19-103866 Building - Commercial
City of Federal Way Permit #:19-103866-00-CO
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: VILLAGE GREEN HEARTHSIDE&GARDENS
Project Address: 35419 1ST AVE S Parcel Number:302104 9024
Project Description: TI-Permit to complete the work and receive final inspection of Permit 16-103322 for"tenant
improvement work to include demolition and construction of new walls to reconfigure floor
plan" and Permit#16-105799 to"reroute(4)ducts and install(2)kitchen hoods,and Permit
#16-105919 to"install(1)sink,(1)floor sink,and(2)coffee makers".
Owner Applicant Contractor Lender
VILLAGE GREEN FEDERAL WAY TODD POWELL OWNER IS CONTRACTOR
PO BOX 98309 PO BOX 98309
DES MOINES WA 98198 DES MOINES WA 98198
Census Category: 437-Commercial alt/add/conversion
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area(sq.ft.)
Additional Permit Information
Mechanical to be Included? Yes Plumbing Work Valuation? 5000
Mechanical Work Valuation? 5000 Number of Stories 4
Is this an Online or O.T.C.application', Yes Permit for Building Shell Only? No
Plumbing to be Included? Yes
Total Valuation: 150,000.00
Ducting 1 Hoods 2
-. t�Y P,x''t j' v;'i' jyY' 4,, ^`,,; . '4:—t k "•, s,,-• ',:! `t�„tt a,, !iy.
T.,` ;fi�.',�,. �'• rF ": •t.; r!* i�s`f' ! AN' t i,..,-,-,1 s" r '.>�. �:.a
Other Plumbing Fixtures 2 Sinks 2
CONDITIONS:
Separate Electrical Permit
PERMIT EXPIRES Saturday,8 February, ,2020
Permit Issued on Monday,August 12,2019
I hereby certify that the above infor 1- on is correct and that the construction on the above described property
and the occupancy and th '•- ' nccordance d the C ithf Federal Ways and regulations of the State of
.h the laws,
Owner or agent: �iri,:71/ Date: 6P-(t ' /9
` THIS CARD IS TO REMAIN ON-SITE ' '
«pf,F =°' Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 16 103322 00 Address: 35419 1ST AVE S
Project: VILLAGE GREEN FEDERAL WAY 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.
..Initial Erosion Control (4365) CI Footings/Setback(4110) El Re-steel(4215)
Initial Erosion Control(4365) Footings/Setback(4110) Re-steel(4215)
By Date By Date By Date
Slab/Concrete Floor(4255) • 111 Underfloor Framing (4285) ® Floor Sheathing(4105)
Slab/Concrete Floor(4255) Underfloor Framing(4285) Floor Sheathing(4105)
By Date By Date By Date
Fire/Draft Stops (4095) nterim Erosion Control(4370 Prior to scheduling a Framing inspection;r�
Fire/Draft Stops(4095) Interim Erosion Control(4370) Electrical,Plumbing&Mechanical Rough-in
and Fire/Draft Stop inspections must be signed- I
By Cl y Date \2-•_.,_-t No By Date I off and approved. IBC 109.3.4
II Framing (4120) • El Insulation (4150) Ill ipsum Wallboard Nailing(412
Framing(4120) Insulation(4150) Gypsum Wallboard Nailing(4130)
3y 0 V,y Date y--_—2�-.j L , By Date By Date
,
t2 Suspended Ceiling Grid (4265: CI Final-SKF&R(4060) C4 Final-Planning
Suspended Ceiling Grid(4265) Final-S K F&R(4060) Final-Planning
3y Date By Date By Date
Final Erosion Control (4375) • i6I Final-Building(4050)
Final Erosion Control(4375) Final-Building(4050)
3y Date By Date
Rough Electrical ❑ Final Electrical Right of Way
Approved Approved Approved
3y Date By Date By Date
THIS CARD IS TO REMAIN ON-SITE
crrr of '.*
Federal Wa Construction Inspection Record
y INSPECTION REQUESTS: (253)835-3050
PERMIT#: 16 105919 00 Address: 35419 1ST AVE S
Project: VILLAGE GREEN FEDERAL WAY 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.
Plumbing Groundwork(4190) M Rough Plumbing(4230) 0 Final-Plumbing(4075)
Approved to cover Approved Approved
By( \{.� Date }. _3_`_j _ By Date By Date
El Rough Electrical El Final Electrical ❑ Right of Way
Approved Approved Approved
By Date By Date By Date
�z,. „'rx -
,-144....., THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 16 105799 00 Address: 35415 1ST AVE S
Project: VILLAGE GREEN LLC 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.
11 Mechanical Rough-in(4165) 0 Gas Piping(4125) Q Final-Mechanical(4065)
Approved Approved to release test Approved
By (l vy;.� Date Nl ')...3„-.`la By Date By Date
El Rough Electrical Ell Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
THIS CARD IS TO REMAIN ON-SITE
CITY OP IA Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 103866 00 Address: 35419 1ST AVE S
Project: VILLAGE GREEN FEDERAL WAY 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.
El Initial Erosion Control(4365) 0 Footings/Setback(4110) 0 Re-steel(4215)
To be done PRIOR to breaking ground Approved to place concrete Approved to place concrete or grout
By Date . By Date By Date
® Plumbing Groundwork(4190) 0 Slab/Concrete Floor(4255) ® Underfloor Framing(4285)
Approved to cover Approved to place concrete Approved to sheath floor
By Date By Date By Date
El Floor Sheathing(4105) ® Rough Plumbing(4230) El Mechanical Rough-in(4165)
Approved to install flooring Approved Approved
By Date By Date By Date
El Gas Piping(4125) El Fire/Draft Stops(4095) El Interim Erosion Control(4370)
Approved to release test Approved Approved
By Date By Date By Date
Prier to scheduling a Framing tospection; El[
Framing(4120) i; Insulation(4150)
Electrical,Plumbing&Mechanical Rough-in
and Fire/Draft Stop inspections must be signed-
off
igned- Approved to insulate Approved to install wallboard
ofand approved IBC 109.3.4
By Date By Date
El Gypsum Wallboard Nailing(4130) El 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
El Final Erosion Control(4375) El Final-Mechanical(4065) El Final-Plumbing(4075)
Approved Approved Approved
By Date By ; Date V 1 By ' Date S 14
El Final-Building(4050)
Approved
By A.13 Date I(1)1.1 )1i,
0 Rough Electrical 0 Final Electrical Right of Way
Approved Approved Approved
By Date By Date .By Date
` RECEIVED PERMIT APPLICATION
CITY OF 2019
1 2 L J PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325
Federal Way AUG 253-835-2607 + FAX 253-835-2609 +permitcenter@cityoffederalway.com
CITY OF FEDERAL-
r......................._,.)
COMMUN6F DEVELOPMWAYENT
PERMIT NUMBER iq _
10 35-?'_6
_ c u
TARGET DATE
SITE ADDRESS SUITE/UNIT*
35 CI 19 i cl: et b-L SO -
PROJECT VALUATION ZONING ASSESSOR'S TAR/PARCEL#
$ 3 o Z L D -( - q a 7_ -
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT U t 11 aci� L,Itta� V-opft tPut t. Gell c 5. !-
PROJECT DESCRIPTION ‘-ik-bLlSCK. 0-6 wit. FIrP 1A4C'b; /I rLLN.10 Uj '�a4/064cooki
Detailed description of work to F frock( - sp�GLT1 t-. S '44I J
be included on this permitI
V t5.1 tittiAl
• / .-/ > � � 'o s' Qf ^
ll/ /4 '- �1
__ _ NAME PRIMARYYPHONE --
PROPERTY OWNER " i`(aq inhiJ 1�(&1 G I Way �b 9'39-03(
Pa MAILINGBC*9M3 DRESS / E-MAIL
CITY STATE ZIP
06C irYl 01105 bt.)Gift 17ep __ _
NAMEPHONE
NIA
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME - _
.. PRIMARY PHONE
'ra D eack-t) Zpe q;qq-03/L
APPLICANT MAILING ADDRESS E-MAIL I
P3 9 ,3Dcj �gclx.,�Twaoelkisys1 it i e0w
CITY - - STATE ZIP
p. J Mot.' 5 lam` 9e/ga
NAME , PRIMARY PHONE
PROJECT CONTACT 'S 1 IM-e, #5 f1 pp I f CC.1
(The individual to receive and MAILING ADDRE S 1 E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME
PROJECT FINANCING r�I A ❑ OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095)
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 • --- out o the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the ity as a piei,,•f this application.
SIGNATURE: - --- DATE ? (2 •I—1
PRINT NAME: O AGIe ll
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application