09-100291 • •Building - Crr�nm rcial
City of Federal Way Permit #: 09-100291 -00-CO
Communit Development Servicesp
P.O.Box 9718
Federal-260, Fax
(253 9718
835- Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax:(253)835-2609 , ;;.' p q
Project Name: THREE DOG DELI
Project Address: 35425 21ST AVE SW SUITE A Parcel Number: 252103 9002
Project Description: TI- Construction of partition walls, counters and finishes for tenant space. Includes
mechanical for gas piping and outlets.
Owner Applicant Contractor Lender
DAVID HOEK LEE'S LUCKY GENERAL LEE'S LUCKY GENERAL 3 DOG DELI
DAVID'S FEDERAL WAY LLC CONSTRUCTION CONSTRUCTION 35421 21ST AVE SW SUITE B
PO BOX 8164 1413 100TH AVE NE LEESLGC000CJ (3/9/10) FEDERAL WAY WA 98032
TACOMA WA 98418 BELLEVUE WA 98004 1413 100TH AVE NE
BELLEVUE WA 98004
Census Category: 437 - Commercial alt/add/conversion
Includes: #1 #2 #3 #4
Occupancy Class: B
Construction Type: Type V-B
Occupancy Load:
Floor Area(sq. ft.) 900 0 0 0
3 3 "" + tional Permitff foithati r „ fi r
Existing Sprinkler System in Building? No Mechanical to be Included? Yes
Number of Stories 1 Permit for Building Shell Only? No
Plumbing to be Included? No New/Additional Sq.Feet-Total 0
Occupancy#1 -Use Restaurant Zoning Designation BN
„,. Mecha r
Gas Piping 1 Gas Pipe Outlets 3
PERMIT EXPIRES Tuesday, September 8, 2009
Permit Issued on Thursday, March 12, 2009
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: (::_seeZ ( - Date: > ( ., )
KJk1A.-- ?"45--/•:=
City of Federal Way • • f'
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: THREE DOG DELI Permit#: 09-100291-00-CO
Address: 35425 21ST AVE SW SUITEA
Includes: #1 #2 #3 #4
Occupancy Class: B
Construction Type: Type V-B
Occupancy Load:
Floor Area(sq. ft.) 900 0 0 0
Owner Name: DAVID HOEK
DAVID HOEK
Owner Name: DAVID'S FEDERAL WAY LLC
Owner Address: PO BOX 8164
TACOMA WA 98418
is
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 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.
ti
THIS CARD IS TOoMAIN ON-SITE
CITY OF ' - ommunity Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 09-100291-00-CO
Owner: DAVID HOEK
Address: 35425 21ST AVE SW SUITE A
FEDERAL WAY, WA 98023
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 Footings/Setback(4110) ❑ Re-steel (4215) ❑ Slab/Concrete Floor(4255)
Approved to place concrete Approved to place concrete or grout Approved to place concrete
By Date By Date By Date
❑ Underfloor Framing(4285) ❑ Floor Sheathing(4105) ❑ Mechanical Rough-in (4165)
Approved to sheath floor Approved to install flooring Approved
By Date By Date By Date
µ
❑ Gas Piping (4125) ❑ Fire/Draft Stops(4095) NOTE Prior to scheduling a Framing(4120)
Approved to release test Approved inspection;Electrical,Plumbing&Mechanical
Rough-in and Fire/Draft Stop inspections must be
9
By
g/9 signed-off and approved. IBC 109.3.4/UBC 108.5.4
j Date 6 / By Date
. '
0 •
Framing(4120) ❑ Insulation (4150) ❑ Gypsum Wallboard Nailing(4130)
Approved to insulate Approved to install wallboard Approved to install mud&tape
By Date / I IA/ By Date By Date
❑ Suspended Ceiling Grid (4265) ❑ Final-Fire Department(4060) ❑ Final-Planning(4070)
Approved to drop tile Approved Approved
By Date By L.; IVB Date —i _CINC By Date
❑ Final-Mechanical(4065) ❑ Final-Building(4050)
Approved Approved
By (., .,„. Date 49 By Ai Date c)_ I.S-4, 1
For inspector reference only
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
itik
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Federal Way -Q 0 d f
y PERMIT
COMMIIMTYDEVELOPMENT SERVICES t, SF MFA 6" IE "EL PL DE EN FP
3332FEDEAv WAYSWA 98063- x89718 N 2 2 zA P P CATION ��//
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, 253-835-2607•FAX 253-8352609 WA
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uww.di,rolTederalway.com y ur FEDERAL
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The following{ r n—an incomplete application will not be accepted. Please print legibly(in ink)or type.
PROPERTY INFORMATION
SITE ADDRESS C'(, e..' SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# ,2--� 4 Q_49"" ---___ __ LOT SIZE(sJ) .7/./,c✓C`j-7
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal descmpnon)
MI PROJECT INFORMATION
TYPE OF PERMIT [ll'BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(P vide detailed description of work' ded on this permit onit!)
.d.. il: C , 66 aA aits, 4/1. b(i-- 7Z
1 e
L` L d
AS 1
PROJECT NAME(Name of Business or Owner Last Name) P—'17 ‘4hk) Pe ( t
• PEOPLE INFORMATION
PROPERTY NAME y � PRIMARY PHONE
OWNER D/91) 1) / /} . Hock (,c6 ) Gjiici-.c66i
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
L s L L&C-K/ r(, - ii% . L-c.4. ( . ) 30=3J
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
. �� %f3U /yG— !7�%//e�'Ae2 , cal 97oot4 (; c6. ) igl--5317
c7/4e/7& 2
WASI CCE/NSE +dEXPIRATION DATEwFAX NUMBER
"2 "I #'° ' P /c? ',
'iCe!ITR Toa's REIMSTRA • . 1'EB TIO DATE ' E-MAIL ADDRESS
ESS f,(.1 .i/� 9l1
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect o Tenant a Agent 0 Other ( ) -
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT
LENDER NAME
Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP – PHONE
IN DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ c ', u-
r
SPRINKLERED BUILDING? (3YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑ NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN a HIGHLINE 0 PRIVATE(SEPTIC)
• . PROJECT FLOOR AREAS.
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ. FT. SQ.FT. ,�
BASEMENT
70()
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS suarao PROPOSED 1O1A/ TOTAL samro ssr TOTAL PROPOSSO SF -,� iT/A4
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ �f'/U
• FIXTURES ••
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL Q
Value of Mechanical Work$ /6 C77). inti (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
r
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe) •
BOILERS FIREPLACE INSERTS HOODS(commeru4
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/shower Co LAVS(Bathroom Sinks) ------URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(roses)
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:
j111/ / DATE
Property Owner and/or Authorized Agent
IMIIIIIIIIIIIIIM-------t----------------- . .
a NEW a ADDITION ❑ALTERATION ❑REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES o NO BASIC PLAN? a YES o.NO
ZONING DESIGNATION CHANGE OF USE? ❑YES ❑NO
NEW ADDRESS REQUIRED? a YES o NO UP/SEPA/SU? ❑YES a NO
PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? ❑YES ❑NO
Bulletin#100—January 1,2009 Page 2 of 4 k\Handouts\Permit Application