05-100503 � ,.
City of Federal Way Demolition Permit #: 05 - 100503 - 00 - DE
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: TUESDAY MORNING
Project Address: 2200 S 314TH\ Parcel Number: 092104 9053
Project Description: Remove interior,non-bearing partions and dressing rooms in preparation fo TI work to create three
seperate retail spaces from one exisiting space.
Owner Applicant Contractor
HILLSIDE PLAZA ASSOCIATES JE CUMMINGS CORPORATION JE CUMMINGS CORPORATION
PO BOX 5003 7554 185TH AVE NE 7554 185TH AVE NE
BELLEVUE WA 98009 REDMOND WA 98073 REDMOND WA 98073
(425)881-5826
PERMIT EXPIRES February 3,2007.
Permit issued on February 3,2005
I hereby certify that the above information is conect 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 ay.
�---
Owner or agent: Date: ��- v � � d �
m�'� i
� ' , � THIS CARD IS TO �VIAIN ON-SITF
���►oF C,ommunity Development Inspection iZecord
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-100503-00-DE
Owner: HILLSIDE PLAZA ASSOCIATES
Address: 2200 S 314TH ST \
FEDERAL WAY, WA
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.
❑ Final-Building(4050)
Approved
By Date ,3 �� QS
' � � ` I�H3
an or� � � ��/ ) �v �
' PERMIT `�L
Federal Way �G�iV
� SF MF CO ME EL PL E N FP
COMMflNfIY DEVEfAPME1IT SERVlCES
4 333258TM AVENf/E SOUTfI.��X��e o 2 Zo�P P LI CAT I O N °
FEDERAL WAY,WA 980G1-9718 /
253-835-2607•FAX 253-835-2609 / -
www.cit ederalwa .mm
rY UF FEDER 4,
� The oilowin {s re fd ��zn incom Iete a iication wiil not be acce ted. Please rint ie ibl (in fn or
- • • i • - �
SITE ADDRESS � J��� � � �' SUITE/UNIT N
ASSESSOR'S TAX/PARCEL� � I � � � - � � � � LOT SIZE(s�
LEGAL DESCRIPTION(e.g.Acme Estates,Lot If
(Atta h s�a(e page f ler�thy legal descnprion)
' • 1 • ' 1 ' •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
� �DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
� PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlul
v� `��aat� 01-� - 1-1- �Zll o�--t �N D �I�S l►-!
� �
f
� �
PROJECT NAME(Name of Business or Owner Last Name) �� ���� �
� • • � • - •
` PROPERTY AME PRIMARY PHONE
� OWNER ���..LS\\� �.�'LV{` �"SS o �s.1�� S �'Zr �S�' -���O
Gh1oN� D. _ $����.�LK` CITY,STATE,ZIP
l SiGN
.�. (30� oc �v� 'A- �� b0
CONTRACTOR COMPANY NAME PPL[CANT NAME OFFICE PHONE
��. �t��r^u--�-� �Q-�('• �1��' 1�11r-�1�� ('�Z�$&1 - S�?iZ.�
� `[LING A�O� ��� CI7'Y.STATE.ZIP ��� ��Q{� �G.�� �N�1� -`_Q�O
V T�Y J
� � CITY OF FEDERAL WAY BUS[NESS UCENSE NUMBER EXPIRATION DATE FAX NUMBER
� o �l - ln�- 5'? Z o O _- B L / / ( ) -
CONTRAC'I'ORS REGISTRATION NUMBER(co y o[eard reqnired with each application) EXPIRATION DATE
, �`� � (JY`'l � � � � � S ��' o ( 11S / O'7
APPLICANT COMPANY APPLICANT NAME OFFICE PHONE
t � , _
MAILING ADDRESS CITY,STATE,ZIP - CELL PHONE
� �
� RELATfONSHIP TO PROJECT FAX NUMBER _
❑ Architect ❑ Tenant ❑Agent ❑ Other(Descnbe) ( �
CONTACT NAME P A�y,PHONE E-MAIL DDRESS
� 1/��t�t W���-�— z� ��t - S�a Z 4 w,-��s.�c�
` LENDER PerRCW 19.27.095��LeniterinJormaRfonis � NAME �
�, ,.,.
� �'.re�/uired if projecf,vaiue exceecls�5,000: �
�
i MAILING ADDRESS � CITY,STATE,ZIP
�
� � : 1 � 1 • ' �
� EXISTING USE PROPOSED USE
� �� �
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ '
SPRINKLERED BUII.DING? ❑ YFS ❑ NO FIRE SUPPRE.SSION SYSTEM PROPOSED/REQUIRED? ❑ YE.S O NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN O HIGFII,INE ❑TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEFiAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
- . . . -
AREA DESCRIPTION EXISTING PROPOSED TOTAL
S . F'T. S . F'I'. S .F'I'. '
BASEMENT �
FIRST
SECOND �
THIRD
FOURTH "•
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?) �
GARAGE ❑ CARPORT❑ �
I
LlOSiING �ROPoSLD TOTAL :�-Td[AL LRSTRVO SF". ���: TOTAL PROPO:ED 3F �� �':��?OLAL E[ �
NUMBER OF FLOORS
•`NEW HOMES ONLY•` NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
i
✓ i •
Indicafe number of each type of fucture to be insfalled or re(ocated as part of fhis project. Do not include ezisting fixtures fo remain.
MEC:FiA1VICAL �
Value of Mechanical Work $
�
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS ,
BBQS FANS HOODS�co��rc�a�� WOODSTOVES �
BOILERS F[REPLACE INSERTS RANGES MISC(Describe) ,
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS P[PE OUTLETS �
PLUMBING
BATHTUBS�o�T�b�snoK«com�� SHOWERS WATER CIASEI'S�roaeq MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS '
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS�eau,�ms�xs� VACUUM BREAKERS ELECTRIC WATER HEATERS
� ' �11� �
I certify under penaity of pery'ury that the informarion Jurnished by me is true and correct to the best oj my knowledge, and further, that I
am authorized by the owner of the above premises to perjorm the work jor which th¢permit application is made. I further agree to hold
luvniiess the City of Federal Way as to any claim(inciuding costs, expenses, and attorneys'fees incurred tn the investigation and dejense of
such claimJ, which may be made 6y any person,including the undersigned,and filed against the City of Federal Way,b�t only where such claim
arises out of the reliance of the c{ tncluding tts officers and employees, upon the accuracy oj the inJormation supplied to the ctty acs a part of
thfs appiication. � �
NAME/TITLE �� �� ��� � " - DATE ��� `
�
(Signa[ure� (Title)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent ❑ Contractor ❑ Architect ❑ Other
�
�,�
'
�`F�'�O�R�OFFICE�USE ONLY::
�
�a'NEW- �' ❑ADDITION �� ��a ALTERATION � � �❑REPAIR ����❑TENANT IlIZPROVEMENT��' �
�BUII,DING SHELL ONLY? o YE.S o NO BASIC PLAN? a YFS a NO '
rZONII�G DESIGNATION CHANGE OF USE? ❑YES ❑NO
;NEW ADAFtESS�REQIIIRED? '� � o YE5� ❑NO ' UP/SEPA/SU?.�� _ � � � �o YFS ���� ❑NO �
-�.
�I'LATTED�LOT? ��'� ��� ; � . r� �,`a YES���;�,n NO �:�� ' DEMO PERMIT��REQULRED? ��� �a�YES n NO. ;
i
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Bulletin#100—January 7,2005 Page 2 of 4 kUiandouts�I'ermit Application