03-105250 City of Federal Way •
Community Development Services Building - Commercial Permit #:03 - 105250 - 00 - CO
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: GENERAL NUTRITION CENTER#500
Project Address: 1823 S SEATAC MALL Parcel Number:762240 0010
Project Description: TI-Non structural TI of fixtures,flooring,ceiling,stock walls and store front.No mech or plumbing.
** 12/9/03 Added plumbing-relocation of existing restroom-(1)WC,(1)lay and water piping.**
*** 12/1.5/03-Added Mechanical-Rooftop HVAC unit,ductwork and restroom fan.***
Owner Applicant Contractor - Lender
NONE JEM CONSTRUCTION INC JEM CONSTRUCTION INC NONE
29506 8TH AVE S JEMCOI*033DD 5/12/02
29506 8TH AVE S
NONE \ROY WA 98580 NONE
Includes:
Census category: 437-Comm #1 #2 #3 @ #4
Occupancy Group: B
Construction Type: I Type V-N
Occupancy Load:
Floor Area(Sq.Ft.): 971
Census Category 437-Commercial altladd Fire Sprinklers Yes
g •
Mechanical.,..... .... Yes Number of Stones.........,.. 1
Permit for Building Shell Only.'. No Plumbing.....<............ Yes
Total Proposed Sq.Feet 971 Will Certificate of Occupancy be Issued'? .....:.Yes
Zoning Designation CC-C
Plumbing Fixtures
Description Quantity Description Quantity Description IQuantity
Lavatories 1 I Water Closets 1
Mechanical Fixtures
Description IQuantity Description Quantity Description Quantity
Ducts 1 Fans 1 Furnaces 1
CONDITIONS:
This decision shall not waive compliance with future City of Federal Way codes,policies,or standards relating to the
subject proposal.
All mechanical and plumbing work must be done on seperate permit
PERMIT EXPIRES July 7,2004.
Permit issued on November 26,2003
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:
ip
City of Federal Way
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 109 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: GENERAL NUTRITION CENTER#5 Permit number: 03 - 105250-00
Address: 1823 S SEATAC MALL
#1 #2 #3 #4
Occupancy Group: B ��
Construction Type: + Type V-N
Occupancy Load:
Floor Area(Sq.Ft.): 971
Owner NONE
Name:
Address:
NONE
_ rnK• nit 46.14% C130 —/2.-o •VGc.j
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.
,,
c.,,,,
City of�cdU"al Way #:03 - 105250 -- 00 - CO
Con,,,�.ant;Development Services Building - Commercial Permit
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253 661 4000 Fax:253 661.4129 Inspection request line: 253.835.3050
Project Name: GENERAL NUTRITION CENTER#500
Project Address: 1714 S SEATAC MALL Parcel Number: 762240 0015
Project Description: TI-Non structural TI of fixtures,flooring,ceiling,stock walls and store front.No mech or plumbing.
** 12/9/03 Added plumbing-relocation of existing restroom-(1)WC,(1)lay and water piping.**
*** 12/15/03-Added Mechanical-Rooftop HVAC unit,ductwork and restroom fan.*** +,yr['gfi
Owner Applicant Contractor Lender
GENERAL NUTRITION CORP. JEM CONSTRUCTION INC JEM CONSTRUCTION INC NONE
300 6TH AVE 29506 8TH AVE S JEMCOI*033DD 5/12/02
PITTSBURG PA 15222 29506 8TH AVE S
\ROY WA 98580 NONE
Includes:
Census category: 437-Comm #1 #2 J #3 #4 j
�r
Occupancy Group - ---. _—- B �r -_�.� JI ----..._ - --- .�
Construction Type Type N .
Occupancy Load
Floor Area(Sq.Pt.): 971 J�—
Census Category........ 437-Commercial altiadd Fire Sprinklers: Yes'
Mechanical... ......... Yes Number of Stories........': .. ...... ................1
Permit!hr Building Shell Only..i .................No Plumbing......... Yes
Total Prorosec_:q.Feet 971 Zoning Designation CC-C
Plumbing Fixtures
Description - 'Quantity Description i'QuantityQuantity
I Descr ption-- lQuantit
Lava idles - - 1 1 L Water Closets — 11 1
CONDITIONS:
This decision shall not waive compliance with future City of Federal Way codes,policies,or standards relating to the
subject proposal.
All mechanical and plumbing work must be done on seperate permit
PERMIT EXPIRES June 9,2004.
Permit issued on November 26,2003
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: ar' .!i -,o' Date: l,F76"..5
i
,
City of Federal Way Building - Commercial Permit #:03 - 105250 00 - CO
Community Development Services
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253 661 4000 Fax 253.661.4129 Inspection request line: 253.835.3050
Project Name: GENERAL NUTRITION CENTER#500
Project Address: 1714 S SEATAC MALL Parcel Number: 762240 0015
Project Description: TI-Non structural TI of fixtures,flooring,ceiling,stock walls and store front.No mech or plumbing.
** 12/9/03 Added plumbing-relocation of existing restroom-(1)WC,(1)lay and water piping.
Owner Applicant Contractor Lender
GENERAL NUTRITION CORP. JEM CONSTRUCTION INC JEM CONSTRUCTION INC NONE
300 6TH AVE 29506 8TH AVE S JEMCOI*033DD 5/12/02
PITTSBURG PA 15222 29506 8TH AVE S
\ROY WA 98580 NONE
Includes:
Census category: 437-Comme #1 #2 #3 #4
Occupancy Group: B
Construction Type: Type V-N
Occupancy Load:
Floor Area(Sq.Ft.): 971
Census Category........ . ................................437-Commercial alt/add Fire Sprinklers, „ ..,..... ... Yes
Mechanical,....,,,..... .. ......... Yes Number of Stories......... ..... 1
Permit for Building Shell Only, No Plumbing.......:. ........ ........,........, Yes
Total Proposed Sq.Feet :971 Zoning Designation- , ,,..,CC-C
Plumbing Fixtures
' KK scr1 r t1 a /i .1.11 Qua ity; Des, . ',.
Lavatories 1 Water Closets I
CONDITIONS:
This decision shall not waive compliance with future City of Federal Way codes,policies,or standards relating to the
subject proposal.
All mechanical and plumbing work must be done on seperate permit
PERMIT EXPIRES May 29,2004.
Permit issued on November 26,2003
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: i�i''/-,c,:=GG Date: /2`��3
411
City ntyc vel Way Building - Commercial Permit #:03 - 105250 - O - 0
Community Development Services
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253 661 4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: GENERAL NUTRITION CENTER#500
Project Address: 1714 S SEATAC MALL Parcel Number: 762240 0015
Project Description: TI-Non structural TI of fixtures,flooring,ceiling,stock walls and store front.No mech or plumbing.
Owner Applicant Contractor Lender
GENERAL NUTRITION CORP. JEM CONSTRUCTION INC JEM CONSTRUCTION INC NONE
300 6TH AVE 29506 8TH AVE S JEMCOI*033DD 5/12/02
PITTSBURG PA 15222 29506 8TH AVE S
\ROY WA 98580 NONE
Includes:
Census category: 437-Comm #1 #2 #3 #4
Occupancy Group: - B
Construction Type: Type V-N
Occupancy Load,,
Floor Area(Sq.Ft.): 971Cif
Census Category........i..... .. 437-Commercial alt/add Fire Spviklers Yes
Mechanicak.. Yes Number of Stories ............ .....' ',.......I
Permit for Building Shell Only. .No No
Total Proposed Sq.Feet 971 i g Designation.,....._ .., CC-G
CO 'F TIONS:
This decision shall not waive compliance with future , ;of Federal Way codes,policies,or standards relating to the
subject proposal.
All mechanical and plumbing work must be do e on seperate permit
PERMIT EXPIRES May 24,2004.
Permit issued on November 26,2003
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: /-.�a---0-3
•
, • •
INSPECTION LOG
DATE INSPECTOR OK CORR/REJ ARE AND TYPE OF INSPECTION
1 :77a5 '74
eoie Dt,sliffpf-# t?Iati"
--
• POST HIS CARD ON THE FRONT OF BUILDI '" - ' • - '
CITY 6'r' - `
, Federal Wa
BUIING DIVISION
INSPECTION RECORD
INSPECTION REQUEST PHONE#: 253-835-3050
PERMIT#: 03-105250-00-CO
OWNER'S NAME: GENERAL NUTRITION CORP.
SITE ADDRESS: 1714 S SEATAC MALL
( ) FOOTINGS/SETBACKS ( ) FOUNDATION WALL
DO NOT POUR CONCRETE UNTIL THE ABOVE IS APPROVED
( ) DRAINAGE: Line ( ) Connection
DO NOT POUR SLAB UNTIL THE ABOVE IS APPROVED
( ) UNDERFLOOR FRAMING
O ROUGH PLUMBING: DWV /Z�� /4 A - Water piping /0 // /
() ROUGH MECHANICAL /-2- 0 V." LLA./ Gas piping
( ) SHEATHING Roof Floor
( ) SHEAR WALLS
O ELECTRICAL ROUGH-IN /2 -"5 -D 3 Tc,r Ditch Cover
() FIRE/DRAFTSTOPS
ALL THE ABOVE MUST BE APPROVED PRIOR TO FRAMING INSPECTION
() FRAMING/FIRESTOPPING /2//1/03 .7-CS
THE ABOVE MUST BE APPROVED PRIOR TO INSULATING OR SHEETROCKING
( ) INSULATION: Floors Walls Attic
THE ABOVE MUST BE APPROVED PRIOR TO APPLYING SHEETROCK
( ) WALLBOARD NAILING /2./2Z/03 re....-/---- ( ) SUSPENDED CEILING /1.-..Z -p 45•/C,c,...)
THE ABOVE MUST BE APPROVED PRIOR TO TAPING OR INSTALLING CEILING TILE
( ) ELECTRICAL FINAL l / 2 O ,3—S
( ) PLANNING FINAL
( ) PUBLIC WORKS FINAL
( ) FIRE FINAL / I - C 1" -R_____,
THE ABOVE MUST BE APPROVED PRIO TO BUILDING DEPARTMENT FINAL
( ) BUILDING FINAL —/,....- 0 q _
DO NOT OCCUPY THIS'BUILDING UNTIL BUILDING FINAL IS APPROVED
f 03-IoS2-To-f
• CONSTRUCWN PERMIT APPLICATION
A CITY OF 443111111114......," APPLICATION NUMBER: "f - -
Federal Way APPLICATION NUMBER: - -
kPPLICATION NUMBER: - -
**The following is required information—Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
- ■ PROPERTY INFORMATION
SITE AD RESS: /7/4( 5 ✓� o"AQ ( ` ASSESSOR'S TAX/PARCEL#: _76 a Y0 - _O 0( ,�
em( w/4f '4 4'S -3
LEGAL DESC•IPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
.. • 111 PROJECT INFORMATION ; '
Nr-
TYPE OF PROJECT(This app Y:.••n): o BUILDING o PLUMBING !'MECHANICAL o DEMOLITION
o ECTRICAL 0 ENGINEERING o FIRE PREVENTION SYSTEM /�
PROJECT DESCRIPTION(Provide de d descr'ption • ✓UE) R ' �sV t 2cT/ <. .3 r
Qr
* PROJECT NAME: C./,X}. C
• P%OpLF INFORMATION
or r
PROPERTY OWNER: NAME: ; DAYTIME PHONE:
°�i�l/1 t- C l� (4'/.?) 4/0,2 -723 (
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): - -
3cr . ,`A/4Z. /? •sl .1/4. /,S2z2--
CONTRACTOR: NAME- ; DAYTIME PHONE:
.i •Z dirg4'eic't/iah -:1, . ! ( 3)60C -S$CY
f MAILING ADDRESS(STREET ADDRESS;CITY,STATE.ZIP): . EVENING PHONE
4� 2ct G F ,/ s. Ec m', .._- gBSst, ; (z 3 )o-43 ;27-45-
CITY
SCITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
_ - _ _ (ZS3 ) t 3 -2.rc.
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) / /
APPLICANT: NAME: DAYTIME PHON :Ja �
^ 0bM7k (Z57)113/
-C I Z
MAILIADDRESS ADDRESI1Y,STATE.ZIP): EVENING
2g57,4 g4 �t S_ mor )% ! (Z3 )q3l -C.2.42_
RELATIONSHIP TO PROJECT: ij FAX NUMBER:
❑ ARCHITECT 0 TENANT MOTHER(DESCRIBE): 7 (z-3) w3 -2 -is----
E-MAIL
E-MAIL ADDRESS'
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER 0 APPLICANT ❑ CONTRACTOR NI
■ DETAILED BUILDING INFORMATION "
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
s ..
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ti4-2'ES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ Y S o NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN 0 HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY. • s-
4
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
■ FIXTURES
Indicate number of each type of fixture mo
MECHANICAL Value of Mechanical Work:$ .
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) / FAN(S) HOOD(S) WOODSTOVE(S)
BOILERS) FIREPLACE INSERT(S) RANGES) MISC.( )
COMPRESSOR(S) IN FURNACE(S)
Qt( DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: o ELECTRIC ❑GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC o GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
•
■ 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(induding costs,expenses,and attorneys'fees Incurred In the
investigation and defense of such daim),which may be made by any person,induding the undersigned,and filed against the City of
Federal Way,but only where such daim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
of the.Information supplied to the city as a part of this application.
NAME/TITLE' DATE: "2—i54:7<::)3
o PROPERTY NER APPLICANT ❑ CONTRACTOR
_,FOR!OFFICEUSE,ONLY ,l
❑ NEW ,;�a ADDITION' 5 ALTERATION'*4,,tk!„ REPAIR`44 f ITENANT IMPROVEMENT ,
'CENSUS'CODE f g u4.t ,. .
'ZONING DESIGNATION,_ , :K * ,o,. BUILDING SHELL ONLY? D YES*s„'❑ NO
COMP PLAN DESIGNATION - t . ASIC PLAN?, ❑:YES °t7 NO„ `
;NEWADDRESSREQUIRED?. YES ❑ NO,
PLATTED LOT? q YES y::o NO afi + '.CHANGE OF USE? `#F, o YES 'o NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.cttvoffederalway.com
��vDc
CONSTRUC I i� PERMIT APPLICATION
CITY OF ��41111116, B APPLICATION NUMBER: 0 a- 1 052 3 -o- Cr-c)
Federal \NayNOv 2 6 2QQ3 APPLICATION NUMBER: - -
kPPLICATION NUMBER: - -
EDERAL WAY
*'The eitilitigSlairovIripformation—Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
■ PROPERTY INFORMATION
SITE ADDRESS: '14-kGCTt. /'dd/ ASSESSOR'S TAX/PARCEL #: -
f lora/ 40/41/ --40,4, 98003 F-/G
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
F -;;- . ■ PROJECT INFORMATION - -
',
TYPE OF PROJECT(This application): 1(BUILDING ❑ PLUMBING 2-MECHANICAL 2'bEMOLITION
0 ELECTRICAL o ENGINEERIING 0FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): ��
. zie7 Gi 2 -/ 1,-,•7a/�I 1 :ra/
(F x+i- res , F1010 rt'✓/ ,eet!`1 , �/e,ei wits , S'74:3,-c Fibte714j
t
PROJECT NAME: (9 of \ IV t tt c f/k- C Lt J
111
-.:;I PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE
4 er/ WeiIirth;c: &-'irk/ V/2 )4/42 - 723 (
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
i 13C0 d..6?--.-96- M is ed.- e'5 .7.
4 CONTRACTOR: NAME: �/ j DAYTIME PHONE:
r J . E..m- .s7z,'eeed 4e -7 .tc&-3 ) -55 y-
MAILING ADDRESS(STREET ADDRESS;CITY,STATE.ZIP): . EVENING PHONE:
z I sa . A 'e 5. 6tkr, 9g0 (433 )Frg3 {G�
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: I FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER: I EXPIRATION DATE:
(ropy of card required) A -C Wt 6 U I- A Q s 3 D (7 ; S / ( . / Zcx,3"
APPLICANT: NAII: DAYTIME PHONE:
L,44e / e/ e ' (253 )'3/ -4242
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
,W 5--s G g ,woe t‹).q 4Cegec) ; (ts3 ) 3-(3 -2765—
RELATIONSHIP
2 $RELATIONSHIP TO PROTECT: i FAX NUMBER:
O ARCHITECT o TENANT BOTHER( DESCRIBE): EY1-)l7— (,7._53 W3 'Cs
E-MAIL ADDRESS:
I �
CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER ,APPLICANT ❑ CONTRACTOR
IIDETAILED BUILDING INFORMATION
EXISTING USE: /Cnn e-4/ ,/ EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ r
I. PROPOSED USE: /{6,'{� f PROPOSED VALUATION FOR IMPROVEMENTS: $ 3- a�
SPRINKLERED BUILDING? %YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑YES /KNO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
•
**NEW RESIDENTIAL CONSTRUCTION Otti*
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• ■ PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST -[ / f q7(
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
■ FIXTURES
Indicate number of each type of fixture
MECHANICAL Value of Mechanical Work: $ 30-64.2.16
ftAIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( h(fc-u-S
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: 0 ELECTRIC ❑GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
■ 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 daim(induding costs,expenses,and attorneys'fees incurred in the
Investigation and defense of such daim),which may be made by any person,induding the undersigned,and filed against the City of
Federal Way,but only where such daim arises out of the reliance of the city,induding Its officers and employees,upon the accuracy
of the Information supplied to the city as a part of this application.
NAME/TITLE: �.ebt` DATE: //"--• C
❑ PROPERTY O ER 1k APPLICANT ❑CONTRACTOR
-FOROFFICE,USE ONLY•__;,.
O NEW, p ADDITION= � ci TENANT IMPROVEMENT ALTERATION -,x5�,„❑ REPAIR:-�
CENSUS`CODE 4 � ..:-Ar ;; . +A'e*..:LOT SIZE: -,• .�x .; _;.,; 4
ZONING DESIGNATION ,, s N 5 BUILDING SHELeittNLY? a YES .°❑
COMP PLAN DESIGNATION'_ h x BASIC PLAN? OYES :x;d NO..
'SECTION :TOWNSHIP ,YRANGE'; .€ ,fi .NEW ADDRESS REQUIRED? _ -o YES _❑ NO
PLATTED LOT? ,..❑YES o NO ` . CHANGE OF'USE? _ d'YES ,•=fl NO
.___............__.._...
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.citvoffederalway.com