05-106040 C°InmunCity of Federal ay DeveopmentServices Building - Commercial Permit #: 05-106040-00-CO
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax (253)835-2609 p q
Project Name: THE FILLING STATION
Project Address: 32015-A 23RD AVE S Parcel Number:
Project Description: Verify occupant load in old Tony Roma's building. No construction work allowed under
this permit.
Owner Applicant Contractor Lender
STEADFAST SEATAC MALL( JIM ROSS
COMMONS) THE FILLING STATION
20411 SW BIRCH ST SUITE 200 1800 SW 320TH CT
NEWPORT BEACH CA 92660 FEDERAL WAY WA 98003
Census Category: 437 - Commercial alt/add
Includes: #1 #2 #3
Occupancy Class: A-2 f
onstruction Type: Type Y- j
Occupancy Load: 203
1€ r Awa(sq. ft.) 6,346 0 0' 'to
"" Ad tonal Pe Information a,
Existing Sprinkler System in Building? No Mechanical to be Included .....N
• Number of Stories 1 Permit for Building Shell Only? Yes
Permit for Foundation Only? No Plumbing to be Included: No
Will Certificate of Occupancy be Issued? Yes Zoning Designation CC-C
No Fixtures Associated With This Permit!I
CONDITIONS:
PERMIT EXPIRES Friday, December 14, 2007
Permit Issued on Wednesday, December 14, 2005
I hereby certify th- - - a•ove 'formation is • -- :.d that the construction on the above described property and
the occupan . and the use wil be i - cordance with he laws, rules and regulations of the State of Washington
-------IIIIIh. .1 o deral Way.
1 � 165
Owner or agent: Date:
City 'of Federal Wa
y a 'ilk-";SN,
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 110.2 of the International 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: THE FILLING STATION Permit#: 05-106040-00-CO
Address: 32015-A 23RD AVE S
Includes: #1 #2 #3 #4
Occupancy Class: A-2
Construction Type: Type V-B
Occupancy Load: 203
Floor Area(sq. ft.) 6,346 0 0 0
Owner Name: JIM ROSS
JIM ROSS
Owner Name: THE FILLING STATION
Owner Address: 1800 SW 320TH CT
r
IEDERAL WAY WA 98003
, r______
K. )244% , Cap
2
Building Official i /' /7C D t
2
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 severly 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.
\ 4�
•
•
•
1 THIS CARD IS TO O/MAIN ON-SITE hik' ,
CITY OF F, ,
Federal WayCommunity Development Inspection Record
IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-106040-00-CO
Owner: STEADFAST SEATAC MALL (COMMON
Address: 32015-A 23RD AVE S
FEDERAL WAY, WA 98003
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) ❑ Fire/Draft Stops (4095) ..,.m
NOTE Prior to scheduling a Framing(4120)
Approved to place concrete Approved
inspection;Electrical,Plumbing&Mechanical
By Date Rough-in and Fire/Draft Stop inspections must be
By Date signed-off and approved. IBC 109.3.4/UBC 108.5.4
Framing(4120) 0 Insulation4150
Approved to insulate ( ) ❑Gypsum Wallboard Nailing(4130)
Approved to install wallboard Approved to install mud&tape
By Date By Date
By Date
❑ Final-Fire Department(4060) 0 Final-Building(4050)
Approved
Approved
By G Date 2 / 04, By Ard Date
0FJOr L - PLu�,leiV
Cyv7r)
. . 04
Federal Way NO 4a / bQLO
COMMUI•T,YDEVELOPMENTEERV] 2 PERMIT
333258*xAVENUESOU771•PoftOXl�. 2•. SF MF 'CO E EL PL DE EN FP
FEDERAL W7$WA 53.83-9718 A' I ' LI C AT I O N TD
253-835-2607.ww.a ddee�way rnm� eU'LO���� / /
The ollowi • is re•sire PT I
d in ormation an n • ,lete a,,lication will not be acce'ted. Please •rint le.ibi in in or
?1I PROPERTY INFORMATION
SITE ADDRESS ' -,( \ ZZ- -f\J CS.. 6,dr f-
SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# (4) Z y►� �-I
'--1Lk 0- v CD-1 C LOT SIZE(sJ7
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
each separate page for lengthy legal description)
i
g A PROJECT INFORMATION
TYPE OF PERMIT )4 BUILDING 0 PLUMBING 0 MECHANICAL _
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed de cription of work included on this permit onlu)
PROJECT NAME(Name of Business or Owner Last Na`e) \ \- ` i A-1 _ �' ,
71 PEOPLE INFORMATION
PROPERTY NAME L
OWNER CS-LeC 4a—Oti ' PRIMARY PHONE
MAILING ADDRESS ; 1`�� CITY,STATE,ZIP
I
4\\ `o 2-cam 4\ ci
CONTRACTOR COMPANY NAME APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP
CELL PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
(: )
EXPIRATION DATE FAX NUMBER
-B L / / ( )
-
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application)
EXPIRATION DATE
I /
APPLICANT COMPANY NAME
APPLICANT
PPPLICANTNAME
OFFICE PONE`-� � �'\\\t l� �� -i \ _TfNA . E ► (z ) - qz^MAILING ADDRESS CITY,STATE,ZIP
CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
o Architect o Tenant a Agent Other(Describe) (7�f-I CM
(� _ 3�Z
CONTACT j
NA;: ^ I ( PH E �fOl /T
E-MAIL ADDRESgS q /
LENDER ` 14e....00
� `1�( l t� .
.J, (d•'+'; r•s ) v-•)---t c air•r tfkon, .t7;x3 NAME
MAILING ADDRESS CITY,STATE,ZIP
IN DETAILED BUILDING INFORMATION
•
EXISTING USE XX" -L _ PROPOSED USE P '.s"tp.,.X"i°\--N, '
EXISTING ASSESSED/APPRAISED V UE
\, .AUE OF PROPOSED WORK $
SPRINKLERED BUILDING? YES az( FIRE SUPPRESSION SEM PROPOSED/REQUIRED? F
/REQUIRED? aYES \)4o
_WASTER SERVICE PROVIDER LAKEHAVEN 0 HIGHLINE 0 TACOMA ❑PRIVATE(WELL)
//
SEWER SERVICE PROVIDER yLAKEIRAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) ,
- PROJECT FLOOR AREAS
AREA DESC' ION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ. .
BASEMENT
FIRST /
/
SECOND ,--
-THIRD /
{
FOURTH •/ /
ADDITIONAL FLOORS(DESCRIBE)
/
DECK(COVERED?)
,--`"l
GARAGE 0 CARPORT 0 !�
r'
sXasrmO PROPOSED TOTAL it l; . K1,* 117 a ER'RR 0' Atli-T.-1-
NUMBER OF FLOORS ;- 1
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATE I ELLING PRICE $
FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this prof- . Do not include existing fixtures to remain.
r
MECHANICAL
Value of Mechanical Work $ \
.7
AIR HANDLING UNITS ,%EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS /'" FANS HOODS(commode) WOODSTOVES
BOILERS i/ FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORSFURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATH S(or ub/Shower Combo( SHOWERS WATER CLOSETS genet) ISC(Describe)
WASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES U' NALS HOSE BIBBS
LAVS(Bathroom Sinks) CUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the info anon 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 0•de by any person,including the undersigned,and filed against the City of Federal Way,but only where such claim
arises out of the,reihince oft -city acting its •fficers and employees,upon the accuracy of the information supplied to the city as a part of
this applicat(�
NAME/' TLE ATE ‘ l 05-
(Signature) (Title)
RELATIONSHIP TO • -OJECT 4 0 er 0 Agent ❑ Contractor ❑ Architect 0 Other
'sP- 1` ;sy ` "-)°-1'(e)31 -;`"'''.-4A'°044 '7'.1,0-V,, , t)•=4) (4.‘4 yr4I ii,' 01t/c)d,,D§"1• stat
`� t-:•__g $ e ,t P it% � } �N(�) � ,t�34!1'4' )(C 3 tI'll � Li t-6:41- ,,t. 49 .1
13:!::T.:.'_:(_,r,Yj)e'ai } 'ii 14 0 ___ ?6 3 _ 40) _ i'rY i!lspt,--1,F:� -,;`,., •;e:,3e
Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application