07-105822 f '
City of Federal Way S Demolition Permit #: 07-105822-00-D E
Community Development Services
P.O.Box 9718
Federal ,WA 98063-
Ph:(253)835-26Way07 Fax:(253)8359718-2609 Inspection Request Line: (253)835-3050
Project Name: WIRB INC
Project Address: 29805 PACIFIC HWY S Parcel Number: 042104 9033
Project Description: Soft demo of interior for future TI.
Owner Applicant Contractor
RICHARD LARSON MICHAEL HOVLAND MOUNTAIN CONSTRUCTION INC
PO BOX 68627 HOVLAND ARCHITECTS MOUNTCI179N2 01/01/09
SEATTLE WA 98168 900 MERIDIAN AVE E SUITE 408 7457 S MADISON ST
MILTON WA 98354 TACOMA WA 98409
Additional Permit Information
CONDITIONS:
After final inspection is complete and approved,please contact K.L. Cimmer by e-mail at
Ka-ic@cityoffederalway.com cityoffederalway.com OR by fax at 253-835-2609 to receive a refund of cash bond.
PERMIT EXPIRES Sunday, October 18, 2009
Permit Issued on Friday, October 19, 2007
I hereby certify that the above information is correct and that the construction on the above described property and.
the occupancy and the u ill b- acc_• •ance ith t - -ws, rules and regulations of the State of Washington
find th= o ederal Way.
Owner or agent: 41(-41 "P. Date: /e// /0-1-
GP'
THIS CARD IS TO WAIN ON-SITE
Pommunity Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 07-105822-00-DE
Owner: RICHARD LARSON
Address: 29805 PACIFIC HWY 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.
0 Final-Building(4050)
Approved
By ///7/)
For inspector reference only _
❑ Rough Electrical ❑ FINAL-Electrical
Approved Approved
By Date By Date
•
• �R RECEt�F `7 - _L Q Z z
Federal way 7 PERMIT 2-t ��
COMMUNITY DEVELOPMENT SERVICES 0 C T 1 9 2007 SF MF CO ME EL PL(11P.) EN FP
33325 813 AVENUE SOUTH•PO BOX 9718
FEDERAL WAY,WA 98063-9718 ' LI CATI N _,--I---------7— __ ._..
253-835-2607•FAX 253-835-2680tT/O F E E D E
wmwc@yoj(edera(3aay.COM
VV��
BUILDING DEPT.
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
• PROPERTY INFORMATION
SITE ADDRESS ?&' P4 to /j�/Cvvw
A l. 5 O CN�7 SUITE/UNIT#_ C,r}
ASSESSOR'S TAX/PARCEL# d fl--I(5 `¢=� ( 7__ LOT SIZE(sfi / 4/6a T S"F.
pppr-6j(.
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) ATTACHED
(Attach separate page for lengthy legal descrtptbn)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
DEMOLITION 0 ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
/Kist./!MIND, - INTARIot CO"(477%0 forte - F°-rff-E. ,:I.
PROJECT NAME(Name of Business or Owner Last Name) W/gel /NC•-
PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER N/gl..Asc/i i-11•.0 ( 1 ) 115 -5i(05
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
Ma40.ftfkli., COA S;(LOCTA ( ) -
MAILING ADDRESS CM,STATE,ZIP ,, CELL PHONE
7 f S1 So. ( i (a 'fl>Kc•r^Pi 3 4 a 5 , ( ) -
CnY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
io1Gl y-a o 12 -i t - o-7 ( ) -
CO R'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
1044 /VT'C1 1q`. IQ2 I /i/a9 ,
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
Pi• H oqi-A146, / .ui irrc7 Micosi c,. t.. rro..0-A, (153.)g-37 -6775
CELL PHONE
c
MAILING
Mt'l-iO/AN r c4 ') /�/tTnw,ADDRESS cny,STATE, �444 Tt3,5i (2'3)157 - 8fn5
RELATIONSHIP TO PROJECT FAX NUMBER
p‘Architect 0 Tenant ❑Agent 0 Other ( Z•c3)$iS -it 0 6
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT MMDU CA rr ( ) -
LENDER NAME Per RCW 19.27.095:
(S f Lf) Lender information is required if project value exceeds$5,000
MARLING DRESS CITY,STATE,ZIP PHONE
( ) -
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES ?NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES NO
WATER SERVICE PROVIDER y LAKEHAVEN 0 IDGHLINE 0 TACOMA ❑ PRIVATE(WELL)
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST ,906G bap(�
g
SECOND ! • o5 i 419
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS m�eavrc rao2 /� fbs osrFj aj5
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project Do not include existing fixtures to remain.
MECHANICAL
Valup of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLHlb WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(commercial)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG Si.15 REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/snow,Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSE1b froaet)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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 part of this application.
SIGNATURE: •' , 1•!T I G 14.1144L se. /4w/L.0t V DATE /a• /9-D 7
Property Owner and . _ thorized Agent
FOR OFFICE USE ONLY
o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES o NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES o NO
10/12/2007 11 : 13 FAX 2536614044 City of Federal way Z 001/002
•
OFCori;sit.Ni't,VDEVELOP MI'N1 SFRVICES
4:1P :3.3325 Srt Avenue South
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CITY >` �,� � railAw"',, Federal way WA 98063-971
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253-835-')607;835-2607;Fax 253-835-2.6M
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DEMOLITION PERMIT REQUIREMENTS
/1 demolition permit is required to remove any structure or structures on a subject property. Check with the City's Planning
Division to see if the proposal exceeds thresholds that trigger an environmental review. An environmental review and
sribmilial of an environmental checklist may he required,which will extend the time period before a demolition permit can
he issued,
1:1 Prior to submitting a demolition permit, the following items(as applicable) must.be signed by the respective
agency(see attached Demolition Permit Contact List).
Nuel:ro ArPI.tco l irrhtres•shall he discnnnccrcrl and services per/irrrned. i%appherrhle,prior r!,issuance of the demolition per-niir.All nlrl>licahle
items helot('are to be Si#.ncd„ynd dstic'r1..b.1'the r•ecpo:live agency mprexr,'ntaltves.
1.ASBESTOS ABATEMENT 6.ELECTRICITY
(Copy of approval fuirn and asbestos survey from Puget Soon .can Air (,lettr#city t0 be shut off and meter removed)
Agency provstt«.,c1) N /
(Paget Sound Energy)
(City of l-rackamel Way Building Official)
2.GAS SUPPLY 7.FUEL STORAGE TANKS
(cia5 to be shut oil,muter removed and final bill paid) (Above or below grade fuel tanks, have been pumped or removed
under Fire Department permit prior to any dismantle/excavation) •
(emit Sound Energy)
(South King Fire and Rescue)
3. SEPTIC SYSTEM S.WATER- Public Source (Chock applicable box)
(Tank to he removed or bink to be drained and filled) rt Meter to be removed and final utility hill paid
`¢r,Meter to remain and he protected
(King County Envauruneritrl Services) ( l Supplier) l6//ce/o7
o
4'AR
4.SANITARY SEWER (Check applicable box) 9.WATER- Private Well(Check applicable box)
.:r Sewer line capped al property lure rt Private well tilled and capped
At a;tinr sewer lint,to remain and be used by proposed new:,tructurc rt Private well to be rr-;0(1 or other purposes
(,ewer District) /6//60/6 7 (Karp County krivironmenli+l Scrvirits)
S. GARBAGE `
(All hnunchoid garbage rlat and final bill paid)
�1/w
(Psi Disposal/Federal Way Disposal)
0 Completed Construction Permit Application form
LI Provide the following fees: 1. Demolition Permit Fee 567.50
2. Automation Fee S,0()
3. WA State Surcharge 4.50
4. (ash Ront.i Deposit _MOO (Refundable upon(.ompleted Final Inspection)
$577.00
lO tI,:lut 1112: J:mi+:,ly 1,2(107 r,igc I on f:V12110 rtri li)Crnolition Prima I\CrEt 111 Y.1 gCl,i'