04-104845 I.. • •
CITY OF 0 (I/ a u( (-1, S—
reWay DA'
Or I T
SF MF CO ME EL PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES
33325 8T"AVENUE SOUTH•PO BOX 9718
FEDERAL WAY,WA 98063-9718 AP D. I C A T I I NTD
253-835-2607•FAX 253-835-2609
uww.at4affederalwtttl.cam
The ollowin• is re•uired in ormation-an incom•lete a••lication will not a acce•ted. Please •rint le•ibl in in., or t •e.
.35S
"� • �PRO/P'�ERTY INFORMATION
SITE ADDRESS ` 5 S3 _ ` '7-/C+11
S SUITE/UNIT# NA
ASSESSOR'S TAX/PARCEL# Bi 3 1 9 0 - _1 0 LOT SIZE(sf)
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1) 6#TW(N Late` s-Z ALL i3,47,.f E OF ilallJ t (4s Div.
(Attach
(v-
(Attach separate page for lengthy legal description) *f/) 2. +`�i . i_, ?1 QT 7' ' ,
■ PROJECT INFORMATION l vv 1` YV l i 1
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING iKMECHANICAL
❑ DEMOLITION 0 ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only)
l(1e )nStA11 (3) Q sT - )(3) hoedS 4 respond,' dc-f ;0:-k.Pm/0e_
./. . ) l 42._' .I 0 --' I 4 ' 4' . i C' .�
• in --filr '10 do t r1UcDPY).
PROJECT NAME(Name of Business or Owner Last Name) I WO, Lakes G
0 tilt 0,(,, All41,er) Re J
NI PEOPLE INFORMATION
PROPERTY NAME. P IMARY PHONE �q
OWNER .. CJ S: `J47 ('53) ql� -�L 0
MAILING ADDRESS Ci TATE,ZIP
CONTRACTOR COM'ANNY��NAME •PLICANT NAME OFFICE PHONE
l +J,yn //yy �'/J'' Li
55 -Zap
MAILING ADDRESS TY,STATE P CELL PHONE
M
C OF F—O — USINESLICENSE NUMBER— B L t 2 •/3'N DATE
0 (AX N�MBFq 5- _ z(4
CONTRACTORS REGISTRATION NUMBER(copy of card required with each application) 'Ni 2 )`EXPIRATION DATE
eic— LLC1'11.- 18 `i- e 1O / ZS / sem
APPLICANT OMPANY NAME AP LICANT NAME OFFICE PHONE
�Vu� L��Gc.Q inc..,
(clic—) 45 - "Z1 n
ikLIN 1ADiRES I �N`-" (U V TATE,Z P kik os (1-12c)CELL NE
7( 3139
RELATIONSHIP TO PROJECT 44 f G pEs- �i FAX NUMBERc_
0 Architect 0 Tenant 0 Agent A Other(Describe) 1 Mit_ ("tZS)4 J' - .44
CONTACT TIAME 141, PRIMARY PHONL E-MAIL ADDRESS
V Al
Nix) ) 4S3 - 2140 faurleibeiletie(hPdet.hu i (IAA
LENDER Per RC W I9. 7.095: Lender information is NAME
required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP
U DETAILED BUILDING INFORMATION
EXISTING USE ,.,i hLA A t PROPOSED USE A 'A
EXISTING ASSESSED/APPRAI ED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA ❑ 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
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT 0
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
**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.
MECHANICALofMech ys�3it `I �J 1(' /v'
Value of Mechanical Work $ (�,f�{
/ AIR HANDLING UNITS / EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS ÷ FANS 416 "v I HOODS(Commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS --- FURNACES GAS WATER HEATERS
3 DUCTS / GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/shower Combo) SHOWERS WATER CLOSETS(Toilet) MISC(Describe)
i DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
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 application.
NAME/TITLE ` DATE .00A,7
(s Hato e 1) (Title)
RELATIONSHIP TO PROJECT 0 Owner 0 Agent %Contractor 0 Architect ❑ Other
FOR OFFICE USE ONLY
s NEW ❑ADDITION ❑ALTERATION ❑REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES ❑NO BASIC PLAN? ❑YES a NO
ZONING DESIGNATION CHANGE OF USE? ❑YES a NO
NEW ADDRESS REQUIRED? ❑YES ❑NO UP/SEPA/SU? ❑YES a NO
PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? ❑YES a NO
Bulletin#100—August 19,2004 Page 2 of 4 k\Handouts\Permit Application
-. • r
City of Federal Waypmen Building - Commercial Permit #: 04 - 104845 - 00 - CO
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: TWIN LAKES GOLF AND COUNTRY CLUB
Project Address: 3583 SW 320TH ST\ Parcel Number: 179021 7660
Project Description: TI-Kitchen remodel;Replace walk-in cooler; replace dry rott flooring system under walk-in,new
partition walls; infill of roof mechanical well;plumbing and mechanical included.Kitchen hood permit
to be submitted seperately.
Owner Applicant Contractor Lender
TWIN LAKES GOLF/COUNTRY CL1 JON GRAVES*ED WELLS* DONOVAN BROTHERS INC NONE
3583 SW 320TH ST 3110 RUSTON WAY SUITED DONOVB109405 3/5/05
TACOMA WA 98402 PO BOX 818
\FEDERAL WAY WA 98023 AUBURN WA 98071 NONE
Includes:
#3 #4— -
Census category: 437 Comm- #t #2 I- -
Occupancy Group A_Z
JI
Construction Type: Type V-N
�I _ i
i
LOccupancy Load _
, Floor Area(Sq.Ft.): J 2000---- F--
_i
Census Category 437-Commercial alt/add Mechanical Yes
Number of Stories 1 Permit for Building Shell Only No
Plumbing Yes Sensitive Areas? No
Plumbing Fixtures
r Description 71Quantity Description Iduantity Description 11Quantity�
Dishwashers
IF 1 I f Gas Pipe Outlets r 1 Sinks T- 11
it
Mechanical Fixtures
Description -itivantityl P Description Quantity r Description l
lQuantityl
1Air Handing Units 1 Ducts 3 Evaporative Coolers I
Fans � 4 I Hoods 1
PERMIT EXPIRES May 30,2005.
Permit issued on December 1,2004
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy;:,nd 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/ ��,C Date: /lb/by
v ` DATE INSPECTOR AREA AND TYPE INSPECTION
ler j741i// Li.v oN 11,° 1-7(- �uoK- / Thr' P27/Pii
fiUd/t 0,442w✓ flo�K -4/A/Rs i.✓ Dec-i f y'
1911
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• THIS CARD IS TO .MAIN ON-SYS E ,,.. * .
CITY OF v� b��... i,ommunity Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04-104845-00-CO
Owner: TWIN LAKES GOLF/COUNTRY CLUB
Address: 3583 SW 320TH ST 1
FEDERAL WAY, WA 98023
MIIMINIMIIIIIIIIMENIMMIIMMIIIIIIIMMIE
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.
O Footings/Setback(4110) ❑ Foundation Wall(4115) 0 Drainage/Downspout(4040)
Approved to place concrete Approved to place concrete Approved to backfill
By Date By Date By Date
O Re-steel(4215) 0 Plumbing Groundwork(4190) 0 Slab/Concrete Floor(4255)
Approved to place concrete or grout Approved to cover Approved to place concrete
By Date By Date By Date
❑ Underfloor Framing(4285) ❑ Floor Sheathing(4105) 0 Shear Walls(4245)
Approved to sheath floor Approved to install flooring Approved to install siding
By Date s By 1/f Date 2. -(/ "O.c By Date
❑ Roof Sheathing(4220) 0 Rough Plumbing(4230)_, 0 Mechanical Rough-in (4165) )
Approved to install roofing Approved Approved
By Date By Date By ftf Date 2--/ i
❑ Gas Piping(4125) ❑ Fire/Draft Stops (4095) t NOTE: Prior to scheduling a Framing(4120) F
Approved to release test Approved inspection;Electrical,Plumbing&Mechanical
Rough-in and Fire/Draft Stop inspections must be
signed-off and approved. IBC 109.3.4/UBC 108.5.4
By Date Z _�'y'as By / Date 2 -1/-45---
❑ Framing (4120) ❑ Insulation(4150) 'Gypsum Wallboard Nailing(4130)
5 pApproved to insulate Approved to install wallboard Ap roved to install mud&tape
4,4
By �r ,t/.- ' Date Z-it W By / 4i Date 2l/I0Lr B �5 Date I ! — 1).3111.
IN Suspended Ceiling Grid (4265) 0 Final-Fire Department(4060) 0 Final-Planning(4070)
Approved to drop tile Approved Approved
By g0 Date 0 By Date By Date
N
❑ Final-Public Works (4080) ❑ Final-Mechanical(4065) [1:1_ Final-Plumbing(4075)
Approved Approved Approved
By Date By Date By Date
•
❑ Final-Building(4050)
Approved
By Date
,e- , .. • . s____
•
• « CITY OF ` :Ms �\��� ��q _ U
Federal Way G -�- C -- l
PERMIT ��\P SF MF CO ME EL PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES
33325 AVENUE BOX 9718
FEDERAL WA ,WA 98063-9718 APPLICATION
TU / /
253-835-2607•FAX 253-835-2609 P \N' /
www.citrloffederalwa4 cot, OC FEC) �sP'C
The ollowi : is 'uired ormation-an incom•lete a..bac;� [ CPGnot beGafcce'ted. Please •rint le.ibl in ink or t •e.
• PROPERTY INFORMATION
SITE ADDRESS 3583 5.W 3,:O T1. ST. SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 8 7 3 I `I 0 - d 7 9 0 LOT SIZE(sf)
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)TV,in /Lc uAl s No Z TrA13" li G " As Real . Vol 79 p ,ALJ
(Attach separate page for lengthy legal descr.ptioo) �^
1411nq Ce,. (. A.
III PROJECT INFORMATION
TYPE OF PERMIT X BUILDING )i'PLUMBING ❑ MECHANICAL
❑ DEMOLITION A.ELECTRICAL ❑ ENGINEERING PC FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onit))
Remove all exi rIifal Ai.141%-e.h Eat,ier,t n-} • RCI"1o'c 4 f c?G,cc WA114 NM ►'crtravt 4 RePlact
Dr./ ea's't' ecske rt tn+,aiv,t ys4tr1 chat,. (JAI k-I W. keMoVC 4 I;r.6..ce All -Flra'rim? R w1,3
PlOo?, ExAtncl CaNc. 4e• Allx.) c0 V' ne43 pa,Y lcaa.i'tah. ?tent,VC d RePlccn ail exilli-irx.
C"iJ. Ins}c.I) new xAcv•u•, ra At SuPPOeillha. Sys7'CY1s. CJtC c,tci pie 1W meek)
PROJECT NAME(Name of Business or Owner Last Name) T1,A/I)V Lg1SF 6e1 f d Cun41+, C`Us9. J
• PEOPLE INFORMATION
PROPERTY NAME
PRIMARY PHONE
OWNER Twlro LAYIS.5 CO)c 4 C.G. ( )S3) 7 -(4140
MAILING ADDRESS CITY,STATE,ZIP
358 3 S•w. 3 )&' $T ccpL=R'L way, Wn 6/800)3
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
D01l110vimv 3RoTHk',R5 INC. RLSS Weli:k (,)531g3' - 77TH
MAILING ADDRESS CITY,STATE,ZIP CELLPHONE
P•0. 3ox S!8Av6uR1n, WA
98071 (
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION UATE FAX NUMBER
I a - 8 8.-o b 0 6 5 2 - B L 12 ` 31 104 (a�3)g3�1 7�1�?y
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
0 ¢ ru 0v21 oqy o5 3 / 5 ' 05
APPLICANT COMPANY NAME APPLICANT NAMEOFFICE PHONE
'GNv CRAVFs EDV1t (x531 d?,) 90 I 11
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
3114 Rasire,n WA y Svi 4s l7 TPtcotr►A, \VA. q/161z1 (45'3 Lc)78 - 7H0)`1
RELATIONSHIP TO PROJECT FAX NUMBER
Architect 0 Tenant 0 Agent 0 Other(Describe) 053 )c7e21 yat
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
Eo Wc115 (d53) .) 7.)- 'Jc 14 ec)wel)s 0,)GiRci-is.con
LENDER Per RCW 19.27.095: Lender information is NAME
required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP
n t �/ II DETAILED BUILDING INFORMATION
CO
EXISTING USE orr /r'y �.Iu d 1414CA'1c."-. PROPOSED USE SA}1. .
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ 4 75000. (70
SPRINKLERED BUILDING? ,)(YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? AYES 0 NO
WATER SERVICE PROVIDER jil LAKEHAVEN D HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER %LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)