02-101350 4• •
clay—of Federal Way Building - Commercial Permit #:02 - 101350 - 00 - CO
Community Development Services
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: FRED MEYER SHOES
Project Address: 33702 21ST AVE SW Parcel Number: 930100 0010
Project Description: TI-Removal of existing wall partitions,removal of existing lighting,construction of new partitions,
modification of ceiling grid,addition of new lighting fixtures,altering existing ducting
Owner Applicant Contractor Lender
FRED MEYER INC WESTERN CONSTRUCTION SERVI WESTERN CONSTRUCTION SERVI FRED MEYER INC
PO BOX 42121 PO BOX 5768 WESTECS162R8 9/16/03 PO BOX 42121
PORTLAND WA 97242 VANCOUVER WA 98668-5768 PO BOX 5768 PORTLAND WA 97242
VANCOUVER WA 98668-5768
Includes:
Census category: 437-Comm #1 #2 #3 #4
Occupancy Group: M
•
Construction Type: Type V-N
Occupancy Load:
Floor Area(Sq.Ft.): 3000
1st Floor Proposed Sq.Feet 3000 Census Category 437-Commercial alt/add
Fire Sprinklers Yes Mechanical Yes
Number of Stories 1 Permit for Building Shell Only No
Plumbing No Total Proposed Sq.Feet 3000
Will Certificate of Occupancy be Issued? No Zoning Designation BN
Mechanical Fixtures
Descripti®rt :. ' '., Gluarltity Description - Quantity _- ;Description !Quantity]
Ducts 1
PERMIT EXPIRES September 29,2002,IF NO WORK IS STARTED.
Permit issued on April 2,2002
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 agen _�� / / Date: -
)41
•
PO THIS CARD ON THE FRONT OF BUILD G
s G BUING DIVISION
V Fly INSPECTION RECORD
INSPECTION REQUEST PHONE#: 253-835-3050
PERMIT #: 02-101350-00-CO
OWNER'S NAME: FRED MEYER INC
SITE ADDRESS: 33702 21ST SW
( ) FOOTINGS/SETBACKS ( ) FOUNDATION WALL
* :T4':DO RIOT-POUR CONCRETE UNTIL'-THE ABOVEwI5`APPROVED
( ) DRAINAGE: Line ( ) Connection
nn"; - DOYNOT POUR SLAB UNTIL THE;;ABOVE"IS APPROVED.:--. x-; `=k
( ) UNDERFLOOR FRAMING
( ) ROUGH PLUMBING: DWV Water piping
() 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
( ) FRAMING/FIRESTOPPING '/ y)2 -
+- . THE ABOVE MUST BE APPROVED PRIOR TO INSULATING OR SHEETROCKING
( ) INSULATION: Floors Walls Attic
THE ABOVE MUST BE APPROVED PRIOR TO APPLYING SHEETROCK
( ) WALLBOARD NAILING /04k ( ) SUSPENDED CEILING
THE ABOVE MUST BE APPROVED PRIOR TO TAPING OR INSTALLING CEILING TILE
( ) ELECTRICAL FINAL -' U
O PLANNING FINAL
() PUBLIC WORKS FINAL
( ) FIRE FINAL 41 b -�, e Zp(///0,10,
THE ABOVE MUST BE APPROVED PRIO TO BUILDING DEPARTMENT FINAL
BUILDING FINAL S-*-- „3 - b "Z
DO NOT OCCUPY THIS BUILDING UNTIL BUILDING FINAL IS APPROVED
•
i
^or = CONSTRUPIONMMIT APPLICATION
AFI APPLICATION NUMBER:C/ 1
APPLICATION NUMBER: - -
RECEIVED APPLICATION NUMBER: - -
**Theefollowing
�is required information—Please print(in Ink)or type**
Please note: Electrical,Ftl�e'Mr+i4eflt h ?steno;and Engineering permits may require a separate application.
:=R^PERTY INFORMATION
' ` SEPT.
SITE ADDRESS:3390 a oa 1s- /TUG' 5t ) ASSESSOR'S TAX/PARCEL#:. 3. Q .1 Q Q - Q Q 1 0
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): BUILDING o PLUMBING ❑ MECHANICAL o DEMOLITION
❑ ELECTRICAL ❑•.ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description 7ENNi✓ L r JQ A-TIO N c .Sm'E J)E)°
PROJECT NAME: =jLeD MEV ---g. %SHOE Derr EE7l/Ot44-T1OI/
• PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
F/ZE-o IllEyER_l� ilk (503)'797 -35-JP
MAILING ADDRESS(STREET ADDROS;QTY,STATE,IIP):
PO lac x y a-I a t ('►l/s 33R ) PPZTLI ,JD oR 9'7.21-/
CONTRACTOR; DAYTIME PHONE:
ESTEed tligd5rEET ADDRESS;_ci110A/ 6E7214e-65i Inc-, (3Lo)(�aq -5�i'7
% EVENING PHONE:
Po ADDRESS* 5-9t,>� 1/�4 n/co ✓ee l�4 ��1a(�� (3100) '117)- -51-0-
CITY OF FERAL WAY BUSINESS LICENSE NUMBER: ( FAX NUMBER:
14PP1E Fog- - - (3100)(09L1 -t7g if
CONTRACTORS REGISTRATION NUMBER: DATE:
(copy ofcard• ) WT' r c s 14. R. 8- 87N/ 111 l 03
APPLICANT: : DAYTIME PHONE:
[3, eo.t)s r S Jw (36c» 1' '1 -5-31
MAILING ADDRESS(STREET ADDRESS;QTY,STATE,ZIP): EVENING PHONE:
Po Bc.w 511k> 1`i evul/ t✓.4- g8L1(e - 040)`717)-
-5y1a-
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ARCHITECT ❑TENANT %OTHER(DESCRIBE):ima,JP1244L C8 eAcnne. (3G 0) 61q-,-2g 1 g
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑PROPERTY OWNER ❑APPLICANT ❑CONTRACTOR brenewes}'P/ncorst(LAct,vrl.colµ
• DETAILED BUILDING INFORMATION
EXISTING USE: ?TH IL sM LES EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: S/tvIAE PROPOSED VALUATION FOR IMPROVEMENTS: $35:, DD()
SPRINKLERED BUILDING? RYES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:o YES ❑ NO
WATER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE ❑TACOMA o PRIVATE(WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE o PRIVATE(SEPTIC)
v
•
n*NC!QI SIRE DENTIAL CONSTRU NLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST �l617),
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
• FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(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 ❑GAS
PLU BING
BATHTUB(S) LAVA R (S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN SY VACUUM BREAKER(S) ❑ELECTRIC o GAS
DRINKING FOUNTAIN(S) SHOW ) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK( ) 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 daim(induding costs,expenses,and attorneys'fees Incurred in the
investigation and defense of such daim),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 the dty,including its officers and employees,upon the accuracy
of the information sup led to the dty as a part is application.
NAME/TITLE: Ih4e1/0, ?/ si.PDATE: 3/Di-3,'/Oa
❑ PROPERTY OWNER ❑APPLICANT 'CONTRACTOR
FOR OFFICE USE ONLY: flA4 I a 5 0X
❑ NEW ❑ADD o ALTERATION o REPAIR t'ENANT IMPROVEMENT
CENSUS CODE: �� LOT SUE:
ZONING DESIGNATIO BUILDING SHELL ONLY? ❑YESAr1O
COMP PLAN DESIGNATION BASIC PLAN? ❑YES 24r)
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? o YES a't o
PLATTED LOT? ❑YES dN0 CHANGE OF USE? ❑YES h4NO
G-758, 0.
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.cftyoffede rafway.com