08-102937 r 1 .. 49„
City of
[' t: eLcesBuild
— Multi Family Permit 08-102937-00—MF
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: CLUB PALISADES BLDG 29 UNIT 104
Project Address: 2211 S STAR LAKE RD Unit 29-104 Parcel Number: 720480 0095
Project Description: ALT-Demo all inside furnishes to the studs due to fire.Reinstall insulation,drywall and
interior furnishes.No mechanical,no plumbing and no framing on this permit.
BLDG 29 Unit 104
Owner Applicant Contractor Lender
JEROME FINK BELFOR USA GROUP INC BELFOR USA GROUP INC JEROME FINK
2 CORPORATE PARK DR SUITE 10 3826 WOODLAND PARK AVE N BELFOUG99OBJ (12/14/08) 12 CORPORATE PARK DR SUITE 10(
IRVINE CA 92606 SEATTLE WA 98103 3826 WOODLAND PARK AVE N IRVINE CA 92606
SEATTLE WA 98103
Census Category: 434 -Residential alt/add - no change in number of units
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area(sq. ft.) 0 0 0 0
Additional Permit Information
New/Additional Sq.Feet- 1st Floor 0 New/Additional Sq.Feet-2nd Floor 0
Existing Sprinkler System in Building? No Mechanical to be Included? No
Number of Stories 2 Permit for Building Shell Only? No
Plumbing to be Included? No New/Additional Sq.Feet-Total 0
No Fixtures Associated With This Permit!!
13214-
LG' - . 5-51,--%-4
CONDITIONS:
Subject to field inspection without plans.
PERMIT EXPIRES Wednesday, December 17, 2008
Permit Issued on Friday, June 20, 2008
I hereby certify that the above infor••,.tion i -or a.i that the construction on the above described property and
the occupancy and the use wil .?-n a •/r•.nce ' the laws, rules and regulations of the State of Washington
I� :nd t ity of Feder I Way.
Owner A agent: ,,1 , , A 5 Date: 6. -12-
FIiALED
- THIS CARD IS TO AkMAIN ON-SITE
communityCITY OF Develo m nt Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 08-102937-00-MF
Owner: JEROME FINK
Address: 2211 S STAR LAKE RD Unit 29-104
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) ❑ Foundation Wall(4115) ❑ Drainage/Downspout(4040)
Approved to place concrete Approved to place concrete Approved to backfill
By Date By Date By Date
❑ 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) ❑ Shear Walls(4245) 0 Roof Sheathing(4220)
Approved to install flooring Approved to install siding Approved to install roofing
By Date By Date By Date
❑ Fire/Draft Stops(4095) NOTE: Prior to scheduling a Framing(4120) 0 Framing(4120)
Approved inspection;Electrical,Plumbing&Mechanical I Approved to insulate
Rough-in and Fire/Draft Stop inspections must be
By 07Date signed-off and approved. IBC 109.3.4/UBC 108.5.4 ByDate
/ �
❑ 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 C �I Date t-1_,21,a_fl$ By ) Date r—Z--‘,s-„,v By Date
,
❑ Final-Fire Department(4060) ❑ Final-Building(4050)
Approved Approved 4?; 6
By Date By . -,/e , Date �,� =-r;�
For inspector reference only
❑ Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
7 CITY OF / `
Federal wayREC EI • ERMIT1 - - - -
COMMUNITY DEVELOPMENT SERVICES SFCO ME EL PL DE EN FP
33325 8TH AVENUE SOUTH•PO BOX 9718 JUN 1 $ APPLICATION
FEDERAL WAY,WA 980639718 TD -y-
253-835-2607•FAX 253-835-2609 / I �/
www.algoliedemlway.cam p�� n _-�-
The following is rl i>egil tff.tRAtio W 4lete application will not be accepted. Please print legibly(in ink)or type.
■ PROPERTY INFORMATION
SITE ADDRESS_ 22—I I S. 5&./ Like r.•• t'e efk t Way W c . `ttuC.3 SUITE/UNIT# 2' 1-'J
ASSESSOR'S TAX/PARCEL# 7 Z O '1 (6 0 - O Ci S LOT SIZE(sJ7
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT ® BUILDING 0 PLUMBING 0 MECHANICAL
GI DEMOLITION 0 ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
Ie " c, (iOw..1 -6 �ut:wt .e - .,1.5.)(4,4-e_. 1 Slr.z<1-✓ ck 1 ki,,.,) ci.(( t Ltter.c;/ 4; . '>6 s.
Ki0 S r.,t.4-)1a.l 34wta e J
j— P-" .� w c 4'(n6,.)--- 1'(q� S
PROJECT NAME(Name of Business or Owner Last Name) L (u P k'S 4 tJ t NS. 2'1 V/ty'1 to j�
r
• PEOPLE INFORMATION
PROPERTYNAME �� rcNt �' PRIMARY PHONE
OWNER �," e
.,e ( ) -
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
y2 (.c:,-pore Pct<k Dr, *la) 17-'rv-h. CA.: `1242O(.
CONTRACTOR COMPANY,NAME 1� APPUCANT NAME OFFICE PHONE
ilC(-Lr 05,+ 6r.sop '34.5....1 ( 1440.1, (ZuG: ) t.,3Z -o$bo
MAILING ADDRESS CITY, ATE,ZIP CELL PHONE
`6Z<., .:,k d i,,,,,`, Pale 'v e 5e,-.-4(.z I'' . F_-c, , ) ct53 -/9/3
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
0 ( ' 10341Lt'-7.--C� ( -2 ( ) -
CONT CTOR'S REOISTRAT 'N NUMBER g� IRATION DATE E-MAIL ADDRESS
*7) (7 4Y61 0
2-(17
APPLICANT COMPANY NAME APPLICANT NAME I OFFICE PHONE
C`b,A`MGI C-�d'- ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect ❑ Tenant 0 Agent 0 Other ( ) -
PROJECT NAME,_,._ PRIMARY PHONE E-MAIL ADDRESS
CONTACT ' 4 5.,y -(N:x .1 (Z.,(•-. ) (53- IC (3
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
/�
1
Ili DETAILED BUILDING INFORMATION
EXISTING USE Ape,/L-,.. (?anLI PROPOSED USE k• .z ?l-ic.r
EXISTING ASSESSED/APPRAISED VALUE \)VALUE OF PROPOSED WORK $ r
SPRINKLERED BUILDING? 0 YES .0(NO FIRE SUPPRESSIIIION SYSTEM PROPOSED/REQUIRED? 0-YES—a NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
•
SQ. FT. SQ. FT. SQ. FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING ST 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
Value of Mechanical Work$ (A COPY OF BID OR ESTIMA MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE(NSE HOODS(Commercial
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SE REFRIG.SYSTEMS
PLUMBING �-
•
BATHTUBS(orTUb/Shower combo( LAVS(Bathroom Si URINALS- MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS S OWERS WATER CLOSETS Rae)
ELECTRIC WATER HEATERS ANKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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 person, including the undersigned, and filed against the city, 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.
SIGNATURE: 1 �� �? DATEC I
Property Owner and/or Authorized Agent
❑NEW a ADDITION a ALTERATION a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? o YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a YES a NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? o YES a NO
Bulletin#100–January 1,2008 Page 2 of 4 k\Handouts\Permit Application