01-101895 City of Federal
Community Development Services ilding - Commercial Peri' #:01 - 101895 - 00 - CO
33530 1st Way 6'
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: D S POINT VILLAGE
Project Address: / DASH POINT RD Parcel Number: 122013 9074
Project Description: D O-Demolish interior 4'foot high non-bearing partition walls.
Owner Applicant Contractor Lender
DASH POINT VILLAGE RANDAL INDUSTRIES RANDAL INDUSTRIES NONE
1640 SW DASH POINT RD 12819 SE 38TH,PNB437 RANDAII01101103(6/9/01)
FEDERAL WAY WA 98023 BELLEVUE WA 98006-1395 12819 SE 38TH,PNB437
BELLEVUE WA 98006-1395 NONE
Includes:
Census category: 437-Comm #1 #2 #3 #4
Occupancy Group:
Construction Type:
Occupancy Load:
Floor Area(Sq.Ft.):
Census Category 437-Commercial alt/add Mechanical No
Number of Stories 1 Permit for Building Shell Only No
Plumbing No
PERMIT EXPIRES November 10,2001,IF NO WORK IS STARTED.
Permit issued on May 14,2001
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy an. - . e wil .- ••. . cordance with the laws,rules and regulations of the State of Washington and
the City of Feder . _
Owner or agent: � Date: c��Ol
alb
•
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lk
CIT.1 Of RE IVEC-) CONSTRUC N PERMIT APPLICATION
\)\> Ef 4=EL_ APPLICATION NUMBER: D 1 - Lc)LP�JS -CO
FIY
'Ay 1 4 ?c 'l APPLICATION NUMBER: - -
GI TY OF FEDERAL WAY APPLICATION NUMBER: - -
1,,LDING DEPT.
**The foirowing is required information-Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
• / 7 • • PROPERTY INFORMATION
SITE ADDRESS: VOZO limsirk'L I\�7‘.-- `J . ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION -
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL%DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING Iii FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Itrovide detailed description): OLA.- 1 r•Pl -b Zk CZ- CAA Cil
( Z cn2 1 q N (54 r�414z-n-71 -c-s---S
PROJECT NAME: : Y-_
1 VI f /i i 1 ' .-
t
• PEOPLE INFORMATION
PROPERTY OWNER: NA DAYTIME PHONE:
• `3 c\)L rs{ W I I .5.1 {LS (Cf z S. )(-/s 3 -Z.JZv
twiT ADDR (STREETESS E1\RE55;C-- ATEA -. , (. 5 S
CONTRACTOR: NADAYTIMETIME PHONE:
c.., 'l,t%-"A Z5 -1-- , C3> LIC., (Z[T� -(7d0
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: ' FAX NUMBER:
- - 4-os )37h-l am
CO CTOR'S REGI _UMBER: EXPIRATION DATE:
(. 0. ) .1,L 0ltO3 CA . / S / ( .
APPLICANT: NA i • ^ CA (DAYTIME PHONE: -
MAILING ADDRESS(STREET ADDRESS;CCM STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: / �, FAX NUMBER:
❑ ARCHITECT CI TENANT MOTHER(DESCRIBE): 44�(Sf"F • ( ) - ,
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT "I, 'CONTRACTOR
• DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: IAA tt 4*" 1ZCC-- PROPOSED VALUATION FOR IMPROVEMENTS: $ /L(it/
SPRINKLERED BUILDING? 'YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN El HIGHLINE El PRIVATE(SEPTIC)
• •
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
••
IN PROTECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
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
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) 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 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 of
Federal Way,but only where such claim arises out of the reliance of the city,including its officers and employees,upon the accuracy
of the informatio supplied to the city as a part of this application. 5-it
r [CI NAME TITLE: � � DATE: -it 4
❑ PROPERTY OWNER ❑ APPLICANT ,CONTRACTOR
FOR OFFICE USE ONLY:
El NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION: BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES Cl NO
COMMI INITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY.WA 98063-9718•253-661-4000•FAX:253-661-4129
DEPARTM• OF LABOR AND INDUSTRIES « . 1
REGISTERED AS PROVIDED BY LAW AS
CONST CONT GENERAL 1/00/TY)
it/00
,:REGIST.+-.# '--''.EXP. DATE pTION
CC01- -RANDAII01103 :06/09/2001 ; FICATE
:1 ND OR
EFFECTIVE'DATE , - 2 .09/23/1999 1 tELOW.
RANDAL INDUSTRIES INC
12819 SE 38TH PMB #437
BELLEVUE WA 98006-1395 ,I
1
1
F625-052-000(8/97) 1;1�
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.111,4141-0.0/1...M.• .. - ... ...-.-••.-, .ANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR POLICY EFFECTIVE POUCY EXPIRATION OMITS
LTR TYPE OF INSURANCE POLICY NUMBER DATE IMM/DD/YY1 DATE CMMIDD/YYI
GENERAL LIABIUTY EACH OCCURRENCE 61, 0 0 0, 0 0 0
X COMMERCIAL GENERAL LIABIUTY FIRE DAMAGE(Any one fire) S50, 000
CLAIMS MADE X OCCUR MED EXP(Any one person) 65, 000
A BH052744269 06/09/00 06/09/01. PERSONAL&ADV INJURY 61, 000, 000
GENERAL AGGREGATE $2, 000, 000
GEN'L AGGREGATELIMIT APPLIES PER; PRODUCTS-COMP/OP AGG 61, 0 0 0,0 0 0
7 POLICY n sr2 I I LOC
AUTOMOBILE UABIUTY COMBINED SINGLE LIMIT $
ANY AUTO
(Ea accident)
_ _...
ALL OWNED AUTOS BODILY INJURY 6
SCHEDULED AUTOS (Per person)
HIRED AUTOS BODILY INJURY 6
NON-OWNED AUTOS (Per accident) --
PROPERTY DAMAGE $
--"` (Per accident)
GARAGE UABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTOOTHER THAN EA ACC 6
AUTO ONLY: AGG 6
EXCESS LIABILITY EACH OCCURRENCE 6
OCCUR CLAIMS MADE AGGREGATE 6
6
DEDUCTIBLE $
RETENTION $ _ $
WORKERS COMPENSATION AND X TORY OMITS °N
A EMPLOYERS'LIABILITY BH052744269 06/09/00 06/09/01 E.L.EACH ACCIDENT el 000, 000
EMPLOYERS E.L.DISEASE-EA EMPLOYEE e1, 0 0 0, 0 0 0
LIABLITY E.L.DISEASE-POLICYUMIT 61, 000, 000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: OPERATIONS OF NAMED INSURED
CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: - CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
INSURED'S COPY DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES. _
AUTHORIZED REPRESEN TIVE
ACORD 25-S(7/97) (i)ACORD CORPORATION 1988
Industries, Inc.
fr. . • 4. . 11 • 1
V: :.. -• - SE 38th #437
,,..A.-:',. 'revue, WA 98006-1395 BID
DATE ESTIMATE NO.
2/19/2001
NAME/ADDRESS 203
Dash Point Shopping Center
Kennedy Wilson Properties
PO Box 52850
Bellevue, WA 98015-2850 PROJECT
ITEM Golden Wok Vanilla Shell
In the former Golden space,Wok DESCRIPTION
following 1620 Dash Point Road,Federal Way, QTY COST
work: TOTAL
SCOPE: complete the
Remove existing 4'tall wall
lattice.Remove bar partitions and planters.Remove existingI
lattice.
sand cooler in bar area. Remove existing wood ceilinglr
g)Remove wall paper if grid I
casings)
s) led byPossible.Remove existing chair rail or wall canrim(not door
hood and fan tenant. Remove existing carpets. Remove and track
assembly. sinks and stoves in kitchen.
repair holes in y Flash over existing curb once hood fan is removed. Patch existing
gypsum wall board. Replace damaged urinal in men's room. Vand I
operation of all toilets and sinks.Repair water leak in kitchen
lamps and ballasts. Paint all walls and ceilings with white stain/odor blocker. Clea
restrooms and kitchen floors with TSP. Replace burned out florescent
GENERAL CONDITIONS: Clean
Working hours are Monday through Frida 7
Y am to Spm.
INCLUDED:
Labor and equipment necessary
NOT INCLUDED: to complete the above described work.
Holiday or off hour pay.
Plans,permits or special inspections.
Hazardous material handling
Electrical,mechanical or spnkler workt or removal.
(Fax
floor prep&unforeseen conditions.
CUSTOMER TO PROVIDE:
Return signed bid to RII 425-373-1800)to authorize work. 1
Work invoiced upon completion
Payment of invoice within 30 days of invoice date. I
ler Demolition permit
ltal/Du••• Disposal costs
1trical Cleaning materials 1 419.20
nbingLamps and ballasts 15 134.40 419.20T
Urinal and toilet kits 2,016.00T
wall GWB, 1 208.00
t tape,mud and corners 1 416.00 208.00T
Stain/odor blocker(Kilz or 123) 416.00T
entry Demolition 1 400.00
ing and repair 1 400.00T
246.40 246.40T
iamcal Repair water leak in kitchen.Disconnect/ca 7 131.20
• 40 45.00 918.40T
act L... p gas appliances except water heater. 1,800.00T
Labor 60 45.00
and materials only1 2,700.00T
Total Sales Tax for -add WSST 840.00 840.00T
City of Federal Way 160 26.60
4,256.00T
I.
Authorized By: 14,220.00 j
8.60% 1,222.92
id for 60 days. Work will not be scheduled until signed bid is returned to RII.
TOTAL
$15,442.92