO ME PL DE EN
i Federal waI ECEIVED
COMMUNITY DEVELOPMENT SERVICES tPPLICATION >V MLGLAT 14 ')S 'A,, UPS''
253-835-2607•FAX 253-835-260'$A A R 2.7 2
MID w.cti uo ffederalwau.co m
M C-l-1- Nk. /A L 1 1219i .
SITE ADDRESS CDS
1701 S Commons(S 320th)Federal Way,WA 98003
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 15,000 CC 7 6 2 2 4 0 - 0 0 1 5
—
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner last Name) Sears Autogas System Installation
PROJECT DESCRIPTION Install one 1,000-gallon horizontal LPG tank for autogas refueling use.Tank installation includes
Detailed description of work to installation of pump and motor,autogas dispenser,and card reader.Tank to be anchored using
be included on this permit only engineered tie-down system and protected from vehicle impact by bollards.
NAME PRIMARY PHONE
PROPERTY OWNER Sears Roebuck&Co.-Tim Williams,Sr.Analyst (847)286-2500
MAILING ADDRESS E-MAIL
3333 Beverly Road
CITY STATE ZIP
Hoffman IL 60179
NAME PHONE
Ferrellgas, LP-Jacob Behrens,Project Manager (360)373-6326
MAILING ADDRESS E-MAIL
CONTRACTOR
3611"A"Street SE JacobBehrens @ferrellgas.com
CITY STATE ZIP FAX
Auburn WA 98002 (360)373-6326
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
FERRELP055LH 09/ 06 /2012
NAME PHONE
Amanda Grindle, Permit Coordinator for Ferrellgas (253)882-4546
APPLICANT MAILING ADDRESS E-MAIL
3611"A"Street SE agrindle @muircontracting.com
CITY STATE ZIP FAX
Auburn WA 98002 (253)559-5452
PROJECT CONTACT NAME PHONE
(The individual to receive and Amanda Grindle, Permit Coordinator for Ferrellgas (253)882-4546
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application) 3611"A"Street SE agrindle @muircontracting.com
CITY STATE ZIP FAX
Auburn WA 98002 (253)559-5452
ALTERNATE CONTACT NAME: PHONE E-MAIL
Jacob Behrens,Ferrellgas Project Manager (360)373-6326 agrindle @muircontracting.com
PROJECT FINANCING NAME ® 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 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 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 cit as a part of this application.
SIGNATURE: DATE 03/27/2012
PRINT NAME: Amanda Grindle, Permit Coordinator for Ferrellgas
Bulletin#100-January 1,2011 Page 1 of 3 k:\Handouts\Permit Application
K!; ,-
y
VALUE OF MECHANICAL WORE $ 15,000 (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 FANS GAS PIPE OUTLETS 4 OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial) LPG Tank
BOILERS FURNACES HOT WATER TANKS(Gas) LPG Dispenser
COMPRESSORS GAS LOG SETS REFRIGERATION SYST LPG Pump&Motor
DUCTING GAS PIPING WOODSTOVES LPG Card Reader
e
` �, il ) irk'_,kkgsse
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.
BATHTUBS(or Tub/Shower Combo) LAVS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
ned� 6 ii i4 da. '�7 L)P k i ,,.. �,-t o Le3 po,C)laq
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
No
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
Sears Auto Parts Store 506,918 ❑Yes❑ No ❑Yes ❑ No
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
4 ���� (00, Ei I! i 1 i a r ......................... ....................................__............................_.........._....._...... ...............
� `' iiilililhPI�gI ix ryn= ;:
FIRST FLOOR(or Mobile Home)
Ilb'
COVERED ENTRY
�IIIIiI�h�l �llll.,i =
Ulgiii!!!!!1"nrill '411111111111111
(t t I I I I 15gO
4 IIIIIIIIl IiIIPIIi d110I gINM tP4 4Illaiig 4 rittii)i II6IIIIi i
GARAGE ❑ CARPORT ❑
^�IBIPIUi�I III(i!�� a`C t � ( t � �� i � � w'I� ) p(" i............................................_........._................................................_..................... ................
mitt tdescr� VIII I( VIII 9 rr = �� ��IIIY
sxtsruvo PROPOSED
Area Totals
r :'1!iii p)h,i). a ,hp:- ;.... il:ili III •'NEW HOM.ESi O1VLF"' "=�''",r � �I �� � IjI YJ'IlhFmv r'ii�'
ESTIMATED SELLING PRICE$ #OF BEDROOMS
is has idil 'a°"-'�'" ���9C �d djllfFtIMLPNP W: ii¢ °'f S
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square Feet Type Stories
IIN G. .Nk e _ C1i II IIi I,i 1
:117511W11:1111111117 "k. I III IItiuj.Illl I) 1 IVI: asakkili = i IA 111101i l,i =-'1. r qp II;IIIIi i iI III„
hI i�
ADDITION
5. a�� , �, . .r; r„ ;.ti i 1° a ,H_<„
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square Feet Type Stories
'`�" i ii I I I Ii 1 iii rm iI t i111111lili i�iiF 3!I au.. iii fliPi idii' : x w _'t..'��a"x 3 III i y '9'C : aiwi ghiiii i _p
II °,?Lt ,>„„r,, ,. ii iiiiii ii'ii,� t ii iii ".,` '` �.. I) IIi t! s <r° s�IIIp III J i®�
lei iii is _ i! f 3�EI7�pC TPIi1:1E.(°x Ilir ill 11 lilh�IIIi iI i� ...= SIMIMaii =� ( i
i � !fi mph i1�7 f>)I II � i b7 r* �d zt
TENANT AREA ONLY
W — °%IeI9 C iJ, 4.y ii�I pp l i i �� i i I t ii1 �° ` 'ad Pr �_ :1111•171:1:2====.5I0- (
1Ii 1 IAi
'
lo. RC Ti=7,1 r i i iI
Bulletin#100—January 1,2011 Page 2 of 3 k:\Handouts\Permit Application