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07-103171 r l C;;mmun'Z DeveopmentServices Buiting — Commercial Permit/1#: 07-103171 -00-CO P.O.Box 9718 Federal Way,WA 98063-9718 Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050 Project Name: INTA JUICE Project Address: 2004 S COMMONS C-6 Parcel Number: 762240 0010 Project Description: TI-572 sq/ft Ti to create a juice bar.All existing partitions will be removed to make room for new tenant,except for the restroom walls. **Mechanical and Plumbing included** I Owner Applicant Contractor Lender STEADFAST COMMONS LLC CNA ARCHITECTS JEM CONSTRUCTION INC 1928 S COMMONS 10715 SE 256TH ST JEMCOI*033DD (5/12/09) FEDERAL WAY WA 98003-6013 KENT WA 98030 29506 8TH AVE S ROY WA 98580 J Census Category: 437 - Commercial alt/add/conversion Includes: #1 #2 #3 #4 Occupancy Class: B Construction Type: Type V-B Occupancy Load: 8 Floor Area(sq. ft.) 572 0 0 0 Additional Permit Information New/Additional Sq.Feet- 1st Floor 0 Building Pre-con.Meeting Required?..................No Existing Sprinkler System in Building? Yes Mechanical to be Included? Yes Number of Stories 1 Permit for Building Shell Only?............................No Plumbing to be Included Yes Special Inspection(s)Required?............................No New/Additional Sq.Feet-Total 0 Occupancy#1 -Use Restaurant Zoning Designation CC-C Mechanical Fixtures Ducts 1 Refrigeration Systems 2 Plumbing Fixtures Lavatories 1 Sinks 6 Water Heaters ". PERMIT EXPIRES Saturday, July 18, 2009 Permit Issued on Wednesday, July 18, 2007 I hereby certify that the abo information is correct and that the construction on the above described property and the occupancy and the us will be in accordance with the laws, rules and regulations of the State of Washington and the City of Federal Way. Owner or agent: i Date: 7, i8 (Y-1 (?( 104., .ib `1() 09 to FWJ'Iiillit) j P O. —1 r C ( / 0 � a ' .... 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: INTA JUICE Permit#: 07-103171-00-CO Address: 2004 S COMMONS C-6 Includes: #1 #2 #3 #4 Occupancy Class: B Construction Type: Type V-B Occupancy Load: 8 _ Floor Area(sq. ft.) 572 0 0 0 Owner Name: STEADFAST COMMONS LLC Owner Address: 1928 S COMMONS • FEDERAL WAY WA 98003-6013 Ar Build� g Official Dat 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. THIS CARD IS TO MAIN ON=SITS- - CITY OF -• Community Developm t Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT#: 07-103171-00-CO Owner: STEADFAST COMMONS LLC Address: 2004 S COMMONS C-6 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. • ❑ Footings/Setback(4110) ❑ Re-steel (4215) 0 Plumbing Groundwork(4190) Approved to place concrete Approved to place concrete or grout Approved to cover By Date By Date By i Date /,/,(//, - 0 Slab/Concrete Floor(4255) 0 Underfloor Framing (4285) ElFloor Sheathing(4105) Approved to place concrete Approved to sheath floor Approved to install flooring By Date By Date By Date ❑ Rough Plumbing(4230) 0 Mechanical Rough-in(4165) ❑ Gas Piping(4125) Approved Approved Approved to release test By Q.,1 - Date O t..estc-icn By 0.A f Date els. -4,,I By Date El Fire/Draft Stops (4095) NOTE: Prior to scheduling a Framing(4120) ❑ Framing(4120) Approved z inspection;Electrical,Plumbing&Mechanical I Approved to insulate Rough-in and Fire/Draft Stop inspections must be signed-off and approved. IBC 109.3.4/UBC 108.5.4 By Date kBy GA Date 0Q„et& , ; gro— ❑ Insulation (4150) 0 Gypsum Wallboard Nailing(4130) ❑ Suspended Ceiling Grid (4265) Approved to install wallboard Approved to install mud&tape Approved to drop tile By Date By 0.A.:L."3 Date ..bgt..q ti Bye, Datc j _ ,%._q71 ❑ Final-Fire Department (4060) 0 Final-Planning (4070) �❑ Final-Mechanical (4065) Approved Approved Approved By Date By Date `By c_.."4 .,. . Datep�,... �_tet, ❑ Final-Plumbing (4075) 0 Final-Building (4050) Approved Approved B6,/4 Daf/J42 By�� Date f1 i ' v i. For inspector reference only D Rough Electrical 0 FINAL -Electrical Approved Approved By 0a Date ©,%,.fir„ irz,gip By Date CITY Of " LRECEVVS Vi__PERMIT � -1(<1 SF MF CO ME EL PL DE EN FP COMMUNITY DEVELOPMENT SERVIC 3332FEDERAENUE SOA 98063 BOR N 1 z 'APPLICATION TD FEDERAL WAY,FAX 98063-260 6 / 2r 2 r /0 7 253-835-2607•FAX 253-835-2609 ,,-.R r.vtua/ledt:rvhcntYlV fl y t OII F FEDERAL WAY The following is ret Y, 1Ytr,,ttFt tion-an incomplete application will not be accepted. Please print legibly(in ink)or type. �f� n ■� PROPERTY INFORMATION v ;} � SITE ADDRESS !OO 4, GO/,/1/1401' S r 'E?A1 L I WA Via&UITE/UNIT#(� a ASSESSOR'S TAX/PARCEL# 7 co L�_�0 , - 0 0 / 0 LOT SIZE(sf) �i127'2/ (L9 LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1) (Attach separate page for Lengthy legal description) / IN PROJECT INFORMATION TYPE OF PERMIT I BUILDING S'PPLLUMMBING I MECHANICAL ❑ DEMOLITION W4I1'�ICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this permit only) Lvc r:5Z (i-1 -rt m m oi✓5 A/0-u-,-TH-6 PFJ -r ecWs/s-rs " SiS6L F-r, I !-r (MF,ZDVEM 7- --/ _w A VA/',41-1,4T 5 4�E TO -4- ..i1.416, ( 4ii: A-LL A C w. . 0145 A .*' - ire! . i " .44 Wit^ I ?131tr—r eel WI-Ha-( wiz-c,levw-ri-1 4' -/s'•.. e,i4.r'�� 7 ntr WU.L �}-[-sv F3,,, r2E PROJECT NAME(Name of Business or Owner Last Name) I(\ rA- , i IA I(. .., • PEOPLE INFORMATION PROPERTY NAME / PRIMARY PHONE OWNER M5' \ 921c1-1-EY pCt4 ( &-ed• / /fl � „-" /yis (2.55) 52 _ - ci-7 I cl C FW4lia ^ ©�MAILING ADDRESS6•3( 1) �1 �i�j S. CITY,STATE,ZIP'%IJL/�/4 VIA (WOO aSS lDDR A I I�LUwY SI l7I'tT 'CONTRACTOR COMPANY NAME � APPLICANT NAME OFFICE PHONE MAILING•C.011/4 SS Ce �J +1 t,t ]'• CITY, STATE, STATE, ler (CEW✓-J LL ON � - /�f 0 • '"'��'���'��� •.,. CITY FEDERAL WAY ESS LICENSE NUMBER j EtA XPIRATION DATE E F�AX"NUMBER _ I1 �ti`� �G�53) FV3 Z I�F� c7.7::::•-•"---')Y or eo,d.eyaieea CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS ith each application I > - 4 Co:: p-334) S-2 -O i APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE �� CAA- A +1--r --r -cop ) 'iJ ( 25 ) ec 4 -241 c \,�iT 1" MAILING ADDRESS CITY,STATE,ZIP CELL PHONE /al/a 2 (#-Ts 'T WA`7`°r C>'( (.2-do)9 -10 11,0(aS RELATIONSHIP TO PROJECT FAX NUMBER , Architect ❑ Tenant ❑Agent 0 Other ( '/c )U✓ I - 21-7 PROJECT NAME ' r`` rr q� 1 PRIMARY PHONE E-MAIL IE-MAIL ADDRESS CONTACT He i14 i-Id (2 J) fi T -zzoo hcie1�1(.�`'` I-( 11%'tedON' LENDER NAME -r'1 Per RCW 19.27.095: 17e v1et/1 - cyAA h c.c._ Lender information is required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP PHONE ( ) • DETAILED BUILDING INFORMATION EXISTING USE 1Z 4(t-- PROPOSED USE ©n ��//VkE- EXISTING ASSESSED/APPRAISED VALUE $ (Q _ VALUE OF PROPOSED WORK $ s V-, SPRINKLERED BUILDING? [ 'ES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES AO WATER SERVICE PROVIDER LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER LAKEHAVEN 0 HIGHLINE 0 PRIVATE (SEPTIC) — , ..,.,- - „AREA DESCRIPTION - � � .a EXISTING PROPOSED —, TOTAL . . SQ.FT. . SQ. FT. SQ.FT. BASEMENT FIRST sii4D a. . '>I' --It, THIRD ADDITIONAL FLOORS(DESCRIBE) DECK(0 COVERED OR 0 UNCOVERED?) GARAGE 0 CARPORT 0 NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING Sr TOTAL PROPOSED Sr TOTAL Sr **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ ■ 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 I- Value of Mechanical Work$ WV 00 (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION) AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES BBQS FANS GAS WATER HEATERS MISC(Describe) BOILERS FIREPLACE INSERTS HOODS(Commercial) VP t, COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS 2... REFRIG.SYSTEMS PLUMBING BATHTUBS iorTub/Shower Co m» LAVS(Bathroom Sinks) URINALS MISC(Describe) DISHWASHERS RAINWATER SYST VACUUM BREAKERS oDRINKING FOUNTAINS SHOWERS WATER CLOSETS(roile) �, ELECTRIC WATER HEATERS "6 SINKS WASHING MACHINES HOSE BIBBS SUMPS u 1 t SIGNATURE 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 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 of Federal Way,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. .....04, r / / (1-61,..,4) _' a _c- ` //4r'A NAME/TITLE `' CO/.- DATE (Signature) (Title) RELATIONSHIP TO PROJECT g owner 0 A•ent 0 Contractor o Architect 0 Other o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT BUILDING SHELL ONLY? ❑YES o NO BASIC PLAN? o YES n 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? ❑YES o NO DEMO PERMIT REQUIRED? o YES o NO Bulletin#100—April 2,2007 Page 2 of 4 k\Handouts\Permit Application [iTY i-I0StH Federal way PERMIT SF MF CO ME EL gkoarimiggii, FP COMMUNITY DEVELOPMENT SERVICES 33325 en AVENUE SOUTH•PO BOX 9778 • APPLICATION TD FEDERAL WAY,WA 98063-9778 / / '253-835-2607.FAX 253-835-2609 www.citrjo(federnlwau.com The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type. 0 PROPERTY INFORMATION SITE SITE ADDRESS ��/'1 %� (AC/A/v�/1147 ��' 1'L �D�-t I! (4 A UITE/UNIT# ASSESSOR'S TAX/PARCEL# 77 (0 2_2_40 , - O 2 / 0 LOT SIZE(sf 02/022 (&i9F- LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1) (Attach separate page for lengthy legal description) /al PROJECT INFORMATION TYPE OF PERMIT II BUILDING [1I'PLUMBING /MECHANICAL ❑ DEMOLITION V ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this permit onhi) (14 T G4M440/\/S A4A-t-L- PPieztJ -r co/4s s-rS oP 57 a- SO_ p-r; riq�•lT (M)Pt2o V A4 0r,-1T K-1201 A VA -p4 Y 5PAf Ta '4- Jvl r c 4-►e. A-z-L p, l oils Ire!-L-__ o Jr--_LA V C p ?lel r e7,ia1/I 1WWH1Gt-f WILL-re, /1/V-11 t-1 T t 7 -oe' �At7 WI L ,s� F3� leo C PROJECT NAME(Name of Business or Owner Last Name) 11\1-7-A- _ 1 U V- 1° a PEOPLE INFORMATION PROPERTY NAME ,p PRIMARY PHONE OWNER •11C,041%•11C,041%;.4\s� .(LAY (W ) �� - I c CT ?0( - 7 MAILING ADDRESS '0 4/i STATE, 1 WA V001 �elrE-MAIL ADDRESS 9` 32 �� J /1144- CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE MAILING ADDRESS � ( I� CELL PHONE RA .6 So (253) - S-577i �CITYLO FEDERAL WAY BUSINESS EXPIRATIOFAX N MBR CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE' E-MAIL ADDRESS COPY of card,pegotred with each application t - je-riri (AJ- 03 p~j 2--0( je MA et 7✓TV /lay.�'4 APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE �� ‘,/ 1A-4(T GTS ):1 1�c9 ( 2.53) - 241 MAILING ADDRESS CITY,STATE,ZIP CELL PHONE (2 1(5 ,76P-714 �T PQ- 1)cl�1S0 '( (ic'o)1(5 .- 110 RELATIONSHIP TO PROJECT FAX-NUMBER !/ / yArchitect ❑ Tenant ❑Agent 0 Other. (?f j)U✓ I - 2 -7 •OJECT NAME Yr` pp qq 1� PRIMARY PHONE IE_-MAIL ADDRESS CONTACT ` I✓ 1� 1'1 " (/I✓5) V54 -2410 I�1elem °J�'''t hifeetS, eA NAME Per RCW 19.27.095: Lender information is required if project value exceeds$5,000 MAILIN ADDR SYS CITY,STATE,ZIP PHONE 1755) (o .tel9 ■ i.o TAIL. D BUILDING INFORMATION EXISTING USE r,i PROPOSED USE 'FOOD ✓moi V1c - EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ 1p C •-•— SPRINKLERED BUILDING? XXES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES AO WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER ❑ LAKEHAVEN o HIGHLINE ❑ PRIVATE(SEPTIC)