10-103199[ 0
City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609
FILE
0
Building - Commercial
Permit #: 10 -103199 -00 -CO
Inspection Request Line: (253) 835-3050
Project Name: JAVA WORX ESPRESSO STAND AT SAFEWAY
Project Address: 28810 MILITARY RD S Parcel Number: 042104 9110
Project Description: ADD -Construct 8' tall, 3 -sided enclosure for espresso stand. No plumbing or mechanical.
Owne
Applicant
Contractor
Lender
SAFEWAY INC STORE 0477
PATRICK MILLETTE
5004 154TH AVE CT E
C/O COMPREHENSIVE PROP TAX
5004 154TH AVE CT E
SUMNER WA 98390
1371 OAKLAND BLVD SUITE 200
SUMNER WA 98390
WALNUT CREEK CA 94596-8408
Census Category: 437 - Commercial alt / add / conversion
Includes:
#1 #2 #3 #4
Occupancy Class:
B
Construction Type:
Type V - B
Occupancy Load:
Floor Areas . ft.
102 1 0 1 0 1 0
Existing Sprinkler System in Building?.................No
Number of Stories ................ ..............................1
Plumbing to be Included?.......................................No
Occupancy # I -Use ............................................... Restaurant
Zoning Designation................................................BN
Mechanical to be Included? ............. ..................No
Permit for Building Shell Only?..... .................No
New / Additional Sq. Feet - Total .......................... 0
Sensitive Areas? (Wetlands/Slopes, etc)................No
PERMIT EXPIRES Tuesday, February 22, 2011
Permit Issued on Thursday, August 26, 2010
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:Date: L�• L �C�
CnrY OF
Federal Way
PERMIT #:
Owner:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
10 -103199 -00 -CO Address: 28810 MILITARY RD S
SAFEWAY INC STORE 0477 FEDERAL WAY, WA 98003-7913
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.
E
SWM Precon Site Mtg (4400)
❑ Roof Sheathing (4220)
Initial Erosion Control (4365)
By
Footings/Setback (4110)
Approved to install siding
Approved
El
To be done prior to breaking ground
By
Approved to place concrete
By
Date
By
Date
By
Date
E]
Foundation Wall (4115)
❑ Roof Sheathing (4220)
Approved to place concrete
By
Date
Approved to install siding
Approved to install roofing
El
Slab/Concrete Floor (4255)
By
Approved to place concrete
By
Date
Drainage/Downspout (4040)
Approved to backfill
By Date
Underfloor Framing (4285)
Approved to sheath floor
By Date
11 Final Erosion Control (4375)
Approved
By Date
Final - Building (4050)
Approved
By Date
Re -steel (4215)
❑ Roof Sheathing (4220)
Approved to place concrete or grout
By
Date
Approved to install siding
Approved to install roofing
❑
Floor Sheathing (4105)
By
Approved to install flooring
By
Date
11 Final Erosion Control (4375)
Approved
By Date
Final - Building (4050)
Approved
By Date
Shear Walls (4245)
❑ Roof Sheathing (4220)
❑
Fire/Draft Stops (4095)
Approved to install siding
Approved to install roofing
By
Approved
By
Date
By Date
By
Date
Date
Interim Erosion Control (4370)
Framing 4120
g ( )
Prior to scheduling a Framing inspection;
Approved
lectrical, Plumbing & Mechanical Rough -in and
I
Approved to insulate
By
Date
re/Draft Stop inspections must be signed -off and
By
Date
approved. IBC 109.3.4
Insulation (4150)
❑ Gypsum Wallboard Nailing (4130)
❑
Suspended Ceiling Grid (4265)
Approved to install wallboard
Approved to install mud & tape
Approved to drop tile
By
Date
By Date
By
Date
Final - Fire Department (4060)
Final - Planning (4070)Final
- Public Works (4080)
Approved
Approved
Approved
By
Date
By Date
By
Date
11 Final Erosion Control (4375)
Approved
By Date
Final - Building (4050)
Approved
By Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
Building Division
CITY OF 33325 Eighth Avenue South
Federal WayPO Box 9718
Federal Way, WA 98063-9718
Phone 253-835-2607
Fax 253-835-2609
CORRECTION NOTICE
ADDRESS: 'Zisl O iI� `I"GIkkPERMIT#: IO -103 1 qj
IF YOU HAVE ANY QUESTIONS CALL Al cA Old �`e� (253) 835-
7,6.71
WHEN CORRECTIONS HAVE BEEN MADE, CALL (253) 835-3050 FOR RE -INSPECTION. SEE BACK OF CARD
FOR DETAILS. NOTE: ELECTRICAL CORRECTIONS ARE REQUIRED TO BE MADE WITHIN 15 DAYS.
X17, LIJ,
DATE INSPECTOR
DO NOT REMOVE THIS NOTICE
Page of
I
QLWY,.
ZWEIVEDWERMIT
"�-83 260E�EFa2�B V 2 7 20f,00APPLICATION
n•n_r_;ilj(c,'jgrtn.gY,py, q: ri
�►.��,'% w_.- �; ..:,- a nr t• i �� a
io 10315!
SI*F `CO ME PL DE EN FP
rb: s'/�/Io
w/ UPt
SITE ADDRESS (^lyS
l
SUITS/UNIT #
1 It- 'LL1Jk- S .
PROJECT VALUATION
20 N6
ASSESSOR'S TAX/PARCEL # ' O O
TYPE OF PERMIT
6LBUILDING ❑ PLUMBING 0 MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
�Q
PROJECT DESCRIPTION
V f
Detailed description of work to
'
'
be included on this permit only.
PROPERTY OWNER
NAME
PREWAAT PHONE
2Cj . i0 - CII
MADJa6 DRESe lC �
St's'-
CITY
G �
STATE
ZIP
NAME •
PHONE
MAILING ADDRESS
E -NAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY RUSDIESS LICENSE #
NAOHSIC
R� . \
.3 Skog 9Ca4
NAILING ADDRESS
1!s, .n -CITY
E -NAIL
APPLICANT
�- `AJ � NZTATE
Zip _ �
�_1yp"yJ��Jo
FAX
PROJECT CONTACT
NAME
PHONE -
(The individual to receive and
respond to all correspondence
:7 Mc
MAILING ADDRESS
E -NAIL
concerning this application)
CITY
STATE
ZIP
FAX
-
ALTERNATE CONTACT NAME:
PHONE
E-NAH,
PROJECT FINANCING
NAME
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 I wail 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 removethe 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 apart of this application.
SIGNATURE: DATE -7(2-%A i CN
PRINT NAME: '
Bulletin #100 - April 14, 2010
Pagel of 3
k:\Handouts\Pernrit Application
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(a copy of bid or estimate must be provided)
Indicate h6w m y eac of furture to be installed or relocated as part of this project. Do not ' ude existing fixtures to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLE OTHER (Describe) �-
AIR CONDITIONER
FIREPLACE INSERTS
HOODS Too .4
BOILERS
FURNACES
HOT R TANKS pad
COMPRESSORS
GAS LO,G SETS
I
IGERATION SYST
DUCTING
GAS PIPING
WOODSTOVES
v: R: ' "Ii:<bi:!.}iiiii '
'al^:
Indicate how many of each type of fixture to be installed relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS )or Tab/Stowe .bo)
LAYS )
TOILETS WATER PIPING
DISHWASHERS
RAIN R SYSTEMS
URINALS .OTHER (Describe)
DRAINS. -
WEIRS
VACUUM BREAKERS- -
DRINKING FOUNTAINSSINKS
Imtchen/utiW
WATER HEATERS (mectoc)
HOSE BIBBS
SUMPS
WASHING MACHINES x Slfl'A%'[M h M <4}>
CRITICAL AREAS OR PROPERTY?
NO
WATER PURVEYOR
SEWERPURVEYOR
VALUE OF EXISTING IMPROVEMENTS
$ /01
EMSTl fG/PR USE
LOT SIZE (la Sqo _Peat)
01
EXISTING FIRE SPRINKLER SYSTEM?
.Yes ❑ No
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes No
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Bulletin #100 —April 14, 2010 Page 2 of 3 k:�Handouts\Permi/