09-102773 _ ..I ti
• • Building - Commercial
Comm unityP
City ofDevelopmentServices Permit #: 09-102773-00-CO
velopmBox ! ,
Federal Way,WA 98063-9718 _„ Inspection Request Line: (253) 835-3050
Ph (253)835-2607 Fax (253)835-2609 i
Project Name: LA INTERNACIONAL MINI SUPER
Project Address: 35425 21ST AVE SW SUITE C Parcel Number: 252103 9002
Project Description: TI- Construct partition walls to create office space. Furred walls for plumbing& electrical.
Mechanical, plumbing and mechanical on separate permits.
Owner Applicant Contractor Lender
DAVID HOEK DAVID HOEK DAVID'S FEDERAL WAY LLC
DAVID'S FEDERAL WAY LLC DAVID'S FEDERAL WAY LLC PO BOX 8164
PO BOX 8164 PO BOX 8164 TACOMA WA 98418
TACOMA WA 98418 TACOMA WA 98418
Census Category: 437 - Commercial alt/ add/ conversion
Includes: #1 #2 #3 #4
Occupancy Class: B
Construction Type: Type III -B
Occupancy Load: 56
Floor Area(sq. ft.) 2,200 0 0 0
Additional 'ermit``Informatiotil '7'-',,7;,
Existing Sprinkler System in Building? No Mechanical to be Included? No
Number of Stories 1 Permit for Building Shell Only9 . No
Plumbing to be Included? No New/Additional Sq.Feet-Total................ ......... 0
Occupancy.41 -Use Market/Grocery Zoning Designation BN
No Fixtures Associated With This Permit!!
PERMIT EXPIRES Monday, January 18, 2010
Permit Issued on Wednesday, July 22, 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: .,�( 'r/t/C --,� Date: 742. )._ :,1 c
P.)tilittueb lz /s' oi
City of Federal Way •
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 1101 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: LA INTERNACIONAL MINI SUPER Permit#: 09-102773-00-CO
Address: 35425 21ST AVE SW SUITEC
Includes: #1 #2 #3 #4
Occupancy Class: B
Construction Type: Type Ill-B
Occupancy Load: 56
Floor Area(sq. ft.) 2,200 0 0 0
Owner Name: DAVID HOEK
DAVID HOEK
Owner Name: DAVID'S FEDERAL WAY LLC
Owner Address: PO BOX 8164
TACOMA WA 98418
FA
wilding Official. C7 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 sever-1y 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.
\ O
p
• THIS CARD IS TO REMAIN ON-SITE
N„,i.......„ •
°rY°� a • Construction hisillOction Record
Federal Way INSPECTION REQUES'fS: (253) 835-3050
PERMIT #: 09-102773-00-CO Address: 35425 21ST AVE SW SUITE C
Owner: DAVID HOEK FEDERAL WAY, WA 98023
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) El 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) D Floor Sheathing(4105) El Fire/Draft Stops (4095)
Approved to sheath floor Approved to install flooring Approved
By Date By Date By Date
Framing(4120) 0 Insulation (4150)
- f'Prior to scheduling a Framing inspection;
Electrical,Plumbing&Mechanical-Rough-in and Approved to insulate Approved to install wallboard
Fire/Draft Stop inspections must be signed-off and
approved. IBC 109.3.4 . By - s Date 1 - By Date
O Gypsum Wallboard Nailing(4130)0 Suspended Ceiling Grid (4265) 0 Final-Fire Department(4060)
Approved to install mud&tape Approved to drop tile Approved
By Date ts_t VC By a Date\2--qz.1 &9 By / .I7 Date j2/1/e27
O Final- Building(4050)
Approved •
By in Date /2/0
•
•
For inspector reference only
•
0 Rough Electrical 0 FINAL-Electrical
Approved Approved •
By Date •
By Date
_ _o q _ / 0z - 73
CITY Of A Federal Way CEPERMIT SMF ,Co ME EL PL DE EN FP
� !f ` /
COMMUMTY DEVELOPMENT SERVICES
AiPLICATION f�)
www.atuoffederalwau.com 1U L' 2 2 ?Pr°
SITE ADDRESS � I �
SUITE/UNIT# ZONING ASSESSOR'S�T L
(__ 2 2IO 3 002
NAME OF PROJECT
(Tenant or Homeowner Name) C"k 1��-�� ��( `) ) 1AzI (((� I ' tfi „,
E7 BUILDING ❑ PLUMBING CIMECHANICAL 1 jt` i
TYPE OF PERMIT y Y /
❑ DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION
PROJECT DESCRIPTIONF 1 Q l rt— Ni 11 , -Fj_�
Detailed description of work to
be included on this permit only NO a-11)4A,1)11J C 1 El L-.:C LC it 0IS1 Q�'q
is iwal it
NAME m Oc..,%d 5 i:::.. PRIMARY PHONE
PROPERTY OWNER t,) i 0 HotIC 1/‘)6\, LL ( ) -
MAILING ADDRESS,CITY,STATE,ZIP ,� E-MAIL
t ' 130>C 'Ii '.( Tit �✓'i cr sfrta7_
OWNER IS ALSO: 'Q CONTRACTOR 'Q APPLICANT V PROJECT CONTACT
NAME T PRIMARY PHONE
(60NTRACTOR MAILING ADDRESS,CITY,STATE,ZIP FAX
WA STATE CONTRACTORS LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME PRIMARY PHONE
APPLICANT ( ) -
MAILING ADDRESS,CITY,STATE,ZIP FAX
1
PROJECT CONTACT NAME PRIMARY PHONE
(The individual to receive and (/-(e' ) 6-7`i - 5(e i,+
respond to all correspondence MAILING ADDRESS,CITY,STATE,ZIP FAX
concerning this application) ( ) -
ALTERNATE CONTACT NAME: PRIMARY PHONE E-MAIL
(
PROJECT FINANCING NAME
p OWNER-FINANCED
Required for projects with ( (`
value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE
(RCW 19.27.095)
(
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the
best of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply
with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit.I understand that
the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses, and attorneys'fees incurred
in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the
city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city apart ofAhiszp.pplicatton.
SIGNATURE: L ,e' A-- � DATE ')/--d7-- -O
,J
PRINT NAME:
Bulletin#100-4/17/2009 Page 1 of 4 k:\Handouts\Permit Application
MECHANICAL FIXT D ; azoi,
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE PROVIDED)
Indicate number of each type of fixture 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(car)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
PLUMBING FIXTIIRES ,
Indicate number 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) LAVS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
PROJECT VALUATION WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$ 75e+°"
EXISTINGI'PREVIOUS USE LOT SIZE)In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes ❑ No ❑Yes ❑ No
SIDENTIAL
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT — -- — — •
FIRST FLOOR(or Mobile Home)
-- --------.. _ ....----------------
SECOND FLOOR --- — —
COVERED ENTRY
DECK
GARAGE CARPORT❑ CARPORT ❑ --
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ # OF BEDROOMS
\` , COMMERCIAL- NEW/ADDITION
s
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square FeetType Stories
NEW BUILDING
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet Type Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—4/17/2009 Page 2 of 4 k:\Handouts\Permit Application