04-104547 City of pederal Way Building - Commercial Permit #: 04 - 104547 - 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: BROADCOM
Project Address: 32001 32ND AVE S Suite410 Parcel Number:162104 9001
Project Description: TI-Tenant improvement project consisting of new partitions,doors,relites,ceiling,lighting,millwork,
and finishes.NO PLUMBING/MECH. Plumbing,mechanical and electrical work to be performed
under separate permits.
Owner Applicant Contractor Lender
FOSS REDEVELOPMENT MARVIN STEIN AND ASSOCIATES JMS CONSTRUCTION CO,A DIVIS FOSS REDEVELOPMENT
1111 FAIRVIEW AVE N 2221 5TH AVE JMSCOC*150RS(12-10-05) 1111 FAIRVIEW AVE N
SEATTLE WA 98109 SEATTLE WA 98121 JMS CONSTRUCTION CO,A DIVIS: SEATTLE WA 98109
8575 WILLOWS RD
Includes:
Census category: 437-Comm #1 Mill #3 #4
Occupancy Grou.: B
Construction Type:. II-A
4.
FOccupancy L aad: 4 86
Floor Area : 4,881
Building Pre-con.Me uired No Census Category` a.v v...43
w 7-Cormiercial alt/add
Fire Sprinklers Yes a. Mechanical...;.... ..., .,,,,. a ! 190
Number of Stories........f-- „4 _ Permit for Budding Shed WY......... „ .No
Permit for Foundation Only No Plumbing No
Special Inspection Required No Will Certificate of Occupancy be Issued? Yes
Zoning Designation OP-1
PERMIT EXPIRES July 3,2005.
Permit issued on December 6,2004
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. C j� /
Owner or agent: See Application Date: //y/ °y
r '
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City of Federal Way
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Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 110.2 of the Uniform 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: BROADCOM Permit number: 04- 104547-00
Address: 32001 32ND S Suite410
#1 #2 #3 #4
Occupancy Group: B
Construction Type: II-A
Occupancy Load: 86
Floor Area(Sq.Ft.): 4,881
Owner FOSS REDEVELOPMENT
Name: 1111 FAIRVIEW AVE N
Address: SEATTLE WA 98109
MK. 410-den Coo Z _ Z _ c 1
Building Official Date
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which experience has shown most severely
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.
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City Federal Way Building - Commercial Permit #: 04 - 104547 - 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: BROADCOM
Project Address: 32001 32ND AVE S Suite410 Parcel Number: 162104 9001
Project Description: TI-Tenant improvement project consisting of new partitions,doors,relites,ceiling,lighting,millwork,
and finishes.NO PLUMBING/MECH. Plumbing,mechanical and electrical work to be performed
under separate permits.
Owner Applicant Contractor Lender
FOSS REDEVELOPMENT MARVIN STEIN AND ASSOCIATES JMS CONSTRUCTION CO,A DIVIS FOSS REDEVELOPMENT
1111 FAIRVIEW AVE N 2221 5TH AVE JMSCOC*150RS(12-10-05) 1111 FAIRVIEW AVE N
SEATTLE WA 98109 SEATTLE WA 98121 JMS CONSTRUCTION CO,A DIVIS SEATTLE WA 98109
8575 WILLOWS RD
Includes:
Census category: 437-Comm #1 h #2 #3 #
r Occupancy Group: B _-11/r —H
Construction ape II-A
FOccupancy'W L 86
loor Area(Sc( :° 4,881
Building Pre-con.Me g-Required ;,.. Census Category •.,..., Commercial a#t18Ktd
Fire Sprinklers .., Yes Mechanical n. No
Number of Stories 4 Permit for Building Shell°Only....,... No
Permit for Foundation Only No Plumbing No
Special Inspection Required No Wilertificate of Occupancy be Issued? No
Zoning Designation OP-1
PERMIT EXPIRES June 4,2005.
Permit issued on December 6,2004
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use ill be in accordance with the laws, les and regulations of the State of Washington an d
the City of Federal Way.
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Owner or agent: /L./ ,, 6 ,,/ / _ Date: e — c— Cl -
DATE INSPECTOR AREA AND TYPE \..4 INSPECTION
/2 .2(3-4V G a ( r c! ►.7 l: _//€11/05 i P9,50- Noc- dcce.. '.
THIS CARD IS T(s*MAIN ON-SITE - •
CITY OF !ommunity Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-104547-00-CO
Owner: FOSS REDEVELOPMENT
Address: 32001 32ND AVE S Suite 410
FEDERAL WAY, WA
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 Date By Date By Date
❑ 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 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
Fire/Draft Stops(4095)
❑ Roof Sheathing(4220) ❑ ra to P ( ) NOTE Prior to scheduling a Framing(4120) g
Approved to install roofing Approved inspection;Electrical,Plumbing&Mechanical
Rough-in and Fire/Draft Stop inspections must be
signed-off and approved. IBC 1093.4/UBC 108.5.4;
By Date By Date
-❑ Framing(4120) ❑ Insulation(4150) ❑Gypsum Wallboard Nailing(4130)
Approved to insulate Approved to install wallboard Approved to install mud&tape
By4c,> Date (-Z_zq,,d By Date By fL,f Date /J i k—
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❑ Suspended Ceiling Grid (4265) ❑ Final-Fire Department(4060) ❑ Final-Planning(4070)
Ap oved to drop tile J Approved Approved
By G Date /+ /11' GZ.5� By 5f Date //2/7/0r.'
?j7//0� By Date
I
❑ Final-Public Works(4080) .El Final-Building(4050)
Approved Approved
(/
By Date By fiX"'"" Date i/i/0
, t
os� �A q - � _a jsC
Federal Way p E R it'o� 0 8 2004 SF MF CO ME EL PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES Y OFA�a
33325 D AVENUE WAY,SOUTH•Po BOX 9718 A P P L I C ATq ,
FEDERAL WAY,FAX 98063-9718 �;y ;Rq� wAY TD / ;-)
253-835.26070 FAX 253-835-2609 y )EPT 19 ({
www.ntgoffederalwau.corn S
The olio • is -•wired i ormation-an inco •fete • v•lication will not be acce• • d. Please • nt in in or •-.
AA• PROPERTY INFORMATION pp aa
SITE ADDRESS 32-401,1 S. 32 Ave•J Q VIA 618091 SUITE/UNIT#k O
ASSESSOR'S TAX/PARCEL# (p 2 0 - I Q LOT SIZE(sj A
i 1 4 1 �- f -c J - — N�
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)�'-7.e.e. (Over skti& (-r1-i) OU QNLIM�)� SCl÷
(Attach separate page for lengthy legal description)
• 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 onlu)
-Tevitud- IA ye-ovrip�ni- r ec f Po1eAl - iii- d- 1/"....." a fiaos, dao^s,
./i ,
. ., , • :/ 4 ! ii WI./IiliI� 1rV�;..- __...41ia�:.--. .:.�I A/ 01 �A i
41%14‘5 G.S. d
PROJECT NAME(Name of Business or Owner Last Name) erO(t,(icon
NI PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER 7 , gig,JI w D00,,ytt," (2o1 )262 -11/00
MAILING ADDRESS / CITY,STATE,ZIP
1111 u;-view Ave, H. exa lr, WA 98109
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
J MS 61m51—rvG1i'0Y, Ja -- 51r kas (4Z5 )853 - evil/
MAILING ADDRESS Road CITY,STATE,ZIP CELL
q Q/.� CELL PHONE//Y�{/) {/�}
(l51✓FEDERAL W111oty BUSINESS RoaV NUMBER PA �O,WAN 16cr 2. (AX NUMBER // 1 DATE
2 o -.Q o_-L0_ 542_ L la- Be)° /Z/ a1 /oat (qZ5) SSZ - 3ZC.Z
CONTRACTORS REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
J_ m s cp c., t i �z o L. 5 )Z/ to /o4
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
Marvti �e1n anc1 A�oc.. Da-11 C.ro",dct,k. (2®(0) iiq I - 1449
MAILING ADD SS CITY,STATE,ZIP CELL PHONE
Z12-I 51- Avem itc S#1-4 WA °18v...1 ( ) N/A -
RELATIONSHIP TO PROJECT FAX NUMBER
Architect ❑ Tenant ❑Agent ❑ Other(Describe) (20t, ) LI1J - ti3(0I
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
'�a� Cry 1 (2o() ) 4t4 I -11449 el.Orevidal)kMdrVt'rlS4f41,c.)%
LENDER Per RCW 19.27.095: Lender information is NAME
required if project value exceeds 55,000 J
MAILING ADDRESS CITY,STATE,ZIP • ++==
fill c t rVI&L) Av*e 1 iq' ss i , WA 98109
n r • DETAILED BUILDING INFORMATION ,�,(��
EXISTING USE tTaC-e pp PROPOSED USE (J'1"71,C4-' Q f-
EXISTING ASSESSED/APPRAISED V A L U E $ N/ A V A L U E OF P R O P O S E D WORK $ _I ,' Z . U lD
SPRINKLERED BUILDING? RYES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES XNO
WATER SERVICE PROVIDER )LAKEHAVE N ❑ HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER xLAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
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PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH 4 881 S, /f B dd/S F
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT❑
NUMBER OF FLOORS ansTIro PROPOSED TOTAL TOTAL sumo sr TOTAL PROPOSE*w TOTAL SP
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
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 GAS LOGS 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 Tab/Shower Combo) SHOWERS WATER CLOSETS(Toile) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAYS(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 authorised 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 relian f the city, nci ••rig i officers and e _ es,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE IJJji / DATE
W (Sign:ure) - (Title)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent ❑ Contractor Architect ❑ Other
FOR OFFICE USE ONLY
❑NEW o ADDITION a ALTERATION a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES o NO BASIC PLAN? a YES a NO
ZONING DESIGNATION CHANGE OF USE? n YES o NO
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NEW ADDRESS REQUIRED? o YES a NO UP/SEPA/SU? o YES a NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? o YES o NO
Bulletin#100—August 19,2004 Page 2 of 4 k\Handouts\Permit Application