10-103846 411 _ _ X03 g" .1--- ,
``""�� PERMIT SF MF CO ME PL DE EN 1,.. .
Federal Way
COMMUNITY
O 3 3I 2 DEVELOPMENT
,V FLOPAX N SERVICES
APPLICATION RECEIVED
OWN'(Hoopow,c1“,m—oin
SEP 0 9 2010 • ;,2.C"-
SITE ADDRESS
Tr
35100 Enchanted Parkway South, Federal Way, WA CITY OF FEDERALs t41rNIT#
CDS
PROJECT VALUATION ZONING ASSESSORS TAX/PARCEL#
$ 105, 000 . 00 CB 2 1 9 2 6 0 - 0 2 9 0
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ENGINEERING M FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) Costco Gasoline
Installation of a 1, 500 gallon double-wall underground
PROJECT DESCRIPTION
Detailed description of work to storage tank. Install additive dispenser pump and
be included on this permit only transition sump with Veeder-Root sensor, mounted on new
vent rack assembly. See attached scope for more detail .
-
NAME PRIMARY PHONE -_.
PROPERTY OWNER Costco Wholesale (425) 313-8100
MAILING ADDRESS E-MAIL
999 Lake Drive thurlocker@costco.com
CITY STATE ZIP
Issaquah WA 98027
NAME _... ,_.
TBD PHONE
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME ... -. ,_ ._ PHONE
Alexia Inigues (425) 251-6222
APPLICANT MAILING ADDRESS E-MAIL
18215 72nd Avenue South ainigues@barghause.com
CITY STATE ZIP FAX
Kent WA 98032 (425) 251-8782
PROJECT CONTACT NAME PHONE
(The individual to receive and Alexia Inigues (425) 251-6222
MAILING ADDRESS
respond to all correspondence E-MAIL
concerning this application) 18215 72nd Avenue South ainigues@barghause.com
CITY STATE ZIP FAX
Kent WA 98032 (425) 251-8782
ALTERNATE CONTACT NAME: PHONE E-MAIL
Angelo Bologna (4 2 5) 251-6222 abologna@barghausen.com
PROJECT FINANCING NAMECostco Wholesale OWNER-FINANCED
Required value of$5,000 or more
(RCW 19.27.095) MAILING ADDRESS,CITY,STATE,ZIP PHONE
999 Lake Drive, Issaquah, WA 98027 (425) 313-8100
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 will 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 remove the 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 a of is application.
SIGNATURE: id,vt/" DATE 09/09/10
PRINT NAME: Tim Hurlocker
Bulletin#100-April 14,2010 Page 1 of 3 k:\Handouts\Permit Application
• i
MECHANICAL FIXTURES
VALUE OF MECHANICAL WORK $ N/A (a copy of bid or estimate must be provided)
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(Commercial)
BOILERS FURNACES HOT WATER TANKS(ca;)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
PLUMBING FIXTURES
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo) LAYS(Hand sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Ki(eheo/uhh(y) WATER HEATERS(E)ecn;c)
HOSE BIBBS SUMPS WASHING MACHINES N/A TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
Fueling Facility 216 , 582 ❑Yes No ❑Yes EiNo
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
"NEW HOMES ONLY"*
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square Feet Type Stones
NEW BUILDING
ADDITION
COMMERCIAL-REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION area Occupancy Group(s) Construction #of Additional Information
In Square Feet Type Stones
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—April 14,2010 Page 2 of 3 k:\Handouts\Permit Application