15-101973 A
0 •Building - Commercial
City of Federal Way
Community&Econ.Dev.Services .--4' Permit #: 15-101973-00-CO
33325 8th Ave S
Federal Way,WA 98003 4 Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax(253)835-2609 p q
Project Name: FEDERAL WAY COMMUNITY CENTER
Project Address: 876 S 333RD ST Parcel Number: 172104 9138
Project Description: TI- Construct one wall with french doors to separate existing senior lounge and classroom.
No plumbing or mechanical.
Owner Applicant Contractor Lender
KIMBERLY SHELTON KIMBERLY SHELTON OWNER IS CONTRACTOR
CITY OF FEDERAL WAY CITY OF FEDERAL WAY
33325 8TH AVE S 33325 8TH AVE S
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
J
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
No Fixtures Associated With This Permit !!
PERMIT EXPIRES Wednesday, December 2, 2015
Permit Issued on Friday, June 5, 2015
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: ,(,�� d 11r'.eDate: 6 5 /S-
S • THIS CARD IS TO leVIAIN ON-SITE r
CITY CFS Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT#: 15-101973-00-CO Address: 876 S 333RD ST
Project: KIMBERLY SHELTON FEDERAL WAY, WA 98003
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 Control(4365) Footings/Setback(4110)
Approved To be done prior to breaking ground Approved to place concrete
By Date By Date By Date
. • •
o Re-steel(4215) 0 Slab/Concrete Floor(4255) ❑ Underfloor Framing(4285)
Approved to place concrete or grout Approved to place concrete Approved to sheath floor
By Date By Date By Date
Floor Sheathing(4105) El Fire/Draft Stops(4095) ❑ Interim Erosion Control(4370)
Approved to install flooring Approved Approved
By Date By Date By Date
Prior to scheduling a Framing inspection; 0 Framing(4120) El
Insulation(4150)
Electrical,Plumbing&Mechanical Rough-in and Approved to insulate Approved to install wallboard
Fire/Draft Stop inspections must be signed-off and
approved. IBC 1093.4 By e Date c —q _l 5 By Date
❑Gypsum Wallboard Nailing(4130) ❑ Suspended Ceiling Grid (4265) El
Final-S K F&R(4060)
Approved to install mud&tape Approved to drop tile Approved
By Date By Date By Date
❑ Final-Planning ❑ Final Erosion Control(4375) El
Final-Building(4050)
Approved Approved Approved
By Date By Date By r Date 1 o—2-—1 S'
Rough Electrical Final Electrical •El
of Way
❑ Approved ElApproved Approved
By Date By Date By Date
CITY OF • PERMI APPLICATION
Federal Way Vi SirAPR 2 3 2015 Ways
Z
PERMIT NUMBER 15 _ ( 0 1 9 7---3 _ CO CIT/ (IFALF.pGp A l vimi 1 3 t s-"
`�'A GC`LD"Dc9A`�f13- YVf�J /
SITE ADDRESS J SUITE/UNIT#
57 5. 333rd S-. Federal Woj, u( a �X)3P 1R
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# 2
$ I,000. 00 17- i la - q I ✓
TYPE OF PERMIT .BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECTAd d l�.9 a wall W L.--14-. 4 -e .ch doors -0 S e.eO4- t r-own
PROJECT DESCRIPTION AAAI 0.. t O' S I H W0.11 taJ l-}L.. ire vac l& ct cxarS '_�
} ,
Detailed description of work to •+ .
t - SGr VI to l0t..04- G(.±' 'tt .e- Fec;12*-& Gl
( W -t� Czwt NI
4. c¢. -r
be included on this permit only
NAME I PRIMARY PHONE
PROPERTY OWNER 01 O� 'Ft k -rem-( W 0L. 2 .S
�3--S-3 -' `t 6. 32__
MAILING Aiib RESS Q E-MAIL V. sei
�3 2Sy 041-, Av G S. k,l Wl -11.IJ M,I/��,
CITY STATE ZIP
Pe-4124,4 W cLAI V `t roo3 choc ' diAkod, u &
NAME PHONE
1.1/A
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAMEPRIMARY PHONE
Kt^I^l S leAkCA t 2 .-3--Fs3 S-(0cC 3 Z.
APPLICANT MAILING ADDRESS E-MAIL
g-/Ce S. 333r-A S+. (� �j7 16TH. , sinet O c
ac-
CITY ia W Sat TATE A ZIP l 0 003 FAX '(,�T.
N}AAMCE���y`^�'/�p� y �� PRIMARY PHONE
PROJECT CONTACT �: -Mf- 61g a-0
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME
PROJECT FINANCING GALA U ���? W vsOWNER-FINANCED
Required value of$5,000 or more MAILING ADDRS, (itCITY..�JCITY,STATE,
ZIP p PHONE
�.�,V
(RCM 19.27.095) WC CO 0\I -- 253-0 3�-Yo-/,
L32
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 arty 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 as a part of this application. I r c--
I •► / / 1 DATE 2-r! 2-4,s, l I.S
SIGNATURE: aa:.A. bleu.
I
PRINT NAME: .‘19)16
: � S k e-` (OV
Bulletin#100—January I.2013 Page 1 of 3 k:\Handouts\Permit Application
• •
VALUE OF MECHANICAL WORK
E WiCPERMIT
11/41
$
Alt at riy of each type of fixture to be installed or relocated as part of this pro
ect. Do not include existing ixtures to remain.
AIR HANDLING UNITS FANS .GA$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 : r
t
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(Eieetrie)
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
',141e4§,EMENT
FIRST FLOOR(or Mobile Home)
If?OR 3
COVERED ENTRY
te-�::,. ,�,� � -----._..._..................._..__............._......_.__._..................._......__.....................
GARAGE ❑ CARPORT ❑
OTHER(describe)
Area Totals EXISTING PROPOSED TOTAL
„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
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet Type Stories
'1'U'1'AL BUILDING 7n 00 O
TENANT AR' ONLY G-�
v
PROJECT AREA ONLY Si 0 0 0 Seal.t/r 1,--"u v(1'. °,Cj . \M Att /t ( I
Bulletin 14100—January 1.2013 Page 2 of 3 k:\Handouts\Permit Application