04-102131 •
City of Federal Way Building - Commercial Permit #: 04 - 102131 - 00 - CO
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: T-MOBILE ALDERBROOK
Project Address: 33003 20TH PL SW Parcel Number:010455 0010
Project Description: NEW-Construct 150 square foot equipment shed for wireless telecommunications facility.
Owner Applicant Contractor Lender
Tame Contoravdis &Evelyn Contorat SECURASITE LLC S&G CONSULTING/GC*GARY DI SECURASITE LLC
33003 20TH PL SW PMB 150 SGCON**071K8(10/12/06) PMB 150
FEDERAL WAY WA 5050 MALTBY RD SUITE 7 12201 NE OLIVE DR 5050 MALTBY RD SUITE 7
98023-6477 BOTHELL WA 98021 KINGSTON WA 98346 BOTHELL WA 98021
Includes:
Census category: 328-New o: #1
Occupancy Group: II S-1
Construction Type: Type V-N
Occupancy Lod:
Floor Area`S4.Ft.): 150
1st Floor ProposedSq.Peet 150 Census Category 32`8-New other nonresidentis
Mech ic •No Number of Stories.. ... , 1
Permit for Building Shell Only, No Permit for Foundation Only .No
Plumbing No Total Proposed Sq.Feet . 150
Zoning Designation RS 5.0
CONDITIONS:
1)Right-of-way permit required for work within the public right-of-way(ie: new pole,electrical trenching). Open cutting
of streets is not allowed. Contact Kathleen Messinger at 253-661-4127.
PERMIT EXPIRES June 27,2005.
Permit issued on December 29,2004
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
the City of Federal Way.
Owner or agent: L,`/ Date: 12,./Z"I /Cr/
I
N
DATE INSPECTOR AREA AND TYPE G_ INSPECTION
ifr 204 ";/,'F Rua 1)/Aie ,f-A/57 (‘-er--&'73
THIS CARD IS TO.EMAIN ON-SITE
CITY OF ommunity Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-102131-00-CO
Owner: TAME CONTORAVDIS
Address: 33003 20TH PL SW
FEDERAL WAY, WA 98023-6477
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 ✓/�7 /_. -' Date i 7 By Date By Date
y I �� G. S y y
❑ 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 / .016 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
ri Roof Sheathing(4220) ❑ Fire/Draft Stops(4095) $ NOTE Prior to scheduling a Framing(4120)
Approved to install roofing Approved inspection;Electrical,Plumbing&Mechanical
, �, Rough-in and Fire/Draft Stop inspections must be
N I�% signed off and approved. IBC 109.3.4/UBC 108.5.41
By OW Date \Z �I\ d< By Date
•
It Framing(4120) ❑ Insulation (4150) ❑Gypsum Wallboard Nailing(4130)
Approved to insulate Approved to install wallboard Approved to install mud&tape
By .11,1 Date `E_Vt.k o . By Date By Date
❑ Suspended Ceiling Grid(4265) ❑ Final-Fire Department(4060) ❑ Final-Planning(4070)
Approved to drop tile Approved Approved
By Date By Date By Date
❑ Final-Public Works(4080) ❑ Final-Building(4050)
Approved Approved
By Date By fW Date f 1-
9
Federal Way PERMIT M CO ME EL PL DE EN FP r��3
COMMUMTY DEVELOPMENT SERVICES
If` 33530 FIRST WAY SOUTH•PO BOX 9718
FEDERAL WAY,WA 98063-9718 A P P L I C AT I 8 2004
TD / XI T-
t` /I"k2536614115•FAX 253-6614129 �/
www.dlrrolfederalwap.wra C1T Or F[1)5:1,: n _•
The ollowin• is re.uired in ormation-an inco •lete a••licatiA4iii ir4i 1:$ -e•ted. Please •rint -•ibl (in ink)or
PROPERTY INFORMATION
SITE ADDRESS , 2 j�a V 3 Z(Yin T y�L' Si) SUITE/UNIT# n ,�y
ASSESSOR'S TAX/PARCEL# D / 0 )1 S - 6 G LOT SIZE(4) • ZC lkit�,s
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) 6°T I , eRoat v/(!d/OJJ 1/1,QCC49ed mb' f o -4 eq-/ArvE 5r•
(Attach separate page for lengthy legal description) 6
PROJECT INFORMATION
TYPE OF PERMIT BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
{
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
. NS-k//c-h∎ or b imxii DH rp.0/ - 0.2d.i2F%GE'/°JE ll�?l'19 1;61,-E- Ai'A
E9U/%o/VE)17I //vs/ae airldiatind a gX€?k
PROJECT NAME(Name of Business or Owner Last Name) VO/CE$ 401/r MD4/�/ 1.,Fllie06�
i
PEOPLE INFORMATION
PROPERTY NAME ' PRIMARY PHONE
OWNER T I 1/F/y✓ CYIii)ICAVIJIS ( ) -
MAILING ADDRESS CITY,STATE,ZIP
33063 ?I:04 et, st-✓ p rn 98'62-3
CONTRACTOR COMPANY NAME v APPLICANT NAME OFFICE PHONE
(
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
B L
/ / ( )
CONTRACTORS REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
k / /
APPLICANT COMPANY NAME • Pi/2461), e/ APPLICANT NAME OFFICE PHONE
,SEtI, yas1lz Lc..0 70,,41 1/1ILTO►Ai ( Zoi) 3SS -/ibz-
MAILING ADDRESS CITY,STAT ,ZIP CELL PHONE
Zo�6 /?ICI i1.3/e7 PInBISD - `� E1/I 444- 7.ozi ( ) -
f RELATIONSHIP TO PROJECT / FAX NUMBER
❑ Architect ❑ Tenant ClAgent ❑ Other(Describe) ( Z01 )A( -7&310
}
CONTACT NAME PRIMARY PHONE - E-MAIL D�DRESS� SI,C,..L(r851`*'
r 14/4 ZT41) ( 2 ) 355 - /La 2- +(dual. I C1 `C")St'_Cu V�Stet
LENDE Per RCW 19.27.095: Lender information is NAME�.�►► ,1 / �'
required if project value exceeds$5,000 i/t'/�,i/l
MAILING ADDRESS CITY,STATE,ZIP
DETAILED BUILDING INFORMATION
EXISTING USE SF XS/C'Lx't- / ,CGS&✓ PROPOSED USE i/") -//SS MS/27/4/7a/V
EXISTING ASSESSED/APPRAISED VALUE $ ! VALUE OF PROPOSED WORK $ /.40,4OQ
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
•
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ. FT. PROPOSED SQ. FT. TOTAL
BASEMENT //
FIRST _ / SZ)
SECOND //
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
**NEW HOMES ONLY'* NUMBER OF BEDROO
FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS G:: OGS REFRIG.SYSTEMS
BBQS FANS HOODS(Commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/ShouerCombo) SHOW WATER CLOSETS(rode) MISC(Describe)
DISHWASHERS SI DRINKING FOUNTAINS
GAS PIPE OUTLETS MPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
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 may be made by any person, including the undersigned,and filed against the City of Federal Way,but only where such claim
arises out of the reliance of the city,including its officers d employees, upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE DATE
S/zVZ) V
(Signature) (Title)
RELATIONSHIP TO PROJECT ❑ Owner tent ❑ Contractor ❑ Architect ❑ Other
F R OFFICE USE ONLY
EW ❑ADDITION ❑ALTERATION ❑ REPAIR ❑TENANT IMPROVEMENT
B DING SHELL ONLY? ❑YES O BASIC PLAN? ❑YES O
ZONING DESIGNATION �� `�`( _ CHANGE OF USE? ❑YES O
NEW ADDRESS REQUIRED? ❑YES / UP/SEPA/SU? 0(t- /097// )(YES ❑NO
PLATTED LOT? S ❑ NO DEMO PERMIT REQUIRED? ❑YES (NO
Bulletin#100—March 30,2004 Page 2 of 4 k\Handouts—Revised\Permit Application