10-103383 t , > juilding - COmniercial
City of Federal Way
Community Development Services aCrs Permit #: 10-103383-00-CO
P.O.Box 9718 :,`
Federal Way,WA 98063-9718 Inspection Request Line: 253 R3r0
050
Ph:(253)835-2607 Fax:(253)835-2609 p a
ggott
Project Name: H&R BLOCK
Project Address: 31721 PACIFIC HWY S Suite A Parcel Number: 082104 9078
Project Description: INITIAL TI-Tenant improvements for initial tenant including partition walls,ducts&
diffusers and finish work. No Plumbing.
l ,
Owner Applicant Contractor Lender
DANIEL NIEDER LINN-DOUGLAS CONSTRUCTION LINN-DOUGLAS CONSTRUCTION
ELLAYENN'S LLC INC INC
5363 S KENYON SW PO BOX 8019 LINNDCL000PC(9/27/11)
SEATTLE WA 98118 COVINGTON WA 98042 PO BOX 8019
COVINGTON WA 98042
Census Category: 437 - Commercial alt/add/conversion
Includes: #1 #2 #3 #4
Occupancy Class: B
Construction Type: Type III B
Occupancy Load:
Floor Area(sq.ft.) 2,660 0 0 0
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... .,. - '.. ... �✓,�Z, ,,,,�..�,�s„w , ., �, era`,° ,.: "v, A�a
Mechanical to be Included? Yes Number of Stories I
Permit for Building Shell Only? No Plumbing to be Included9 No
New/Additional Sq.Feet-Total 0 Occupancy#1 -Use Professional
Services/Offices
Zoning Designation CC-F
'-,0,-k,„-tKIRVI,tf
Ducting 1
PERMIT EXPIRES Wednesday, February 2, 2011
Permit Issued on Friday, August 6, 2010
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 la rules and regulations of the State of Washington
and the City •.--eral Way.
Owner or agent: i1 400, ! ,0 -40 -ID"40 I UDate:
Ll /I,\
0 - (- I A, -4.' (.1ci-n \) 4
FINALED
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City of Federal Way •
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: H & R BLOCK Permit#: 10-103383-00-CO
Address: 31721 PACIFIC HWY S SuiteA
Includes: #1 #2 #3 #4
Occupancy Class: B
Construction Type: Type III-B
Occupancy Load:
Floor Area(sq.ft.) 2,660 0 0 0
Owner Name: DANIEL NIEDER
DANIEL NIEDER
Owner Name: ELLAYENN'S LLC
Owner Address: 5363 S KENYON SW
SEATTLE WA 98118
L -e-•2
T 11
Buildin icial Date
The priority focus in the review and i spection 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.
THIS CARD IS TWEMAIN ON-SITE r , ,-
CITY
CITY QF - 0Construction I 3nection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 10-103383-00-CO Address: 31721 PACIFIC HWY S Suite A
Owner: DANIEL NIEDER FEDERAL WAY, WA 98003
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 SWM Precon Site Mtg(4400) 0 Initial Erosion Control(4365) El Footings/Setback(4110)
Approved To be done prior to breaking ground Approved to place concrete
By Date By Date By Date
El Re-steel(4215) ❑ Slab/Concrete Floor(4255) Underfloor Framing(4285)
Approved to place concrete or grout Approved to place concrete Approved to sheath floor
By Date By Date By Date
o Floor Sheathing(4105) 0 Mechanical Rough-in(4165) Gas Piping(4125)
Approved to install flooring Approved Approved to release test
By Date By Date By Date
LI Fire/Draft Stops(4095) ❑ Interim Erosion Control(4370) Prior to scheduling a Framing inspection;
Approved Approved Electrical,Plumbing&Mechanical Rough-in and
Fire/Draft Stop inspections must be signed-off and
By Date By •Date
approved. IBC 109.3.4
•❑ Framing(4120)s ie itlif 4El Insulation (4150) '❑Gypsum Wallboard Nailing(4130)*
Approved to insulate fie -we Approved to install wallboard Approved to install mud&tape
`By ,. Date ,/ 17/y, By Date 'By `-z#.;„ Date' /,
0 Suspended Ceiling rid (4265)+ •�• -0 Final-Fire Department(4060) • Final-Planning(4070)/
Approved to drop tile Approved Approved
By Date By Date By Date
0 Final Erosion Control(4375) El Final-Mechanical(4065) ElFinal-Building(4050)
Approved Approved Approved
•
By Date By j.iDateck. v3,1Bye Dat
0 Rough ElectricalEl Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
• 11°0
_ 3 3 3
A ' 1r RECEIVED � - _ - g
Federal Way RMIT SF MF ME PL DE EN FP
AUA 1 ICATION
COMMUNITY DEVELOPMENT SERVICES O 7tt.
253-835-2607•FAX 253-8 253-835-2609 WAY
turu?a;._;iiyr211i:d7nitrpy:'''�" CIS OF FEDERAL.
CDS
SITE ADDRESS SUITE/UNIT#
31721 Pacific Hwy South - Federal Way, WA 98003 A
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 18,327.00 CF 0 8 2 1 0 4 _ 9 0 7 8
TYPE OF PERMIT a BUILDING 0 PLUMBING l3 MECHANICAL
0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) H & R Block, Branch 63585
Construction of interior partitions and doors with ADA Hardware
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Ellayenn's LLC (Jane Landford - Leasing Agent) 425-653-3000
MAILING ADDRESS E-MAIL
103 Newell Street, Suite B Jane.Lanford@grubbellison.com
CITY STATE ZIP
Seattle WA 98109
NAME PHONE
Linn-Douglas Construction, LLC 253-939-5190
MAILING ADDRESS E-MAIL
CONTRACTOR PO Box 8019 Kirk@Linn-Douglas.com
CITY STATE ZIP FAX
Covington WA 98042 253-939-5189
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
LINNDCLOOOPC 09 / 27 /2011 HI20N�-09-104281-00-BL
NtLILinn-Douglas Construction, LLC P'? 939-5190
APPLICANT MAILING ADDRESS E-MAIL
Same as Contractor
CITY STATE ZIP FAX
PROJECT CONTACT NAME PHONE
Kirk Figenshow
(The individual to receive and
respond to all correspondence MAILING ADDRESS E-MAIL
Same as Contractor
concerning this application)
CITY STATE ZIP FAX
ALTERNATE CONTACT NAME: PHONE E-MAIL
Lori Harvey 253-939-5190 Lori@linn-douglas.com
PROJECT FINANCING NAME e'��
Tenant Financed Hie_ 0 OWNER-FINANCED
Required value of$5,000 or more
(RCW 19.27.095) MAILING ADDRESS,CITY,STATE,ZIP PHONE
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 p ..n,including the undersigned,and filed against the city,
but only where such claim arises out of the reliance of the city, i' uding its officers and employees, upon the accuracy of the
information supplied to t e city as a part of this application.
8-5-10
SIGNATURE: DATE
PRINT NAME: Kirk Figenshow
Bulletin#100—April 14,2010 Page 1 of 3 k:\i-Iandouts\Pernut Application
411 ill
.0,
MECHANICAL FIXTURES
VALUE OF MECHANICAL WORK $ 1,159.00 (a copy of bid or estimate must be provided)
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.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
2 DUCTING GAS PIPING WOODSTOVES
PLUMBING FIXTURES
Indicate how many of each type offvcture 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/Ututty) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
No LakeHaven Lake Haven 318,500
$
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
Vacant 14,472 E(Yes❑ No ❑Yes ❑ No
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- EW/ADDITION
LIDITION
AREA DESCRIPTION `reS Occupancy Group(s) Construction #of
In Square Feet P Y P( ) Additional Information
Type Stories
NEW BUILDING
ADDITION
COMMERCIAL-REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction #of
in Square Feet P y P( ) Type Stories Additional Information
TOTAL'BUILDING 3;,376 B-Business SIM 1
TENANT AREA ONLY 2,260 B-Business IIIB 1
PROJECT AREA ONLY
Bulletin#100—April 14,2010 Page 2 of 3 k:\Handouts\Permit Application