09-100871Cir of Federal Way •
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609 r -
i
Wuilding- Commercial
Permit #: 09 -X100871 -00 -CO
Inspection Request Line: (253) 835-3050
Project Name: MI PUEBLO MARKET In
Project Address: 31007 PACIFIC HWY S Suite A Parcel Number: 082104 9061
Project Description: STFI, NO PLANS - Construct a non-structural interior partition wall in existing tenant
space.
caner
Applicant
Contractor
Lender
SALVADOR PALACIOS
SALVADOR PALACIOS
OWNER IS CONTRACTOR
3001 288TH ST APT A39
3001 288TH ST APT A39
FEDERAL WAY WA 98003
FEDERAL WAY WA 98003
Census Category: 437 - Commercial alt / add / conversion
Includes: # 1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Areas . ft.) 0 0 0 0
Mechanical to be Included?...............................No
Permit for Building Shell Only? ...... ..................No
New / Additional Sq. Feet - Total .......................... 0
CONDITIONS:
SUBJECT TO FIELD INSPECTION WITHOUT PLANS
PERMIT EXPIRES Saturday
Permit Issugl0nop Monday
I hereby certify that the above information is rrec
the occupancy and the use will be in accord nce N
/ a the
Owner or agent:
of Stories.................................
to be Included?......................................
2009
that e C24'
truction on t ove described property and
s, es and reg s f the State of Washington
rFe al Way.
Date:
1 N THIS CARD IS TO MAIN ON-SITE
fa
CITY OF - Community Develop nt Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 09 -100871 -00 -CO
Owner: SALVADOR PALACIOS
Address: 31007 PACIFIC HWY S Suite A
FEDERAL WAY, WA 98003
This card is part of your required inspection documents. 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.
❑ Footings/Setback (4110)
Approved to place concrete
By Date
❑ Foundation Wall (4115)
Approved to place concrete
By Date
❑ Drainage/Downspout (4040)
Approved to backfill
By Date
❑ Final - Fire Department (4060)
Approved
By Date
❑ Final - Building (4050)
Approved
By 13 Date fl
For insp ctor reference only _
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
❑
Re -steel (4215)
❑ 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)
❑ Shear Walls (4245)
❑
Roof Sheathing (4220)
Approved to install flooring
Approved to install siding
Approved to install roofing
By
Date
By Date
By
Date
❑
Fire/Draft Stops (4095)
NOTE: Prior to scheduling a Framing (4120)
❑
Framing (4120)
Approved
inspection; Electrical, Plumbing & Mechanical
Approved to insulate
Rough -in and Fire/Draft Stop inspections must be
By
Date
signed -off and approved. IBC 109.3.4/UBC 108.5.4
By
Date �j
❑
Insulation (4150)
❑ Gypsum Wallboard Nailing (4130)
❑
Suspended Ceiling Grid (4265)
Approved to install wallboard
Approved to install mud & tape
Approved to drop the
By
Date
By , � Date 8—.3-Lcj
t By
Date
I
❑ Final - Fire Department (4060)
Approved
By Date
❑ Final - Building (4050)
Approved
By 13 Date fl
For insp ctor reference only _
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
4 E tri L V E p�
�n. of
Federal_Way�pR 0 9 28n PERMIT — —
coeuwna7rnEVELor�rrsErrlH SF M CO ME EL PL DE EN FP
3332S 8m AVENUE SO[/171 • PO BOX 9718
u.dt o i.
3 FEDER APPLICATION
'
LSA_ CVS
The foliowbW is required informadon - an incomplete appiicadon wiii not be aempted Please Print hgffibj lin ink1 or tW&
PROPERTY•- • ,v
8ITE ADDRESS C L C1 Z % 7-7L 7 y �- sum/IINIT #
ASSESSOR'S TAX/PARCEL # — — — — — — — — — _ LOT SIZE (sfi
LEGAL DESCRIPTION (e.g. Adne Estates, Lot 1)
PROJECT,- •
TYPE OF PERMIT "UJLDI FG ❑ PLUAWING O NOCAANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGMIEER13FO ❑ FERE MWENTION SYSTEM
PROJECT DESCRIPTION (Provide detaUed option of umrk inckided on this hermit onlu)
�N.S�lK/GT itlO �(/ - •f � TG L�T�CO`L �i4,��11 i"�O�✓ //�
PROJECT NAME (Name OfA== orOuvwLast Namel (l '" t 6LJ-e,6 W vvi O'r b--�
PEOPLE INFORMATION
PROPERTY
NAME /
PRIMARY PHONE
OWNER
- L• -_ /u� .0 r
c 6)13 Z
CI Y OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
MAII.INO ADDRESS CITY, STATE, ZIP
CQ_
E-MAIL ADDRESS
E-MAIL ADDRESS
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
COMPANY NAME
APPLICANT NAME
/OFFICE PHONE
MAIL1NO ADDRESS
CITY. STATE, ZIP
CELL PHONE
CI Y OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
FAX NUMBER
00>lTRACTOIR'8 R1pMila!>ZATT� E70'litATiOX DATS
C' LL E fL
E-MAIL ADDRESS
COMPANY NAME
�
APPLICANT NAME
OFFICE PHONE
MAIL 40 ADDRE33
CITY, STATE, ZIP
M1 PHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
( ) _
NAME (u V PRIMARY PHONE _ E-MAIL ADDRESS
NAME
Per RM 19.27.095.-
9.?7.095:Lender
Z—d-bVorn-ion to required if project maim &weeds "000
MAIMO ADDRESS
CRY. STATE, ZIP
PHONE
( )
EXISTING USE PROPOSED USE
EXWTING ASSESSED/APPRAISED VALUE VALUE OF PROPOSED WORN $ Z
8PRINKLERED BUUMI iG? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ MM ❑ NO
WATER SERVICE PROVIDER ❑ LAKEgAVEN ❑ MGMANE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER 0 LAWMAVEN 0 MGMANE 0 PRIVATE (SEPTIC)
J -k
_ t PROJECT FLOOR AREAS
AREA DESCRIPTION
EXISTING
SQ. FT.
PROPOSED
SQ. FT.
TOTAL
SQ. FT.
BASEMENT
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
FIRST
BLBCTRZC WATER HEATERS
SINKS
WASHING MACHINES
SECOND
SUMPS
NEW ADDRESS REQUIRED?
a YES o NO
THIRD
a YES
a NO
PLATTED LOT?
ADDITIONAL FLOORS (DESCRIBE)
DEMO PERMIT REQUIRED?
o YES
a NO
DECK (❑ COVERED OR ❑ UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
sem-
reOresm
tea'
"O1"�1°u
rorearsaraeeou
TOM"
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fUture to be owtalled or relocated as part of this project Do not ftwhide existing fres to remain.
Valise of Medumical Work $ (A OF BOOR ESTIMATE MUST BE INCLUDED WJTHAPPLICATIOM
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC (Desm *e)
BOILERS FIREPLACE INSERTS HOODS
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG. SYSTEMS
BATHTUBS (wT b/snewrcmnq
LAVS ( s& sw*
URINALS MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS pwo
BLBCTRZC WATER HEATERS
SINKS
WASHING MACHINES
HOSE BIBBS
SUMPS
NEW ADDRESS REQUIRED?
I
I aorto under penalty of perjury that I ane the property owner or authorised agent of the pmpwV omnw. I owt(& that to the bat of my
knowledge, the ie{/ornueNnn sabndttsd in ern,PPort of this Permit aRPlioatton is true and correct I c0rtV9 that I will conygy with all applicable
City q f Federal Way ins pertaining to the work authorized by the issuance of a permit': I understand that the issuance of this permit
does not nanous the osener's riesponsWItty for compliance with local shat@, or federal laws regulating construction or environmental linos.
I further agree to hold harmless the City of Federal Way as to any claim (including assts, wronses, and attorneys' fees incurred in the
investigation and defense of such ckzb4 which may be mads by ww person, includbW the undersigned, and filed against the city, but only
where such claim arises out of the reliance of the atty, including its qfflcers and anploytes, upon the aeanuveg of the information supplied to
the city as apart of this application.
SIGNATURE: < .____. _ DATE - G
and/or Authorised Agent -'
a NEW o ADDITION
o ALTERATION
o REPAIR o TENANT ndpMVE1gENT
BUILDING SHELL ONLY?
o YES o NO
BASIC PLAN?
a YES
a. NO
ZONING DESIGNATION
CHANGE OF USE?
o YES
a NO
NEW ADDRESS REQUIRED?
a YES o NO
UP/SEPA/SU?
a YES
a NO
PLATTED LOT?
a YES ONO
DEMO PERMIT REQUIRED?
o YES
a NO
Bulletin #100 - January 1, 2009 Page 2 of 4 klHandouts\Permit Application