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15-103612City of Federal Way Community & Econ. Dev. Services 33325 8th Ave S Federal Way, WA 98003 Ph: (253) 835-2607 Fax: (253) 835-2609 Project Name: LAKE HAVEN ESTATES Project Address: *NO SITE ADDRESS* Project Description: FILL/GRADE - Regrading for lot preparation. Building - Commercial Permit #: 15 -103612 -00 -CO Inspection Request Line: (253) 835-3050 Parcel Number: 242103 9053 Owner ARRlicant Contractor Lender OMEGA INTERNATIONAL FILIPP KAPUSTIN J K MONARCH LLC OWNER IS LENDER INVESTMENTS J K MONARCH JKMONML874NA (8/1/17) 19625 93RD PL NE PO BOX 188 - PO BOX 188 BOTHELL WA 98011 PUAYLLUP WA 98371 PUYALLUP WA 98371 Census Category: 999 - Unknown Includes: #1 #2 #3 #4 Occupancy Class: Construction Type: Occupancy Load Floor Areas . ft. 0 1 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 No Fixtures Associated With This Permit 11 CONDITIONS: Prior to any clearing, grading, or filling, the contrctor shall conduct an on-site TESC pre -construction meeting. Contact Bill McCollum, Construction Inspector, at (253) 835-2741 to schedule the pre -con. PERMIT EXPIRES Wednesday, March 30, 2016 Permit Issued on Friday, October 2, 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 nd the City of Federal Way. 4o- Owner or agent: Date: 1DZ hs CITY OF Federal Way PERMIT #: Project: THIS CARD IS TO REMAIN ON-SITE - Construction Inspection Record INSPECTION REQ TS: (253) 835-3050 15 -103612 -00 -CO Address: *NO SITE ADDRESS* OMEGA INTERNATIONAL INVESTI FEDERAL WAY, WA 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. ❑ Final - Public Works (4080)Final - Building (4050) Approved By Date Approved By Date El Rough Electrical Approved 1:1Approved Final Electrical Right of Way Approved By Date By Date By Date � 6ECEIVED PERMIT *APPLICATION "TMS Federal Way JUL 2 8 2015 • CITY OF FEDERAL WAY c"I PERMIT NUMBER I 5_ , 0S L- - - O TARGET DATE SITE ADDRESS I q4"" Ave v) ,vt v, d Stn/ 9-rh s SUITE/UNIT # PROJECT VALUATION Co S DOd ZONING ASSESSOR'S TAR/PARCEL If 2 ' Qd S 1 q Z t = q 0 2-S -- TYPE OF PERMIT COCA ®BUILDING UMBING 1:1 MECHANICAL El DEMOLITION E] ENGINEERING ❑FIRE PREVENTION NAME OF PROJECT Lq Wn v m � PROJECT DESCRIPTION G a e c m( KV 1Av-e a- 5 Detailed description of work to be included on this permit only PROPERTY OWNER NAME , -S K �- lea Y 1 ,C � ` PRIMARY PHONE 2 640-- (OGO MAILINGG AD?RES v O x ( � EAUL (f �o �� CITY STATE wA ZIP 3 (� NAME S K' _Aoyn a c t I1 PH9NE W g o ��06 MAILING ADDRESS ( ` x ' E-MAIL _ r_ C ko400ck(4). CONTRACTOR CITY Py �4cl (/ up S`TA'TE ZIPq % IF AX WA STAT ONTRACTOR'S LICENSE # EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE # •� / I (/ 4Ii 7VI NAME \, Ka ?us�,� PP PRIMARY PHONE 2 3 $yo- S6(po MAILING ADDRESS PO Rn X (cg E -MAD. -e< ' [� nci c APPLICANT L7a �� Y' CITY � ullY STATE w� ZIP �g AX PROJECT CONTACT r^ --�II NAME Ri G � o P LOS -5) Y PHONE G G MAILING ADDRESS 00X E MAIL Zi C C C (The individual to receive and respond to all correspondence CITY cl cf&2 STATE ZIP 17S57I FAX concerning this application) PROJECT FINANCING NAME OWNER -FINANCED Required value of $5,000 or more (RCW 19.27.095) MAILINGADDRESS, CITY, STATE, ZIP ( / �O S�� ir I U w '� q 1 �/ PHONE /+ V� C` l`P0 - G 60 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 tI a city as apart f this appiic tion. SIGNATURE: ff'r DATE PRINT NAME: Bulletin # 100 —January 1, 2013 Page 1 of 3 k:\Handouts\Permit Application ((L Y,• CONI N T 4ek RESUBMITTED EPARTMENT OF COMMUNITY DEVELOPMENT SERVICES 33325 8`s Avenue South CITY OF ^.r../ AUG 17 2015 Federal Way, WA 98003-6325 253-835-2607; Fax 253-835-2609 Federal Way C1TY OF FEDERAL WAY www.cityoffederalway.com CDS RESUBMITTAL INFORMATION This completed form MUST accompany all resubmittals "Pleasenote Additional or revised plans or documents for an active project will not be accepted unless accompanied by this completed form. Mailed resubmitials that do not include this form or that do not contain the correct number of copies will be returned or discarded. You are encouraged to submit all items in person and to contact the Permit Counter prior to submitting ifyou are not sure about the number of copies required. ** ANY CHANGES TO DRAW/NGS MUST BE CLOUDED. Project Number: I; - 1 O 3 (o t Z. - © O _ C Project Name: La kc 1 mv-e R EtAo des Project Address: Project Contact: 1:(tJ i' kr ber- Phone: RESUBMITTED ITEMS: Copies .1_ r =.. 7= . .aim k ,. Y aP a� 3 a * r D�stribub+onDate- � BY, W11 ZZMV0 a, MAO 111 Or n—- I - Name # Description Building Plannin [ PW ; ** Always submit the same number of copies as required for your initial application.** Resubmittal Requested by: KtV ky1 %VSor Letter Dated: _�/ I (5r, 5111Minim) RESUB#.-�_ k ,. Y aP a� 3 a * r D�stribub+onDate- � BY, Dept/Div Name # Description Building Plannin [ PW ; Fire Other Bulletin #129— January 1, 2011 Page 1 of 1 kMandoutMesubmittal Information