17-103581 Building - Commercial
City of Federal Way Permit #:17-103581-00-00
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: PALISADES RETREAT CENTER
Project Address: 4700 SW DASH POINT RD Parcel Number: 112103 9010
Project Description: REP-Remove existing single layer,replace rotten plywood and install new composite roofing
over entire roof.
Owner Applicant Contractor Lender
CCAS PROPERTY& SAM KELLERC J NORTHWEST OWNER IS CONTRACTOR OWNER IS LENDER
CONSTRUCTION CONSTRUCTION INC
710 9TH AVE 834 NE 195TH ST NE
SEATTLE,WA 98104 SHORELINE WA 98155
Census Category: 555-Non-structural roofing permits
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area(sq.ft.)
Additional Permit Information
Mechanical to be Included? No Number of Stories 1
Is this an Online or O.T.C.application? No Permit for Building Shell Only? No
Plumbing to be Included? No
Total Valuation:25,562.00
3�
�_ �, No Erne5Irsocmt,dIIVttiDt This �rm�#
PERMIT EXPIRES Sunday,21 January,2018
Permit Issued on Tuesday,July 25,2017
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
W shington and the City of Federal Way.
Owner or agent: Date: 7/z,s'./7
THIS CARD IS TO REMAIN ON-SITE
�,noF Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 17 103581 00 . Address: 4700 SW DASH POINT RD
Project: CCAS PROPERTY & CONSTRUCTI FEDERAL WAY WA 98023-2048
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.
® Roof Sheathing(4220) Q Final-Building(4050)
Approved to install roofing Approved
By !Tw Date 7/ Z(i/j'7 By , ) Date $)'hi
0 Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
'�. JUL 2 5 2017 PERMIT APPLICATION
CITY OF
Federal Way PERMIT CENTER+ 33325 8th Avenue South + Federal Way,WA 98003-6325
CITY OF FEDERAL WAY 253-835-2607 + FAX 253-835-2609 +perrnitcenter@cityoffederalway.com
cityoffederalway.com
Y COMMUNITY DEVELOPMENT
j7 / o s j
PERMIT NUMBER
TARGET DATE ` /( L�/ /
SITE ADDRESS / SUITE/UNIT#
`7 7&) �j 0 lQ a"S L �o; „✓� �2 a t-d 4
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 5, S6� ° -
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION �c �/�`' r ^'G PER,
1
Detailed description of work to / -eC- / C r ��Cr�j 7.Ai' Si.A.fi(C /Gt y r
be included on this permit only
%2t
coo U Spec 5` rWit,' L v..1.rca c
NAME PRIMARY PHONE
r�1ti �ti.�c c'5e a 6-J �� . Zc 7'/6 r`1
PROPERTY OWNER MAILING ADDRESS , E-MAIL
7/C /'Jari-r, A'VC
CITY. - STATE ZIP -
r
NAME / PHONE
6U,CVt(L°✓ i 5
MAILING ADDRESS E-MAIL
CONTRACTOR
-
CIT" - STATE 7". FAX
I `
WA STATE CONTRACTOR'S LICENSE#. EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME PRIMARY PHONE
APPLICANT MAILING DRESS E-MAIL
` 7vU 1-1-) �a s�7 �O, (�d s.et.+--te,trJ
CITYI �- f STATE ZIP FAX 0 e"
LA 44-
NAME i• PRIMARY PHONE
PROJECT CONTACT )C.. 1(t
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME ��
PROJECT FINANCING „�f OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,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 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."ity as a part of this application.
"atm
SIGNATURE: �� �e DATE 7/2,51/
PRINT NAME:
Bulletin#100—January 29,2016 Page 1 of 2 k:AHandouts\Permit Application
NNW
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how many of each type of j xtur e to be installed or relocated as part of this project.Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(Commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
I VALUE CF niUwvIEtNv
WORK
PLUMBING PERMIT $
Indicate how many of each type of fixture to be installed or relocated as part of this project.Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo( LAVS(Nana Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No ❑Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ # OF BEDROOMS
COMMERCIAL—NEW/ADDITION
Area in Construction 1 #of
AREA DESCRIPTION sz,tarP Feet Occupancy Groups) ,hype Stories Additional Information
NEW BUILDING
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area in Occupancy Group(s) Construction # of Additional Information
Square Feet Type Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—January 29,2016 Page 2 of 2 k:\Handouts\Permit Application