02-102807f 0 . .
City of Federal Way Building - Commercial Permit #:02 - 102807 - 00 - CO
Community Development Services
33530 1st Way S
Federal Way,WA 98003-6210
• Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: ESPRESSO EXPRESS
Project Address: 33501 1ST S Parcel Number: 926504 0010 1`�(11q
Project Description: TI-Non-structural interior alterations to install cabinets counter and display for existing accessory b
espresso bar/booth in medical clinic building located on main floor,per plans and subject to field
inspection. Includes Plumbing work.
Owner Applicant ! Contractor Lender
VIRGINIA MASON CLINIC ESPRESSO EXPRESS LTD g ESPRESSO EXPRESS LTD NONE
1100 9TH AVE 22004 34TH AVE S
SEATTLE WA 98101-2756 SEATAC,WA 22004 34TH AVE S
98198 SEATAC,WA NONE
Includes:
Census category: 437-Comm #1 #2 #3 #4
Occupancy Group: B
Construction Type: Type V-N
Occupancy Load:
Floor Area(Sq.Ft.): 173.75
Census Category 437 Commercial alt/add Fire Sprinklers Yes
Mechanical No Number of Stories 2
Permit for Building Shell Only No Plumbing Yes
Will Certificate of Occupancy be Issued? Yes Zoning Designation OP
Plumbing Fixtures
Descrier ' n.._.. 1 Crti
�.� � ��, �esrlpf�n ��, �- '.. �� tltY � E�9.{�es�rlMPn ;Quantity
Dishwashers 1 I Drains 1 Sinks 3 1
CONDITIONS:
1.This decision shall not waive compliance with future City of Federal Way codes,policies,or standards relating to the
subject proposal.
PERMIT EXPIRES December 30,2002,IF NO WORK IS STARTED.
Permit issued on July 3,2002
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 a .
Owner or agent: Date: 7- 'v 2
• 1111
City of Federal Way
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 109 of the Uniform 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: ESPRESSO EXPRESS Permit number: 02- 102807-00
Address: 33501 1ST S
#1 #2 #3 #4
Occupancy Group: B
Construction Type: Type V-N
Occupancy Load:
Floor Area(Sq.Ft.): 173.75
Owner VIRGINIA MASON CLINIC
Name: 1100 9TH AVE
Address: SEATTLE WA 98101-2756
4QJ '+ enti .04!
fficiDate
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 severely
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'o 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.
POITHIS CARD ON THE FRONT OF BUILD 1"G
BUIING DIVISION
VL INSPECTION RECORD
INSPECTION REQUEST PHONE#: 253-835-3050
PERMIT #: 02-102807-00-CO
OWNER'S NAME: VIRGINIA MASON CLINIC
SITE ADDRESS: 33501 1ST S
( ) FOOTINGS/SETBACKS ( ) FOUNDATION WALL
Ox-G-• T °�0 ISa,APP
( ) DRAINAGE: Line ( ) Connection
/ 01*-!„0 ItA61,' : fiLI •E` •OVEIS OT ED
( ) UNDERFLOOR FRAMING
() ROUGH PLUMBING: DWV /D/Lff/OLS S Water piping (V J'C
() ROUGH MECHANICAL Gas piping
() SHEATHING Roof Floor
( ) SHEAR WALLS
() ELECTRICAL ROUGH-IN Ditch Cover
( ) FIRE/DRAFTSTOPS
®I :yolk., ''» ! .uo t1103i I SPE 19„N
( ) FRAMING/FIRESTOPPING
° ® :COM:
H SAW1 • .O.' .0 a!TING gH 'rio:q TNG
( ) INSULATION: Floors Walls Attic
'I
__ T' t; .,s °�ORTQf GS ; TItOCKi
( ) WALLBOARD NAILING ( ) SUSPENDED CEILING
'I ° T B °`UV / ' • e °L Oa i0*—G . 'STAY CEILIlYG TILE:
() ELECTRICAL FINAL
() PLANNING FINAL
() PUBLIC WORKS FINAL
() FIRE FINAL
1.01-W01: ...-10 ..... ° 'R e {1 RI '-4p BUILDING DEP,4RTME Ji NAL
( ) BUILDING FINAL ( I Z /137-- 53
o O` T OGCUPi S . ING UN° SIL BUILDINGFINAL iIS APPRO D
;. ... ,.� �-.� .. «g..� ,.. _�. .m -,.�.=;��.x_,s.as.l�.°-:+u�i�,��sr.;. ....t,.�.� �ri�,.. . . A.1=
• �
a of CONSTRUCWON PERMIT APPLICATION
�� � L RECEIVED APPLICATION NUMBER: p` `2-- /< Z die- fee
APPLICATION NUMBER: -
JUL 0 3 2002 APPLICATION NUMBER: - -
Sn , **The ftq�4 pfbit'Ws�n�r�it pT� matiofi—Please print(in ink)or type**
��� 0' Please note: Electrical, Fire Par�i+ott�S9-7prhs and Engineering permits may require a separate application.
• I! PROPERTY INFORMATION
SITE ADDRESS: A3 601 `' 5 ASSESSOR'S TAX/PARCEL#: q 2 é 60e - oo 1 0
-QctD
LEGAL DESCRIP ON OF SOBJECCTT P ay A -CH SEPARATE DESCRIPTION IF LENGTHY): V h /7/C//f �fG` q�..
: .t , PROJECT INFORMATION - . .
TYPE OF PROJECT(This application): ErBUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
El ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(provide detailed description): 0'5kt(J (.1"57 )0) C( h777e,f 5 0,Yid
c tA`7o c ci G 10(u,0?lytn' e ,(ec,PrI ccc4l frk ,Or/4'' l =-u ri.
--5c( rdlitA di / p5r14.4i0PROJECT NAME: E3010e-360 i K1 ) -'-, I \ t fi a
_ ' Z. PEOPLE INFORMATION
PROPERTY OWNER: NAME: t ' yr,0 I 0 ]i be n /i I I DAYTIME PHONE:
/TI JI.f►/9n, ' i j 7?c' /' (Z5 7cf ) c/3
MAILING A�DRESSkSTZ Ef ADDRf$5;CITY,STATE ZIP): J5
f-fad( � jia1 Ott I [VC0
CONTRACTOR: NAME: DAYTIME PHONE:
Tom, N/1 (5- e--e-- ( ) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
(
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
- - ( ) - l
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) /' / I
APPLICANT: NAME.F5 re ,Jc fY v,,�5 `j tOf DAYTIME PHONE: /2g9
��/`' �//
MAILING A DR I/ tfET DRESS; TE,�P,� ����V// Y� `-. COZ-,) /qe/ - /GO 9
,�F O O -E ' ( . T , ,� 1 EVENING PHONE. -
rr1 �, ( I
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECTENANT ❑ OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: LI PROP'RTY OWNER ❑ APPLICANT ❑ CONTRACTOR
IV
DETAILED BUILDING INFORMATION
EXISTING USE: /010 by EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ ` SPS %tire
PROPOSED USE: -- abol ..5.P r I.JiCC € PROPOSED VALUATION FOR IMPROVEMENTS: $ 20,00‘A
4
SPRINKLERED BUILDING? YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ► rv0
WATER SERVICE PROVIDER: VytKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: KEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION O *
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
•
PROJECT FLOOR AREAS •
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND ()ar3/1 y qi /'l//, (1THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL: /1 3" 7 (`
7-3r /45
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET 1 j�� �
GAS PIPE OUTLET(S) 3 SINK(S) WATER CLOSET(S) MISC.( V t' )
INTERCEPTOR(S) SUMP
`DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and
further,that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I
further agree to hold harmless the City of Federal Way as to any daim(induding costs,expenses,and attorneys'fees incurred in the
investigation and defense of such daim),which may be made by any person,induding the undersigned,and filed against the City of
Federal Way,but only where such claim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
of the information su plied to the city as a part of this application.
NAME/TITLE: Len ;/ /1./.71 fr?1 A / /✓C L`tti(Ji DATE: 2 U 2
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION -° ❑ ALTERATION ❑ REPAIR 0 TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:.
ZONING DESIGNATIO BUILDING SHELL;ONLY?: CI-YES- ❑ NO
COMP PLAN DESIGNATION gB BASIC PLAN? 0 YES ❑ NO
SECTION; TOWNSHIP RANGE NEW ADDRESS REQUIRED? 0 YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-6661-4129
www.atvoffederalway.com