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17-100193
• Qr,r-v,-, / 1/Z) / •a;ea lua6e Jo JauMQ •AeM leJapa j;o Apo 944 pue uo;6un s M ;o a;e;g 944 Jo suogein69J pue sap 'sMei 944 Lpinn eouep 000e u!aq IRM asn 944 pue Aouedn000 044 pue Apadoid paquosap anoge 941 uo uoi;onJ;suoo aq;;ey;pue;oa.poo sI uoj;eu.uo;u!anoge 844 ley;Appao Ag9Jay LIOZ`ZI A.iunuuf`Aupsanq,L uo panssi;luuad LIOZ'Sint' II qupsanl S32iIdX31IWN3d ON 6papnloui aq of 2mginn[d oN AAIuo TINS SuIPITEI a03 i!uuad saA ouoileaildde'D".1:0 ao amryO Lie SRI SI I SaI IOIS JO iaquin oN 6PaPnloui aq of IeoiuegoaiN uopewJoluj pulled Ieuo r pp 00.0 owo o0.0 (•g•bs)eald.loot,q :peoi iiouednoo0 :odic j,uoiionaisuop :sseo iiouednoop b# £# Z# I# :sapnjoui uois iaeuoa/ppu/;In IuiaaauimoD-LEI, :Ajo22;i snsua- 60186 VM 3ZL.LV3S 60186 VM 3ZL.LVaS IS NOS2I3?IOIN 17ZZ IS NOS2I3?IXIN 17ZZ 61L8-Z171798 ZV AID QV3H I I1H SaO2InoS32I s3OyInos32I ITU NO212IVInII3 S 06LE NOI.LJn2I.LSNOJ aU MJYAI NOIIDIIII.LSNOO 3oDIHDLAI NMSnVID 3Dn21H Jepuei Jo;oemoo ;ueoliddy aaumo ***QaIAt2IOd2Idd ag OZ 311IOM'IVN0I.LIQ(Id ON*** •sasodind , S.Ipnaas pue Ala;es aoi pitnga i pue scale a2euiep Jo A uo uoi;llouiap;3os.io;molls 03 l!uiaad :uoi;duasaU;oafo.zd ZEZ6 170IZ60:aaqulnN tao d S AAM DIJIDYd £Z170£ :ssoippd 43a1oad INIOr 21IVH 3H1 :awN;oafoad 090£-S£8(£SZ) :aui�;sanbaH uo�;oadsul 6092 5E8(ESZ):xe3 L09Z 4E8(£56 4d £0086 dM'Aeht IeiaP03 OD-00-i6I00 I-L I• t tI.I# 3 iii S a qi8 u£££ • .�ad 'idaQ ivanxdolanaQ,gcannnuoo Suitt ItuaPa3 Jo Ain Intalau uto3 - &uipttng THIS CARD IS TO REMAIN ON-SITE `"vo Construction Inspection Record Federal Way INSPECTION REQUESTS:(253)835-3050 PERMIT#: 17 100193 00 Address: 30423 PACIFIC HWY S Project: . BRUCE CLAUSEN FEDERAL WAY WA 98003-4815 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. Q Initial Erosion Control(4365) ElFootings/Setback(4110) '•Q Foundation Wall(4115) , • To be done PRIOR to breaking ground Approved to place concrete Approved to place concrete By Date By Date By Date • • ,• ® Drainage/Downspout(4040) Q Re-steel(4215) ® Slab/Concrete Floor(4255) Approved to backfill Approved to place concrete or grout Approved to place concrete By Date By Date By Date ,• • 121 Underfloor Framing(4285) ® Floor Sheathing9 (4105) ❑ Shear Walls(4245) Approved to sheath floor Approved to install flooring Approved to install siding By Date By Date By Date 1 •� 1U Roof Sheathing(4220) ® Fire/Draft Stops(4095) [E] Interim Erosion Control(4370) Approved to install roofmgApproved Approved .By Date By Date By Date Prior to scheduling a Framing inspection; In Framing(4120) "�� Insulation(4150) Electrical,Plumbing&Mechanical Rough-in Lis,and Fire/Draft Stop inspections must be Approved t0 insulate Approved to install wallboard signed- off and approved. IBC 1093.4 By Date By Date D Gypsum Wallboard Nailing(4130) El Suspended Ceiling Grid(4265) In Final-SKF&R(4060) Approved to install mud&tape Approved to drop tile Approved By Date . By Date ' By Date • D Final Erosion Control(4375) El Final-Building(4050) Approved Approved By Date By Date S.9.Z...q , ❑ Rough Electrical ❑ Final Electrical ❑ Right of Way Approved Approved Approved By Date - By Date `By Date A. . I p CITY OF ERMIT�PPLICATION Federal Way mrvEDaq-- JAN 122J', 7 PERMIT NUMBER— — — TARGET DATEt SITE ADDRESS SUIT 1VIT# ,- C;14'Z -3 rAC C- . L S PROJECT VALUATION ZONING ASSESSOR'S TAX PARCEL# $ © 9 .z 1 d at- _ 9 z "3Z- TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION NAME OF PROJECT /n p [la t r2 JO1',,,--I-- PROJECT DESCRIPTION J Detailed description of work to PL'y11w e u2e le/ke do iyie,`1 P/C"Li yp 14 j /9 -Sec`p 12 be included on this permit only ✓ `J _ NAME�J - PRIMARY PHONE - PROPERTY OWNER f3,2 ( e C 1 a U 5e n MAILING ADDRESS E-MAIL . ---) q6 5 C if'1QX2/2,©/U 0 eZ CITY STATE ZIP C I I h0 Cl7 A z 6 yq2- mm61 NAME ► PHONE P bi2i(]e 6,15/0•(..c Ams sty, a6C-- 3-7 12 MAILING ADDRESS E-MAIL CONTRACTOR r p_1'-f (I IC I r, 'SG�' 51 el aek olct fik bl?ee ce),'Is.a.,'t/ci'l,, CITY / c- $f'(.{ I'/'lr STATE 9 Zq o 9 FAX r WA STATE CONTRACTOR'S LICENSE# F`7 _/EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# / / NAME PRIMARY PHONE rMi4I2 11110ch ill) APPLICANT MA G ADDRESS A E-MAIL t/f�) LI r C k C'/Z .SU CITY / JISTAT ZIP FAX I, — UigA , NAME PRIMARYPHONE PROJECT CONTACT 0/1 Ail 0 ( k i L 3/v 61 7-3536 (The individual to receive and MAILING AD ss E-MAIL respond to all correspondence 1M t4LLI M Pole bl2idts CA'1,S'l u,,`i concerning this application) CITY STATE ZIP FAX C C, NAME - .. _ PROJECT FINANCING 0 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 city a part of this application. SIGNATURE: I DATE PRINT NAME: f2/ 0114 14 C 11 iii' Bulletin#100—February 22,2016 Page 1 of 2 k:\flandouts\Pennit Application • • VALUE OF MECHANICAL WORK MECHANICAL 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. 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 VALUE OF PLUMBING 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(Hand 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 D CARPORT 0 OTHER(describe) EXISTING PROPOSED TOTAL Area Totals **1VEW HOMES ONLY** ESTIMATED SELLING PRICE$ #OF BEDROOMS COMMERCIAL-NEW/ADDITION Area in OccupancyGroup(s) Construction #of Additional Information AREA DESCRIPTION Square Feet Type Stories NEW BUILDING ADDITION COMMERCIAL-REMODEL/TENANT IMPROVEMENTS Area in Construction #of Additional Information AREA DESCRIPTION Square Feet Occupancy Group(s) Type Stories TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY>, Bulletin#100—February 22,2016 Page 2 of 2 k:\Handouts\Permit Application