15-103756CITY OF� PERM%(AM&ICATION
Federal Way
PERMIT NUMBER ` ) _ 1 D *3 -15
6 — �_?
JUL 2 9 2015
CI %&g C AL WAY
SITE ADDRESS
SUITE/UNIT #
104 SW 312th Street, Federal Way, WA 98023
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$ 45,000.00
-0-7 Z _1 0 4- 9 2
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ® FIRE PREVENTION
NAME OF PROJECT
7 -Eleven Store No. 17463 Fuel System Removal
Remove existing fuel equipment, including (3) 12,000 -gal underground storage
PROJECT DESCRIPTION
Detailed description of work to
tanks; vent, vapor, and product, piping, dispensers, monitoring equipment, tank
and concrete drive slab. Demolition of canopy covered under separate permit.
be included on this permit only
Existing convenience store to remain.
NAME
PRIMARY PHONE
PROPERTY OWNER
7 -Eleven, Inc.
(972) 828-7011
MAILING ADDRESS
E-MAIL
P. O. Box 711
'osem s@7-11.com
CITY
Dallas
STATE
TX
ZIP
75221
NAME
To Be Determined
PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
Stantec Consulting, Inc.
PRIMARY PHONE
425 289-7343
MAILING ADDRESS
11130 NE 33rd Place, Suite 200
E-MAIL
paul.fairbairn@stantec.com
APPLICANT
CITY
Bellevue
STATE
W
ZIP
98004
FAX
NAME
PRIMARY PHONE
PROJECT CONTACT
Amanda Grindle Permit Coordinator
253 882-4546
MAILING ADDRESS
3745 N 30th Street
E-MAIL
agrindle@muircontracting.com
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
Tacoma
WA
1 98407
PROJECT FINANCING
NAME
❑X OWNER -FINANCED
Required value of $5, 000 or more
IRCW 19.27.095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
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 lincluding 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 thecityas apart of this application.
SIGNATURE: C = - DATE - / z q
PRINT NAME: Amanda Grindle, Permit Coordinator on behalf of Stantec Consulting, Inc. and 7 -Eleven, Inc.
Bulletin #100 —January 1, 2013 Page 1 of 3 k:\Handouts\Permit Application
VA
MECHANICAL PERMIT LUE OF MECHANICAL WORK
Indicate how many of each type offmiture to be installed or relocated as part of this project. Do not include existing tures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial)
BOILERS FURNACES HOT WATER TANKS Pas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VA LUE OF PLUMBING WORK
PLUMBING PERMIT
No.
N/A - no water disconnection.
N/A - no water disconnection.
in Square Feet
a
$
Indicate how many of each type o
ixture to be installed or relocated as
part of this project. Do not include existing tures to remain.
BATHTUBS (orTub/Shower combo)
LAVS (Hand Sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Kitohon/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
No.
N/A - no water disconnection.
N/A - no water disconnection.
in Square Feet
a
Stories
$ N/A - Demolition
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
Gas Station
14,866 SF
❑ Yes ® No
❑ Yes x No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING PROPOSED
TOTAL FOR OFFICE USE
Construction
# of
��� ... .. ... .. .. .. .. .... .. ..... .. .... ........................................... ...._.... ...
$}1ifi>i+JT , Irl hldG.
in Square Feet
a
Stories
A
FIRST FLOOR (or Mobile Home)
%N1
A- ITI11"
—01
1
JAW
_ �•- • u _ P
I�NkC���« Gc.� S 1 1
m «> ".; 3' s.� ��' ..
ry "
F 'wdi` 3 q iii
�+lt
COVERED ENTRY
.. .. ..... .... .. ..._....,...................... .. .......... ............ .... ..
COMMERCIAL - REMODEUTENANT IMPROVEMENTS
AREA DESCRIPTION
e'?`
Occupancy Group(s) Construction
# of
Additional Information
GARAGE ❑ CARPORT ❑
Square Feet
a
g...........................
a?.
ry �� ( �k,
.................................. .. .............. .......
°t r
WIN(�
d «•
Area Totals
BXISTINO PROPOSED
TOTAL
**y )
ESTIMATED SELLING PRICE $ # OF BEDROOMS
COMMERCIAL - NEWADDITION
Bulletin
AREA DESCRIPTION
Area
Occupancy Group(s)
Construction
# of
Additional Information
in Square Feet
a
Stories
%N1
" .,',
1
JAW
_ �•- • u _ P
I�NkC���« Gc.� S 1 1
m «> ".; 3' s.� ��' ..
ry "
F 'wdi` 3 q iii
�+lt
ADDITION
ADDITION
COMMERCIAL - REMODEUTENANT IMPROVEMENTS
AREA DESCRIPTION
Area
in
Occupancy Group(s) Construction
# of
Additional Information
Square Feet
a
Stories
;fl84
TENANT AREA ONLY
O$ 0I
?
Aa S
i
.. . y..h"01
Bulletin #100 — January 1, 2013 Page 2 of 3 k:\IIandouts\Perniit Application