19-101687 4„
' a Building - Commercial
City ofFederal ay Permit #:19-101687-00-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: BROOKDALE SENIOR LIVING
Project Address: 31002 14TH AVE S Parcel Number: 082104 9088
Project Description: Repair structural damage to wall from leaking cooler;shoring,wall repair and freezer
replacement. No plumbing.
Owner Applicant Contractor Lender
BROOKDALE SENIOR LIVING INTERSTATE RESTORATION WA INTERSTATE RESTORATION WA OWNER IS LENDER
31002 14TH AVE S LLC LLC
FEDERAL WAY WA 98003 3401 QUORUM DR SUITE 300 3401 QUORUM DR SUITE 300
FORT WORTH TX 76137 FORT WORTH TX 76137
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? 0
Mechanical Work Valuation? 3000 Number of Stories I
Is this an Online or O.T.C.application? No Permit for Building Shell Only? No
Plumbing to be Included? No Comprehensive Plan Designation Community Business
Zoning Designation BC
Total Valuation:60,000.00
RZAM=Art- i ,,r✓ `. :` s n r fig "ttli a _
Refrigeration Systems 1
CONDITIONS:
Extend fire sprinkler protection into new freezer.
PERMIT EXPIRES Wednesday,4 December,2019
Permit Issued on Friday,June 7,2019
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
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Washington and the City of Federal Way.
._
Owner or agent:c.� +-^--� Date: (U/t-2/20
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THIS CARD IS TO REMAIN ON-SITE .
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 101687 00 Address: 31002 14TH AVE S
Project: BROOKDALE SENIOR LIVING FEDERAL WAY WA 98003-4712
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) El Footings/Setback(4110) ! ❑ Foundation Wall(4115)
To be done PRIOR to breaking ground Approved to place concrete Approved to place concrete
By Date , By Date By Date
0 Drainage/Downspout(4040) ® Re-steel(4215) i ® Slab/Concrete Floor(4255)
Approved to backfill Approved to place concrete or groutApproved to place concrete
By DateBy Date By Date
® Underfloor Framing(4285) ® Floor Sheathing(4105) ' ® Shear Walls(4245)
Approved to sheath floor i Approved to install flooring Approved to install siding
I
By Date ' By Date B 4>S Date ,,,
El Roof Sheathing(4220) El Mechanical Rough-in(4165) 0 Gas Piping(4125)
Approved to install roofing Approved Approved to release test
By Date 1 By Date ' By Date
13 ?? Fire/Draft Stops(4095) j 14 Interim Erosion Control(4370) Prior to scheduling a Framing inspection;
Approved Approved Electrical,Plumbing&Mechanical Rough-in
i and Fire/Draft Stop inspections must be signed-
By ,,L Date 1 By Date off and approved. IBC 109.3.4
E5 Framing(4120) ! in Insulation(4150) 1:1 Gypsum Wallboard Nailing(4130)
Approved to insulate I Approved to install wall d I Approved to install mud&tape
ByZ CV; Date b `/if ; By/ $ Date 2 3/(y ! By iia,S Date 0 7//9
El Suspended Ceiling Grid(4265) : 1:1 Final-S K F&R(4060) ; ® Final-Planning
Approved to drop tile Approved Approved
By Date ' By Date By Date
•21 Final Erosion Control(4375) 22 Final-Mechanical(4065) ® Final-Building(4050)
Approved Approved Approved
By Date �,By Date ��By $ Date `p 2///
Rough Electrical C3 Final ElectricalElRight of Way
Approved Approved Approved
By Date By Date By Date
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�.; PERMIT APPLICATION
CITY OF � - RECEIVED
Federal Way PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
APS 0 9 2019 253-835-2607+FAX 253-835-2609+permitcenterfalcitvoffederalway.com
li;iTY OF FEDERAL WAY
#1.ML.�PERMIT NUMBER
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— _ La TARGET DATE 1 17/zo i CA
SITE ADDRESS SUITE/UNIT C
30 .2___ HAIA Ni.k.Aw,Q„ ,so -A\r c-eicVc-tA Wo-Au‘wk ittz
PROJECT VALUATION WRING ASSESSOR'S TAX/PARCEL t
$LOS,o00. �� Q _ / O 5' - Q U g 2
_ ifTYPE OF PERMIT UILDING ❑ PLUMBING(///1b1 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT d\ - 36 �i��"' f\skpc- Li\ k •
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PROJECT DESCRIPTION k0 \'2..p�`.' , , l�\1 �6\Q-c , \� c-'• 1
Detailed description of work to v\1 I�U
be included on this permit only W P1\ c l ZQ-4--
NAME
PHONE c : V\Sb
PROPERTY OWNER MAILING ADDRESS E-MAIL
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CONTRACTOR W43\ 1"0�nN Zr. OO01\tr Q) rit(Sk P--.
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WA STATE CONTRACTOR'S LICENSE II EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE•
TeP--9A)a05'i?Dr-1 / / ',
NAME PRIMARY PHONE
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APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT Spac._ V1 \b. u('3bb' U B
(The individual to receive and MAILING ADDRESS l EE--MAIL j,
respond to all correspondence 2_2-3L12 6 T7'tw\ C1 (\ n�1� ,� �0►,`er)
concerning this application) C STA �' FAX .c-oryn
W ' •C�2
PROJECT FINANCING NAME I(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 authorised 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 authorised 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 Wag as to any claim(including costs,expensesand 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 the city as a part of this application. ��//
SIGNATURE: � ✓\-� DATE -1(2/L o q 1
PRINT NAME:
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application
l •
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $ 3 000
Indicate how many of each type of fixture to be installed or relocated as part of this project Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS)commercial)
BOILERS FURNACES HOT WATER TANKS(Gan)
COMPRESSORS GAS LOG SETS >e REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT
Indicate how many of each type of fixture to be installed or relocated as part of this project.Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo) LAVS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS)Kitchen/Utility) WATER HEATERS(ksiechic)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes ❑ No ❑Yes 0 No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE 0 CARPORT 0
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
Square Feet Type Stories
NEW BUILDING
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in Occupancy Group(s) Construction #of Additional Information
Square FeetType Stories
TOTAL BU LDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—January 29,2016 Page 2 of 2 k:\Handouts\Permit Application