09-103920City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph. (253) 835-2607 Fax (253) 835-2609
Project Name: WALMART
Project Address: 34520 16TH AVE S
Building - Commercial
Permit #: 09-103920-00-CO
Inspection Request Line: (253) 835-3050
Parcel Number: 212104 9010
Project Description: TI - Split existing vision center and provide space for future tenant. Partition wall to be
built to separate the existing vision center and future tenant. Relocate existing lighting
fixtures.
Owner
Annlicant
Contract
Lender
WALMART REAL ESTATE
RACHEL .IANZEN
TRI RIVER DESIGN AND
WALMART REAL ESTATE
BUSINESS TRUST
UARRISON FRENCH &
CONSTRUCTION INC
BUSINESS TRUST
ASSOCIATES
TRI RIDC01 1 B2 (10/24/10)
809 SW "A" ST SUITE 201
2840 LIBRARY ROAD SUITE 300
BINTONVILLE AR 72712
PITTSBURGH PA 15234
Census Category: 437 - Commercial alt / add / conversion
Includes:
# 1
#2
#3
#4
Occupancy Class:
B
Construction Type:
Occupancy Load:
Floor Area (sq. ft.)
372
0
0
1 0
< Additional Per► It fn#ortnatiQrs
Existing Sprinkler System in Building?.................Yes Mechanical to be Included?... ................................. No
Number of Stories..................................................1 Permit for Building Shell Only? ...................... .......No
Plumbing to be Included?......................................No New / Additional Sq. Feet - Total.......................... 0
Occupancy # 1 -Use ....................................... ....Clinic -Outpatient Zoning Designation ............................. ................... CE
No Fixtures Associated With This Permit It
PERMIT EXPIRES Saturday, April 17, 2010
Permit Issued on Monday, October 19, 2009
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 agent: Date:
* Z lo
City of Federal Way
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 110.2 of the International Building Code certifying that
at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building
construction or use. This certificate is valid ONLY when endorsed by City staff.
Tenant Name: WALMART
Address: 34520 16TH AVE S
Permit #: 09-103920-00-CO
Includes:
#1
#2
#3
44
Occupancy Class:
B
Construction Type:
Occupancy Load:
Floor Area (sq. ft.)
372
0
0
1 0
Owner Name: WALMART REAL ESTATE BUSINES:
Owner Address:
Building Official
Date
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which
experience has shown most severly affect the health and safety of the general public. Although the City has made as complete a
review and inspection as is reasonably possible (within budgetary time and personnel limitations), the City neither guarantees nor
warrants to the owner / occupant or to any other person that this Certificate evidences strict compliance with each and every
ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon
which it is situated. Such compliance is the responsibility of the owner and/or occupant of the premises.
THIS CARD IS TO P`7MAIN ON -SITE
CITY Or Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 09-103920-00-CO Address: 34520 16TH AVE S
Owner: WALMART REAL ESTATE BUSINE FEDERAL WAY, WA 98003-6841
Scheduled inspections may be failed if this card is not on -site. DO N01 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.
SWM Precon Site Mtg (4400)
Initial Erosion Control (4365)
Footings/Setback (4110)
Approved
To be done prior to breaking ground
Approved to place concrete
By
Date
By
Date
By
Date
Slab/Concrete FIoor (4255)
Underfloor Framing (4285)
Re -steel (4215)
Approved to place concrete or grout
Approved to place concrete
Approved to sheath floor
By
Date
By
Date
By
Date
Interim Erosion Control (4370)
Fire/Draft Stops (4095)
Floor Sheathing (4105)
Approved to install flooring
Approved
Approved
By
Date
By
Date
By
Date
Insulation (4150)
❑
Framing (4120)
Framing inspection]and
Prior to scheduling a
to insulate
Approved to install wallboard
Electrical,
Plumbing &Mechanical Rough-inApproved
Firc/Draft Stop inspections must be signed -of
IBC 109.3.4
/
is Date 16 — Z _p
By
Date
approved.
Gypsum Wallboard Nailing (4130)
Final - Fire Department (4060)
Suspended Ceiling Grid (4265)
Approved to install mud & tape
Approved to drop tile
Approved
By
f!S Date l0 _ '�►j
By
Date
By
Date
El
Uin.tl - Building (4050)
Final Erosion Control (4375)
Final -Planning (4070)
Approved
Approved
By
Date
By
Date
By
y /Approved
1 7 C/ Date rW
Rough Electrical
Approved
Final Electrical
Approved
1:1Approved
Right of Way
By
Date
By
Date
By
Date
c�rroF RECE�.VEi� PERMIT
Federal C25 Way
i u 7 2oo�PPLI CATI O N
OMMUNITY DEVELOPMENT SERVICES
&835-2607• FAX 253-835-2609
„n V~-v viF FEDERAL. WAY
SITE ADDRESS
34520 16Th Avenue South Federal Way,
WA 98003
PROPERTY
LC/_J - Oao
SF MF O ME EL PL DE EN FP
Io Iy od)
SUITE/UNIT # ZONING
ASSESSOR'S TAX/PARCEL #
# 3794 CE
2 1 2 1 0 4 _ 9 0 1 0
PROTECT
NAME OF PROJECT
(Tenant or Homeowner Name) Walmart Vision Center/ Professional Office
XI BUILDING N PLUMBING ® MECHANICAL
TYPE OF PERIKIT ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION
Tenant remodel: Vision Center/ White Box
PL, 4. T Z , R 1- 7f2j- t
PROJECT DESCRIPTION
elalled description of work to
be included on this permit only
j eq .�VAIXT111tio4 . ■ 9 ^1 6, 1 -
^to��
F PEOPLE rr- rk r1 rw a TU 17 f rCr+�'+M'i.
NAME
PRIMARY PHONE
PROPERTY OWNER
Wal-Mart Real Estate Business Trust
( 479 ) 204 - 3525
MAILING ADDRESS, CITY, STATE, ZIP
E-MAIL
2001 SE 10th St. Bentonville, AR 72716 - Dept. 44-6562
OWNER IS ALSO:
❑ CONTRACTOR ❑ APPLICANT PROJECT CONTACT
NAME
PRIMARY PHONE
TBD - 1 V4-IR TI�'ur
-
MAD.ING ADDRESS. CITY, STATE, ZIP
h�L '°
FAX
CONTRACTOR
�� L• 113 (� Ii�i�'� c i%G m
-
WA STATE CONTRACTOR' LICENSE #
EXP TION DATE
FEDERAL WAY BUSINESS LICENSE #
Nam,
PRIMARY PHONE
Rachel Janzen
(479 ) 273 - 7780 x 380
APPLICANT
MAILING ADDRESS, CITY, STATE, ZIP
FAX
809 SW A Street Suite 201 Bentonville, AR 72712
( 479 ) 273 - 9436
PROJECT CONTACT
NAME
PRIMARY PHONE
Rachel Janzen —+
( 479 ) 273 - 7780 x 380
(The individual to receive and
MAILING ADDRESS, CITY, STATE, 21F
FAX
respond to all correspondence
concerning this application)
809 SW A Street Suite 201 Bentonville, AR 72712
( 479 ) 273 - 9436
ALTERNATE CONTACT NAME;
PRIMARY PHONE
E-MAIL
( ) _
rachel.janzen@hfa-ae.com
PROJECT FINANCING
NAME
® OWNER -FINANCED
Wal-Mart Stores, Inc.
Required for projects with
MAILING ADDRESS, CITY, STATE, ZIP
PRIMARY PHONE
value of $5,000 or more
(RCW 19.27.095)
2001 SE 10th St. Bentonville, AR 72716 - Dept. 44-6562
( 479 ) 204 - 3525
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 env nmmentaf laws.
Ifia-ther a 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 whe su h claim arises ou[R��+N¢r-elionce of the city, including its officers and employees, upon the accuracy of the
information suppI' to the city as a part of th -Opp c 1y
d s' c) O f
SIGNATURE: DATZ
_ t,M
PRINT NAME: r
Bulletin #100—4/2112 9 Page 1 of 4 kAHandouts\Per-mit Application
!,Kvv us
MECHANICAL FIXTURES
Value of Mechanical Work $
N/A fA COPY OF BID OR ESTIMATE MUST BE PROVIDED)
Indicate number of each type of ixture to be installed or relocated as pgrt of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS
FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERT$ HOODS (Conorn—lap
BOILERS
FURNACES HOT WATER TANKS (cas)
COMPRESSORS
GAS LOGS REFRIGERATION SYST
DUCTING
GASH ' WOODSTOVES
PLUMBING FIXTURES
Indicate number of each type of fixture to be installed or relocatedlE part of this project. Do not include existing fixtures to remain.
BATHTUBS (or T�rb/sno—Combo) LAVS (nand sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSIToe URINALS OTHER (Describe)
DRAINS SHOWERS � VACUUM BREAKERS
DRINKING FOUNTAINS SINKS [KISYt1tPRY} WATER HEATERS (electric)
HOSE BIBBS su WASHING MACHINES N/A TOTAL FIXTURES
GENERAL INFORMATION
PROJECT VALUATION
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
$75,000
$
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
EXISTING/PREVIOUS USE
Vision Center
372
❑ Yes ❑ No
❑ Yes ❑ No
RESIDENTIAI,
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
BASEMENT
FIRST FLOOR (or Mobile Home)
SECOND FLOOR
COVERED ENTRY
�•`
DECK
GARAGE ❑ CARPORT ❑
OTHER (describe)
Area Totals
ERI97Di6
PROPOSED
TOTAL—
•"IVEW HOMES ONLY**
ESTIMATED SELLING PRICE $
# OF BEDROOMS
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION
Area
in Square Feet
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
NEW BUILDING
ADDITION
COMMERCIAL — REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area
in Square Feet
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
TOTAL BUILDING
203,818
M- Mercantile
513
1
TENANT AREA ONLY
372
M- Mercantile
5B
1
PROJECT AREA ONLY
372
M- Mercantile
5B
1
Bulletin #100 - 4/21/2009 Page 2 of 4 k:\Handouts\Permit Application