14-101154 r' 1
• s
__ • Building - Commercial
City of Federal Way
Community&Econ.Dev.Services Permit #: 14-101154-00-CO
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p q
Project Name: NORTHWEST FOURSQUARE CHURCH
Project Address: 34800 21ST AVE SW Parcel Number: 542350 0630
Project Description: REM-Enclose 169 square feet of storage area. No plumbing or mechanical.
Owner Applicant Contractor Lender
NORTHWEST FOURSQUARE NORTHWEST FOURSQUARE OWNER IS CONTRACTOR
CHURCH CHURCH
34800 21ST AVE SW 34800 21ST AVE SW
FEDERAL WAY WA 98023 FEDERAL WAY WA 98023
Census Category: 437 - Commercial alt/add/conversion
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 Included? No Number of Stories 1
Permit for Building Shell Only? No Plumbing to be Included? No
New/Additional Sq.Feet-Total 0 Zoning Designation RS 7.2
No Fixtures Associated With This Permit !!
PERMIT EXPIRES Wednesday, September 10, 2014
Permit Issued on Friday, March 14, 2014
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 Washington
and e City of Federal Way.
i(
Owner or agent: � .,l'
Date: 3
L.e�J1-y
FINALED
R
A-
CITY
THIS CARD IS TO MAIN ON-SITE
OF v
Federal Way • Construction In ection Record
INSPECTION REQUE TS: (253) 835-3050
PERMIT#: 14-101154-00-CO Address: 34800 21ST AVE SW
Project: NORTHWEST FOURSQUARE CHU FEDERAL WAY, WA 98023-3044
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.
❑ SWM Precon Site Mtg(4400) ❑ Initial Erosion Control4365
Approved ( ) ❑ Footings/Setback(4110)
To be done prior to breaking ground Approved to place concrete
By Date By Date
By Date
❑ Foundation Wall(4115) ❑ Draina e/Downs out(4040)
Approved to place concrete g p ❑ Re-steel (4215)
Approved to backfill Approved to place concrete or grout
By Date By Date
By Date
Slab/Concrete Floor(4255) g( ) 0 Floor Sheathing(4105)
0 ❑ Underfloor Framin 4285
Approved to place concrete Approved to sheath floor
Approved to install flooring
By Date By Date
BY Date
0 Shear Walls (4245) I 10 Roof Sheathing(4220) 1 ID Fire/Draft Stops(4095)
Approved to install siding Approved to install roofing Approved
By Date By Date
BY Date
,❑ Interim Erosion Control (4370) g g.p Framing(4120)
Approved Prior to schedulin a Framin ms ection;
Electrical,Plumbing&Mechanical Rough-in and Approved to insulate
By Date By Stop inspections must be signed-off and
approved IBC 109.3.4 By Date i ( iri (l,�
O Insulation (4150) ❑Gypsum Wallboard Nailing(4130) ❑ en
Suspded CeilingGrid 4265
Approved to install wallboard Approved to install mud&tape ( )
Approved to drop tile
By Date 4to (Eli
By WA Date 4 ( '24 9 I k' By 9,45 Date t(2L (I LI
O Final-Fire Department(4060) ❑ Final-Planning ❑ Final Erosion Control(4375)
Approved Approved
Approved
By Date By Date
BY Date
❑ Final-Building(4050)
Approved
By ) Date 4-1 ?A J14
❑ Rough Electrical Final Electrical Right of Way '
Approved Approved Approved
By Date
BY W'4 Date4. 1.2,4 ((`y 1 1 By Date
41/416.
cmr OF r PERMIT' aPPLICAZ'ION
Federal Way
RBCeIVE D
PERMIT NUMBER / _ / l 5 _ G/ ) mAT 14 2ARGET 014 6) TC
r! �/ CITY OF FEDERAL MMi' SUITE/UNIT#
SITE ADDRESS
3L- SDO aOSf Svc Sw CDS
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ .3000 ('-‘2 5 y Z 3 C _ 3 0
TYPE OF PERMIT lClj$UILDING ❑ PLUMBING 0 MECHANICAL ❑ DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT /\.10 b c")E o R S Q u 4 C ifo R C t{
PROJECT DESCRIPTION Co i c--r 4' 13(04 X )3 O eve r'oo r+^ ),- Q,kci 0/V 1 eo
Detailed description of work to a VO St-tc-+1 Ge Vl d Ec YYI e LJi A-.
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER FC it."7C {a (1/4-7-4-0(Yk T \ii '\Cc\ CV-hk,'c-A".. Z53 -- 3 $ - 43 Z 1
MAILING ADDRSE-MAIL (,'..U1�„ F<'e)'ie t�e
3�{-300 2-t5l t A'J S� n t�c.1.fo(A , (-1
CM'Yef<.x.( a.1 STATE ZIPS h 0 Z 3
NAME PHONE
o v.D rn e e
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT 7avi ku v'i 2S 3 -?S 3'3 —f 3 Z.( eLy3
(The individual to receive and MAILING ADDRESS S, h � E-MAIL DCW1et. Ere I,e��
respond to all correspondence3c' Zl /C t S t•'•• it L(-u v� "csci=�c r 'e O
concerning this application) CITY STATE ZIP FAX
re6•e•tC;4 V‘...)Ct.-.� v.�A ��'023 2_53 - 33 -
NAME OWNER-FINANCED
PROJECT FINANCING
1•40r-VA �� 4 �t:�5 r.G ��-,_c-�,�
Required value of$5,000 or more MAILIING ADDRESS,CITY,STATE,ZIP V G 7 y PHONE
(RCW19.27.095) 4WOy3 ziS� / � SIV'.c,, t...;#4 9gL�Z-3 253 'LJ,}\, - ���
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-totheci as a .art of this application. - _
'
SIGNATURE: �`,n� ��, ♦ DATE 3 1 I ) �1t-1
PRINT NAME: /►'IQvt yMlifrt
Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit 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 SETSREFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
\- ,, OF PLUMBING WORK
PLUMBING PERMIT $
Indicate how many of each type of fixture to be installer •r relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower combo) LAVS(H-•.sinks) TOILETS WATER PIPING
DISHWASHERS -' oftATER SYSTEMS URINALS OTHER(Describe)
DRAINS HOWERS VACUUM BREAKERS
DRINKING FOUNTAINS / SINKS(Kitchen/Utility) WATER HEATERS(Electric)
HOSE BIBBS 7 SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMP OVEMENTS
tv° L.U_I> wp
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIR RINKLER SYSTEM? PROPOSED FI SUPPRESSI SYSTEM?
C^ , f4 zC i I. Yes ❑ No ❑Yes VNo
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) F XESTINU PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR c\
— -- — — —
COVERED ENTRY s
DECK
GARAGE ❑ CARPORT ❑
OTHER(describe)
EXISTIRO PROPOSED TOTAL
Area Tot 1 ) i
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square Feet Type Stories
NEW BUILDING
ADDITION
7X COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
Area Construction #of Additional Information
AREA DESCRIPTION in Square Feet Occupancy Group(s) Type Stories
TOTAI BUILDING'
TENANT AREA ONLY j
PROJECT AREA ONLY 1 Gj 9 5 r 5-1--L C V D 1
Bulletin#100—January 1,2013 Page 2 of 3 k:\Handouts\Permit Application