00-106136 • •
City of Federal Way Building - Commercial Permit #:00 - 106136= 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: JACK IN THE BOX
Project Address: 31130 PACIFIC HWY S Parcel Number: 785360 0186
Project Description: TI-Modifying restrooms in existing restaurant. Also,other finish changes. Including some plumbing
and mechanical.
Owner Applicant Contractor Lender
JACK IN THE BOX*ATTN:MANA( NONE MONARCH INC JACK IN THE BOX*ATTN:MANA(
JACK IN THE BOX JACK IN THE BOX
31130 PACIFIC HWY S PO BOX 472 31130 PACIFIC HWY S
FEDERAL WAY WA 98003 NONE GIG HARBOR WA FEDERAL WAY WA 98003
Includes:
Census category: 437-Comm #1 #2 #3 #4
Occupancy Group: B
Construction Type: Type V-N
Occupancy Load:
Floor Area(Sq.Ft.):
Census Category 437-Commercial alt/add Fire Sprinklers No
Mechanical Yes Number of Stories 1
Permit for Building Shell Only No Plumbing Yes
Will Certificate of Occupancy be Issued9 No Zoning Designation BC
Plumbing Fixtures
„ Descriptio" {Quantity Description . {Quantity Description {Quantityd
Lavatories 2 Water Closets 2
Mechanical Fixtures
Description nr = 'Quantity Description IQuantity Description Quantity
Fans 2
CONDITIONS:
1.All new and refaced signs require a separate permit.
PERMIT EXPIRES November 27,2001,IF NO WORK IS STARTED.
Permit issued on May 31,2001
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: 7( Date: _ /
/ \
1 \
. ,
POST r . ON THE FRONT OF BUILDING.
7 •
CITYOF =
EJZIERRI._ BUILDING DIVISION
FlY INSPECTION RECORD
INSPECTION REQUEST PHONE#: 253-661-4140
Request must be received by 3:30 PM for next day inspection
PERIVIIT #: 00-106136-00-CO
OWNER'S NAME: JACK IN THE BOX *ATTN: MANAGER *
SITE ADDRESS: 31130 PACIFIC S
( ) FOOTINGS/SETBACKS ( ) FOUNDATION WALL
DO NOT POUR CONCRETE UNTIL THE ABOVE IS APPROVED
( ) DRAINAGE: Line ( ) Connection
DO NOT POUFt SLAB-UNTIL TII1E ABOVE IS Al'PROVED
( ) UNDERFLOOR FRAMING
( ) ROUGH PLUMBING: DWV 67- 2.0 -•• 01 C,.(,.%) Water piping - --
) ROUGH MECHANICAL Gas piping
( ) SHEATHING Roof Floor
( ) SHEAR WALLS
( ) ELECTRICAL ROUGH-IN Ditch Cover
( ) FIREiDRAFTSTOPS
ALL THE ABOVE MUST BE APPROVED PRIOR TO FRAMING INSPECTION
( ) FRAMING/F1RESTOPPING - fc
THE ABOVE MUST BE APPROVED PRIOR TO INSULATING 0 .SHEETROCKING
( ) INSULATION: Floors Walls ‘:, C>/ Attic
THE ABOVE MUST BE APPROVED PRI R TO APPLYING SHEETROCK
( ) WALLBOARD NAILING Ce, --7 c;) ( ) SUSPENDED CEILING 67 -Zs C2/c ci
THE ABOVE MUST BE APPROVED PRIOR TO TAPING OR INSTALLING CEILING TILE roe'P
) ELECTRICAL FINAL 6> - 3c - ,/,//4
) PLANNING FINAL
( ) PUBLIC WORKS FINAL
( ) FIRE FINAL .0' - _
THE ABOVE MUST BE APPROVED PRIOR TO BUILDING DEPARTMENT FINAL
( ) BUILDING FINAL -
-
DO NOT OCCUPY THIS BUILDING UNTIL BUILDING FINAL IS APPROVED
ar.CW ''' S CONSTRI.ION P RMIT APPLICATI.
F�E.M=1L- APPLICATION NUMBER: l,'- ( - LU LL,, - i_
uv FIY
DEC 2 APPLICATION NUMBER: - _ - -
APPLICATION NUMBER: -
t,►i PING DEPT*A*The following is required information—Please print(in ink)or type**
pitilLPlease note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application,
d • PROPERTY INFORMATION C
SITE ADDRESS: 3f I3c /"itC//. C ///&+/7� ASSESSOR'S TAX/PARCEL #: 78 5/-
J 6 C- C' / g 6,
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
5e e co -e- - 54e el--
■ PROJECT INFORMATION .
TYPE OF PROJECT(This application): YLBUILDING ,PLUMBING ,MECHANICAL ❑ DEMOLITION
• ❑ ELECTRICAL ❑ ENGINEERING FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
,( $rs'Of97 5 - l 4',v 7 ' 7 --re,r,gel/s" �/,7�i2O Ged.oka.�� ' 1o�i ,.✓e,) 0c; A
,�✓iS 'QD2 /,01/0,69,-no. .. ree 5s/e.-/',47-
T , 44-eaA f -'-./vee 4 /�,,,/-s 440 , / 6e ei - , - e ,/o -erg,�,�er__
i ' w./7 be ,,a,9E.v
PROJECT NAME: `Jx /d✓ -Ne 4Q x
■ PEOPLE INFORMATION `
PROPERTY OWNER: NAME: DAYTIME PHONE:
7171GK IN TSE fou /A1 G. ( ) -
MAING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
3To ,6./x.9 ,c 519 / 7, 67 64 9a/023
CONTRACTOR: NAME: DAYTIME PHONE:
gA/ired /IVC. 679 54 (253)6 3/3/
MAI AD S(STREET7 ADDRESS;CITY,ST/6 IP �, i1 J (VENING PHONE: -
' CITY OF FEDERAL WAY BUSINESS LICENSE NNNUU+MBER: FAX NUMBEJR:
— — ( )
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
/ /
APPLICANT: NAME: DAYTIME PHONE:
p,relm/o2 e-C--__ (;S3)2(ac -2.5--Y --
MAILING_'9SS(- STREETADD �9TE,ZIP): #/6 /7 t/. ilt EVENING PHONE: -
RELATIONSHIP TO P OJECT: ,wl,!u_/I FAX NUMBER:
❑ ARCHITECT ❑ TENANT OTHER(DESCRIBE): 6,Q0e0-edi✓lgl,P ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ceCONTRACTOR
II DETAILED BUILDING INFORMATION .
EXISTING USE: Si lelXi "`(4r EXISTING BUILDING ASSESSED/APPRAISED VALUATION() 3.1S3 0 D 0
PROPOSED USE: Si +'b PROPOSED VALUATION FOR IMPROVEMENTS: $ :',5-0/ eV 0
SPRINKLERED BUILDING? �❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES i=i NO
WATER SERVICE PROVIDER: LIf LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: 1LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)
RESIDENTIAL CONSTRUCTION/kY**
VNEW *
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
L! FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(.5)
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) I-' 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
GAS PIPE OUTLET(S) SINK(S) �- WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
n 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 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 appli . -in.
NAME/TITLE: / ` i DATE: /T .-�,
❑ PROPERTY OWNER L! I. ••LICANT ❑ CONTRACTOR
Or
FOR OFFICE USE ONLY:
0 NEW ❑ ADDITION ❑ALTERATION REPAIR TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION: BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE _ NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES CI NO CHANGE OF USE? ❑ YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129