14-103441 r riilding - Commercial
City of Federal Way Permit #: 14-103441-00-CO
Community&Eccyn.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph.(253)835-2607 Fax.(253)835-2609 FILE
Project Name: T-MOBILE SE04693A MIRROR LAKE
Project Address: 31627 1ST AVE S Parcel Number: 072104 9210
Project Description: ALT-Removal& replacement of(6)antennas and addition of(3)antennas and
miscellaneous tower-mounted equipment.
Owner Applicant Contractor Lender
SOUTH KING FIRE&RESCUE T-MOBILE MYCOM NORTH AMERICA INC
31617 1ST AVE S 19807 NORTH CREEK PKWY N MYCOMNA882PB(10/2/16)
FEDERAL WAY WA 98003 BOTHELL WA 98011 15340 NE 92ND ST BLDG D
REDMOND WA 98052
Census Category: 999-Unknown
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load
Floor Area(sq.ft.) 0 0 0 0
Additional Permit Information
Mechanical to be Included9 No Number of Stories. 1
Permit for Building Shell Only? No Plumbing to be Included? No
New/Additional Sq.Feet-Total 0
No Fixtures Associated With This Permit!!
PERMIT EXPIRES Monday, April 13, 2015
Permit Issued on Wednesday, October 15, 2014
I hereby certify that the above infor -tion iscorrect and that the construction on the above described property and
the occupancy and the use ,<� accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
2-0
Owner or agent: t 7—'4'767—'4'76 D Date: j O /5-- /71
THIS CARD IS TOSMAIN ON-SITE
CITY
OFConstruction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 14-103441-00-CO Address: 31627 1ST AVE S
Project: SOUTH KING FIRE & RESCUE FEDERAL WAY, WA 98003-5201
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.
O SWM Precon Site Mtg(4400) ❑ 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
o Foundation Wall(4115) 0 Drainage/Downspout(4040) Re-steel(4215)
Approved to place concrete Approved to backfill Approved to place concrete or grout
By Date By Date By Date
O Slab/Concrete Floor(4255) 0 Underfloor Framing(4285) El Floor Sheathing(4105)
Approved to place concrete Approved to sheath floor Approved to install flooring
By Date By Date By Date
El Shear Walls(4245) ❑ Roof Sheathing(4220) ElFire/Draft Stops(4095)
Approved to install siding Approved to install roofing Approved
By Date By Date By Date
❑ Interim Erosion Control(4370) Prior to scheduling a Framing inspection; ❑ Framing(4120)
Approved Approved to insulate
Electrical,Plumbing&Mechanical Rough-in and
Fire/Draft Stop inspections must be signed-off and
By Date
approved. IBC 109.3.4 By Date
o 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 Date By Date
• Final-Fire Department(4060) CI Final-Planning 0 Final Erosion Control(4375)
Approved Approved Approved
By Date By Date By Date
❑ Final-Building(4050)
Approved
By Date 2)/41i‘¢
•
❑ Rough Electrical1:1 Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
•
art of $ JUL i i 2014 PERMIT APPLICATION
Federal Way
CITY OF FEDERAL WAY
/�
CDS
` 3/?4:711/C/PERMIT NUMBER / - J /j 3 C,y Y L - c 0 TARGET DATE V ?� /C/
SITE ADDRESS J.
�L ---.!!! //7 1� SUITE/UNIT S
* !ST 4/LIE 5.s+�XbE'i4#IL WItti k4# 714M 3
PR ECT VALUATION ZONING ASSESSOR'S TAS/ CEL S
$ t ,¢s9.g o '' 2 ! o ail - 7 4 l o
TYPE OF PERMIT 3UILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
•
NAME OF PROJECT 7-4yp.0✓G E 5E�l•TM /J/tZDA LA i '•{IEr/Yo0 fk�Ecr
•
ReAfDyAG 1 z ,-01ex�J~1�E417- or Cc.) E'v LTiy✓Gt
PROJECT DESCRIPTION •
Detailed description of work to its,} eirdm �' .9x•Pm2M/ dF (R) Aran/"PI mr'✓A/4 r �'
be included on this permit only AlfSGIizz _ S jr m�Zl �, t14t//ellEe✓7
NAME �Y PRIMARY PHONE
PROPERTY OWNER PAirKeT I — 7,2"1•7,1"- --•
MAILING ADDRESS E-MAIL
t6!,r 1.51- ,'h/E 5 . ._.
CITY STATE ZIP
.DiE, [. Wily WA- i7B�3
NAME PHONE
7• g. z>.
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE M EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE S
/ /
NAME PRIMARY PHONE
T--Aya�gi GE
APPLICANT
MAILING ADDRESS E-MAIL
0°771E74 Wil C STATE Z?gilt
my! • PRIMARY PHONE
IP FAX
PROJECT CONTACT tie++fi J6/nV X e.DNl 2e -z a.-4,647
(The individual to receive and j`�� 4 s• tr`mAIL'17-40/e.• Lex
CIC p
respond to all correspondence G /7 FG�JG+%'7
concerning this application) * f STA 'a`D4 ., O— od etevet
NAME / 1� OWNER-FINANCED
PROJECT FINANCING
Required value of$5,000 or more MAILING ADD CITY,STATE,ZIP 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 defens • `/ ch claim),which may be made by any person,including the undersigned,and filed against the city,
but only where such slat - res o t of the reliance of the city, including its officers and employees, upon the accuracy of the
iirceivED
information supplied to 1 `as • •art of this application.
SIGNATURE: �' r �, c 7—•'I iefee E- DATE `/l"-see I'
PRINT NAME: fog Jo1V#h b+f
Bulletin#100-January 1,2013 Page 1 of 3 k:'.Handouts\Permit Application