03-104591 . lt#p14
_Q COR EIVEDl` CONSTRUCT rERMIT APPLICATIONOF ^pdi
CITY ' APPLICATION NUMBER: Q3 - IC) - 00
Federal Way OCT 0 7 2003 APPLICATION NUMBER: - •-
CITY OF FEDERAL WAY APPLICATION NUMBER: - -
BUILDING DEPT.
**The following is required information-Please print(in ink)or type**
101
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application. 1
n �,, -2-)t4-0,-,5/-:■ PROPERTY INFORMATION q
SITE ADDRESS: �o / �i0` .T ASSESSOR'S TAX/PARCEL#: e ! I D 4. _q o
51
LEGAL DESCRIPTI• • SUBJECT PRO TY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): Sv,-" 77.0 T
• PROJECT INFORMATION
TYPE OF PROJECT(This application): XBUILDING o PLUMBING ❑ MECHANICAL ❑ DEMOLITION
o ELECTRICAL 0 ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): /\ , (1 ) i( nA,---or oRt co , AN,J2
c r ) (vt ✓cveetkaiovn .
PROJECT NAME: `1-1,1 r I(A Pi-t LL.S
• PROJECT INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
R 05 Al F lw r 1F (4f-5) (p52,- (S2.
MAII7NG1ADDRESS (4 ,PRESS;CITY,STAT.E,ZIP): J / q
61 TRACTOR: NAME: \x�,l/� �' ' 7V9/��t7�fl�•ice DAYTIME PHONE.
MA N ADDRESS(STREET ADD'ESS;CITY,STATE,ZIP):i\u�W- EVENING P)ONE:
( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER: .1 PIRATION DATE:
(copy of card required) r.3v / /
APPLICANT' NAME: DAYTIME PHONE:
G rntDY K �1 /-,c4L. N1 i�2Zz (4w) 670 - 6706
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): �/ _ EVENING PHONE:
0 OOb (94 r/t A,/ . W 5/-1/7- - ' Moui l h� (70(0) 59? - 7*
RELATIONSHIP TO PROJECT: FAX NUMBER:
$ARCHITECT o TENANT o OTHER(DESCRIBE): (/196") 7 74/- J2/1
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER APPLICANT o CONTRACTOR CintkiK @6/11176"5/r, Cwt
• PROJECT INFORMATION Stern'
EXISTING USE: pE7FUL. EXISTING BUILDING ASSESSED/APPRAISED VALUATION S A'
PROPOSED USE: K KAU. PROPOSED VAL:JATION FOR IMPROVEMENTS: $ • OJ
SPRINKLERED BUILDING? ,YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN o HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) tGc,51,
SEWER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE ❑ PRIVATE(SEPTIC) g& (YT ,
**NEW RESIDENTIAL CONSTRUCTION ONLY**
J
r . f ; 04 •
It ' 11 • r 'ip S
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT /I . ((�K5 2 //
FIRST / 5i 6,4-- s �✓; 3 I. /S fr#3 Sr,
SECOND
THIRD
•
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
■ FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING EVAPORATIVE GAS LOG(S) REFRIG.SYSTEM(S)
UNIT(S) COOLER(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC o GAS
• PLUMBING
BATHTUB(S) 2.--LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER VACUUM BREAKER(S) o ELECTRIC o GAS
SYS.
DRINKING SHOWER(S) WASH MACHINE
FOUNTAINS) OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
■ 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 e city,Including its officers and employees,upon the accuracy
of the information supplied to the city as a part of this applica 'on.
NAME/TITLE: C PIJOY I A ' 6 I 417 DATE: (t (0 ' 692
o PROPERTY OWNER APPLICANT ❑ CONTRACTOR
FOR OFFICE USE ONLY: 15-
o NEW o ADD T O ❑ ALTERATION o REPAIR TENANT IMPROVEMENT
CENSUS CODE: I.LOT SIZE: ?j C,%( p
ZONING DESIGNATION : ae
A BUILDING SHELL ONLY? ❑YES p(NO
COMP PLAN DESIGNATION �"(,(i SIC PLAN? 0 YES 4 NO
SECTION RANGE NEW ADDRESS REQUIRED? ❑ YES �S NO
PLATTED LOT? yrHIP
o NO CHANGE OF USE? o YES (NO
•
• POS�HIS CARD ON THE FRONT OF BUILD) ,
CITY OF
Federal Way BU ,DING DIVISION - •
INSPECTION RECORD
INSPECTION REQUEST PHONE#: 253-835-3050
PERMIT #: 03-104591-00-CO
OWNER'S NAME: Rosemary Chau
SITE ADDRESS: 2020 S 314TH
() FOOTINGS/SETBACKS () FOUNDATION WALL
DO NOT POUR CONCRETE UNTIL THE ABOVE IS APPROVED
O DRAINAGE: Line ( ) Connection
DO NOT POUR SLAB UNTIL THE ABOVE IS APPROVED
( ) UNDERFLOOR FRAMING
( ) ROUGH PLUMBING: DWV /6 - Z?'-- D 3 G Water piping e O• Z/..p
() ROUGH MECHANICAL Gas piping
( ) SHEATHING Roof Floor
() SHEAR WALLS
() ELECTRICAL ROUGH-IN Ditch Cover
() FIRE/DRAFTSTOPS
ALL THE ABOVE MUST BE APPROVED PRIOR TO FRAMING INSPECTION
( ) FRAM1NG/FIRESTOPPING d — Q/ — 03 c_ J
THE ABOVE MUST BE APPROVED PRIOR TO INSULATING OR SHEETROCKINC•
( ) NSULATION: Floors Walls Attic
THE ABOVE MUST BE APPROVED PRIOR TO APPLYING SHEETROCK
() WALLBOARD NAILNG /D/Zy/o3 -Pee > SUSPENDED CEILNG
THE ABOVE MUST BE APPROVED PRIOR TO TAPING OR INSTALLING CEILING TILE
() ELECTRICAL FINAL
( ) PLANNING FINAL /, -AL 11/9103PUBLIC WORKS FINAL
() FIRE FINAL
THE ABOVE MUST BE APPROVED PRIOR TO BUILDING DEPARTMENT FINAL
( ) BUILDNG FINAL I I/31/45 C i
DO NOT OCCUPY THIS BUILDING UNTIL BUILDING FINAL IS APPROVED
•
0
Contractor
City of Fed%ral Way
Rosemary Chau
Building
DAVIS SCHUELLER INC
Cunmmmty Development Services
1191 2ND AVE #18TH
CONNELL DESIGN GROUP
DAVISSI105PN 7/1/04
33530 1 st Way S
SEATTLE WA
22000 64TH AVE W UNIT 2F
2122 164TH ST SW SUITE 200
Federal Way, WA 98003-6210
98101-3438
MOUNTLAKE TERRACE WA 9804
LYNNWOOD WA 98037
Ph: 253.661.4000 Fax: 253.661.4129
Will Certificate of Occupancy be Issued? ............
Yes
Project Name: STUPID PRICES
Project Address: 2020 S 314TH ST
- Commercial Permit #:03 - 104591 _'0'0 -to'
Inspection request line: 253.8:3.3050
Parcel Number: 092104 9053
Project Description: TI - Add two restrooms, one interior office and one interior breakroom, including plumbing fixtures.
All mechanical to be on separate permit.
Owner
Applicant
Contractor
Lender
Rosemary Chau
CONNELL DESIGN GROUP
DAVIS SCHUELLER INC
Rosemary Chau
1191 2ND AVE #18TH
CONNELL DESIGN GROUP
DAVISSI105PN 7/1/04
1191 2ND AVE #18TH
SEATTLE WA
22000 64TH AVE W UNIT 2F
2122 164TH ST SW SUITE 200
SEATTLE WA
98101-3438
MOUNTLAKE TERRACE WA 9804
LYNNWOOD WA 98037
98101-3438
Includes:
Census category: 437 - Comm
#1
#2 ��
#3
#4 --
Occupancy Group:
Cstruction Type:
on YP ��
M
Type V - N
.... Yes
Mechanical.l.`. ......... ................. I
No
_ _ _
Occupancy Load:
Permit for Building Shell Only :. ......... .........
No
Permit for Foundation Only........: ................♦
rFloor Area (Sq Ft.):
15643
_
Special Inspection Required ................................
No
1stFloor Proposed Sq. Feet ...............................
15643
Building Pre -con. Meeting Required .................No
Census Category .......: .................................
437 - Commercial alt/add
Fire Sprinklers .........
.... Yes
Mechanical.l.`. ......... ................. I
No
Number of Stories........ ....... ..................1
Permit for Building Shell Only :. ......... .........
No
Permit for Foundation Only........: ................♦
No
Plumbing .................................................
Yes
Special Inspection Required ................................
No
Will Certificate of Occupancy be Issued? ............
Yes
Zoning Designation .............................................
CC -F
Plumbing Fixtures
Description (Quantity L Description Quantity Description�IQunt fii
Iavatories 2 Water Closets 2
CONDITIONS:
Reminder: All new and refaced signs require a separate sign application and review. (FWCC, Sec. 22-335(g)(6))
PERMIT EXPIRES April 10, 2004.
Permit issued on October 13, 2003
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
the City of Federal Way.
Owner or agent: Date: /
�My 'of federal Way
Ce. tificate of Occupancy
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code certifying that at
the time of issuance, this structure was in compliance with the various ordinances of the City regulating building
construction or use. This certificate is valid ONLY when endorsed by City staff.
Tenant Name: STUPID PRICES Permit number: 03 - 104591 - 00
Address: 2020 S 314TH
#1 II #2 II #3 1 #4
Occupancy Group:
Construction Type:
M
J
1 Occupancy Load:
Floor Area (Sq. Ft.): 15643
Owner Rosemary Chau
Name: 1191 2ND AVE #18TH
Address: SEATTLE WA
98101-3438
Building Official Date
The priorityfocus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which experience has shown most severely
affect the health and safety of the general public. Although the City has made as complete a. review and inspection as is reasonably possible (within budgetary time
and personnel limitations), the City neither guarantees nor warrants to the owner/occupant or to any other person that this Certificate evidences strict compliance
with each a.id every ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon which it is
situated. Sa.`h compliance is the responsibility of the owner and/or occupant of the premises.
CITY OF - PERMIT
Federal way CEIv
COMMUNITY DEVELOPMENT C6S�E P L I C A T I O N
253-835-2607•FAX 253-835-2605-2609
_anrru�. n.'!�nfferi_tnfrra�.rnge ��� O (���
-L 7 7
MF CO ME PL DE ENFP
SITE ADDRESS Cl " OF FED
d oo - 3(,;(c �'f I-� r-lei,I f WA �✓1 I� '�
PROJECT VALUATION
ZONING
ASSESSOR'S T /PARCEL #
ggv5—' I -D
—
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
IJr� � /} C i k V_ 11C c h(/`-�' s
�`'
r ✓.,otd r cF
AE S
1
PROJECT DESCRIPTION
-Pice-
1
Detailed description of work to
,) I 1 ✓x!� odaVAA.
be included on this permit only
PROPERTY OWNER
NAME C ,(�
LC1� 7f ( l ('
PRIMARY PHONE
2( 3_132)
MAILING ADDRESS 1
E-MAIL
V
CITY STATE �vi WA ZIP
NAME
PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME1�rU •1
PHONE2S3 p�
LING ADDRESS
.59 11r� fi J
E-MAIL
P►� YAV_A6 V1\UiMj4r6;t,
APPLICANT
CITY ._(aP_ STATE ZIP 1.1-6`7
FAX - � y 131; �
PROJECT CONTACT
NAME S
fmcuwk(h (r t� wkvi
PHONE (
2 � ~ T1- - f� (Z_
(The individual to receive and
MAILING ADDR S
cin1
(( �� ✓�
E-MAIL
rKO�arA 49 i►1t:uh IN aYrk
respond to all correspondence
concerning this application)
CITY
�-
STATE
ftp
ZI
FAX
2'S 4- S 2
ALTERNATE CONTACT NAME:
Gn
PHONE
Z�3-4-73-3B12-
E-MAIL
SWeWSe-N MCa P1 ta ItA.�a
PROJECT FINANCING
NAME
OWNER -FINANCED
❑
Required value of $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
1 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 part of this application.
SIGNATURE: DATE
PRINT NAME: S
Bulletin #100 -January 1, 2011 Page] of 3 k:\Handouts\Permit Application