HomeMy WebLinkAboutPermit 5468 - Foodmaker Inc - Slab, Dock Levelers and FreezersCITY OF TUKWILA
Building Division
6200 Southcenter Boulevard
Tukwila, Washington 98188
(206) 433-WiC I g4-9 BUILDING PERMIT
Work to be done
Site Address
Building Use
Property Owner
Address
Contractor
Address
T.I. (NiW, dix) eVie ie t%9 •— Free z r )
18151 SEGALE PK DR 'B" Suite # Tenant
OFFICE Assessors Account #
SEGALE BUSINESS PARK Phone #
PERMIT #
Control #
88 -338
(512)
P.O. BOX 88050
MAYER CONST CO, INC.
P.0 B
FOR BUILDING PERMIT ONLY
TUKWIIA, A, WA
#MAYFRC34095
Approved for Issuance By:
Sq. Ft.
Office
Storage/ e
Wareh ous
Retail
Other
Occ.
Load
1st F1.
'2nd Fl.
3rd Fl.
x/09
1
Total
Fire Protection:
Sprinklers ❑ Detectors
Zoning (Y) Type of Construction
Special Conditions
575 -3200
Zip 9813.
Phone # Zip 878-4797
-48
P c1d
Date: 1/ -9 -1�D ,
Fees
sq. ft. @ 1st Fl. $
sq. ft. @ 2nd F1. $
sq. ft. @ other $
sq. ft. @ other $
Total Valuation of Construction $ 96,203
Bldg. Permit Fee
Plan Check Fee
Demolition
Surcharges
Other
Other
TOTAL
Receipt # 5930 $ 622.00
Receipt # 5930 $ 404.00
Receipt # $
Receipt # 5930 $ 3.50
Receipt # $
Receipt # $
$ 1,029.50
FOR SIGN PERMIT ONLY
0 Permanent J Temporary
Single Face [] Double Face 0 Wall Mounted ❑ Free Standing ❑ Other
Building face Setbacks: Front Side Side Rear
Square Footage of each sign face Total square footage of sign
Special Conditions
THIS PERMII BEGUMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FUR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT, ALL PROVISIONS OF LAWS AND ORDINANCES
GOVERNING THIS TYPE OF YORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DUES NOT PRESUME TO GIVE AUTHORITY TO
VIOLATE UR .Cy$ EL xAE PRO IONS OF OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
Signed _,:e/4
Date
LICENSED CONTRACTORS DECLARATION
I hereby affirm that l an licensed under provisions of the Business and Professions Code, and my license is in full force and effect.
Contractor (signature)/ _ Date %�1fa"_$g_.__�.____ �.._.___._.__.
OWNER - BUILDER DECLARATION
( ) 1, as owner of the property, or my employees, with wages as their sole compensation, will do the work, and the structure is not intended or
offered for sale.
( ) 1, as owner of the property, am exclusively contracting with licensed contractor's to construct the project.
Owner (signature) Date
CITY OF TUKWILA
Building Division
6200 Southcenter Boulevard
Tukwila, Washington 98188
(206) 433 - 184.9 BUILDING PERMIT
Work to be done T.I. (tl
Site Address 18151 SEGALE PK DR
Building Use OFFICE
Property Owner SEGALE BUSINESS PARK
Address P.O. BOX 88050
Contractor MAYER CONST CO. INC,
Address P.O. BOX 28280
1011
E—r' .3
Suite enant F00DMAKER
Assessors Account #
Phone # 5515 -3 200
Zip 98132
Phone # 878 -4797
Zip 98198 c1d
Date: / / -9 -DO
PERMIT # c� C
Control #
TUKWII A, WA
#MAYFRC34095
DES MOTNFS._
88 -338
(512)
FOR BUILDING PERMIT ONLY
Approved for Issuance By:
S q • Ft.
Offi
Office
Storrehousage/ e
Wa
Retail
Other
Occ.
Load
1st F1.
'2nd F1.
3rd F1.
11m
Total
Fire Protection: Sprinklers 0 Detectors
Zoning 01-A Type of Construction
Special Conditions
lel,Q4tO
Fees
sq. ft. @ 1st F1. $
sq. ft. @ 2nd F1. $
sq. ft. @ other $
sq. ft. @ other $
Total Valuation of Construction $ 96,203
Bldg. Permit Fee Receipt # 5930 $ 622,00
Plan Check Fee Receipt # 5930 $ 404.00
Demolition Receipt # $
Surcharges Receipt # 59 $ 3.50
Other Receipt # $
Other Receipt # $
TOTAL
$ 1,029.50
FUR SIGN PERMIT ONLY
0 Permanent ❑ Temporary
[] Single Face ❑ Double Face [] Wall Mounted [] Free Standing ❑ Other
Building face Setbacks: Front Side Side Rear
Square Footage of each sign face Total square footage of sign
Special Conditions
i
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK 15 SUSPENDED OR
ABANDUNEU FUR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
1 HEREBY CERTIFY THAT l HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SANE TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES
GOVERNING THIS TYPE OF ORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 00ES NOT PRESUME TO GIVE AUTHORITY TO
VIOLATE UR CA EL j E PRO IONS OF _A OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
Signed _+�/ % Date �f �
1
LICENSED CONTRACTORS DECLARATION
I hereby affirm that I am licensed under provisions of the Business and Professions Code, and my license is in full force and effect.
Contractor (signature)_ ix L o Date /I1% .:�p__._____. -_ - _ -- -• -•
OWNER- BUILDER DECLARATION
( ) 1, as owner of the property, or my employees, with wages as their sole compensation, will do the work, and the structure is not intended or
offered for sale.
( ) 1, as owner of the property, am exclusively contracting with licensed contractor's to construct the project.
Owner (signature)_ Date
CITY OF TUKWILA
Building Division
6200 Southcenter Boulevard
Tukwila, Washington 98188
(206) 433-1849
Type of Inspection
INSPECTION RECORD
PERMIT #
Date
Site Address /0///c--/ ..9.664-1,/.2- 4
Requestor
Date Wanted
Project tpi#,,/4/9-ii/1"...5
Phone #
a.m. p.m.
Special Instructions
Inspection Results/Comments(
Inspector „0,11--
Date
CITY OF TUKWILA
Building Division
6200 Southcenter Boulevard
Tukwila, Washington 98188
(206) 433 -1849
ype of Inspection
FLiMck '44 MeZ, cut
INSPECTrN RECORD
PERMIT # 56/68 d
Date / / - /op `8
Date Wanted 11 / - 3'
ite Address /els57 Spg6r 6 Project Fdca.."// J_kzK�'
equestor //' _'/ �/.'. /._ : Phone # �f'73 7t7'%
_� 7-0 /G( AS//7 / i- 4Y>Q,Ci. , 7�T ,/-n( ! & ?) aM 1
11CGC/ 26-1 14— /- 1 ()?-7 l c,
pecial Instructions
Inspection Results /Comments: aPf 221 ,' 't'j- C /9�/iva/i'� 6' /1 /L�/��
Inspector ,A let,
Date //-4-c0
r'
CITY OF TUKWILA
Building Division
6200 Southcenter Boulevard
Tukwila, Washington 98188
(206) 433 -1849
INSPECTON RECORD
PERMIT # S y 6 Y
'ype of Inspection 4 e Date Wanted Tea
;ite Address /'/ G / .S707,67_,4 ,k "8"
equestor ,6
special Instructions
it -/s" .S4
Project rod,LjC.e,.,
Phone # c 7 x-.-17 6. r
Inspection Results/Comments: 9/( /i62
fik/n ,V,7,4—z9&,-ed
e4C
Inspector 1/762-A-7
Date / /%y /Ail
CITY OF TUKWILA
Building Division
6200 Southcenter Boulevard
Tukwila, Washington 98188
(206) 433 -1849
Type of Inspection
;ite Address
equestor
special Instructions
ied)-e4A
INSPECTr,N RECORD
PERMIT # 5—`-(4g
Date
Date Wanted 7 /(-70 -01.m•
Project
Phone # ? 7' `/7 F7
18/ -/
1Q-a 147/ a_
ro�.mer 71,
Inspection Results /Comments: 111$ ed,6,I &ea le), ', t hecaus'e
lalti* Clt �'� � r L:)ot^ i 01, C - I'Kte'fo Was
Safe' he Cow bye hitis i n api Nadi •0.704/ r
no VrDtiocir
etsJ Otohlacfor
Inspector
Date
CITY OF TU K VILA Jontrol No. ice- 338 /
Central Permit System Permit No. 5I(
FINAL APPROVAL FORM
TO: ❑ Building
❑ Planning
❑ Public Works
L(Fire Dept.
❑ Police
❑ Parks/ Recreation
Project Name
Address
Type of Permit(s)
it
k'L
This project is nearing completion. Please investigate your area of responsibility and indicate
below either your final approval or necessary corrections.
If no response is received within one week, it will be assumed that the project is of no concern
to your department and a certificate of occupancy may be issued.
This project is NOT approved by this department; the following corrections are necessary:
()
( )
()
()
()
()
()
()
()
()
()
()
Authorized Sign'ature Date
This project is approved by this department:
Author zed Signature
T12 3/2.. /- . - - -5
Date
CPS Form 3
THE FOLLOWING COMMENTS APPLY TO AND 4EZOME PART OF THE APPROVED PLANS UNDER
TUKWILA BUILDING PERMIT NUMBER
1. No changes will be made to plans unless approved by Tukwila Building
Department. Additional construction or change in scope of work as
outlined in Phase I, shall be detailed as proposed, and submitted to
Tukwila Building Department for review and approval.
2. Plumbing permit to be obtained through King County Health Department
and plumbing will be inspected by that agency (including all gas
piping).
All permits to be posted at job site prior to start of any
construction.
4. When. Special Inspection is required either the owner,. architect Or
engineer shall notify the Tukwila Building Department of,appointMent of
the inspection agencies prior to the first building inspection. Copies
of all spacial 'inspection reports shall be submitted ta.the,Building
Department in a timely manner. Reports shall contain address and
permit number of the project being inspected.
5. All structural concrete to be special inspected. (Sec. 306, UBC),
6. All construction to be done in conformance with approved plans And
requirements of the UnifOrm Building Code .(195 Edition), Uniform
Mechanical Code (1985 Edition), Washington State Energy Code (1986
EditiOn), and Washington State Regulations for Barrier Free
Facility (1986 Edition).
11,' 11,28 14:00 CHARLES NEEDHAM I HD.
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«Charles Needham Industries
P. O. Box 14248 • 4201 lanada Street • Fort Worth, Texas 76117 • 817 / 281.5121
June 2, 1988
Mr. Bill Boncher
Foodmaker
P.O. Box 783
San Diego, CA 92112
RE: Foodmaker
Seattle, Washington
Dear Bill:
/76- 6- --...!c11,7Zd-
PILE
1 Dc.K'%:0' � Ott E ,
LS
t4Desz.
Enclosed please find some ske ches concerning the floor
modifications at the above referenced project.
We are submitting two (2) proposal- and they are as follows:
Phase I
Phase I is based upon the removal of the top wearing slab, curbs
and floor insulation. We would inspect the base slab and if found
satisfactory then install a seamless piping glycol system on top
of the base slab then apply 6" of 2 lb. density eps (R28.6) with
10 mil vapor barrier. We propose a 5" thick concrete wearing slab
with a single mat of 03 grade 60 rebar 18" o.c.e.w. Concrete
shall exhibit 3000 psi at 28 days. Finish shall be hard troweled.
Curbs shall be poured around the entire perimeter inside the box.
Curbs shall be 6" wide by 12" tall with n3 grade 60 dowels 24"
o.c. into the wearing slab and two (2) r3 grade 60 horizontal bars
thru the curb.
All curbs shall have a rubbed finish. No sealer is included on
the floor at this time due to the concrete not being at least 30
days cured. If your desire is to have a sealer applied to this
floor we will investigate the possibility of other types of
products which may be used. Upon completion of the floor work we
will adjust all doors and check anels for leaks. We estimate the
time for completion to be weeks_ rom_ the start of workJ This
plan does not require any panels to be removed except those
required to gain access to the project by equipment used in the
demolition process.
We estimate this work to cost $ 96,203.00.
Phase II
Phase II is based upon removal of the top wearing slab, curbs and
floor insulation. Upon inspection of the base slab if it is found
to be unsatisfactory we would remove the base slab and excavate
all frozen or unsuitable soils and remove them from the site.
This quotation is based upon excavation of 6 feet of soils in the
entire cooler /freezer area. Upon completion of the excavation,
select backfill would be brought. An underground PVC vent system
would be installed as detailed in sketch FB -01 and would be
connected to a gas fired forced air unit located inside the dry
warehouse. Warm air would flow thru the vent system piping and
vent to the outside. We include core drilling the existing
concrete stem walls and applying screens on the ends of the pipes
to eliminate the removal of the exterior wall panels, the base
slab would be saw cut approximately 6" inside the wall line as
shown in our attached sketches. We would need to remove the
partition wall and reinstall it after completion of the concrete
work. We have included all electrical and mechanical work in this
proposal. Floor insulation would be increased to 10" of 1 lb. eps
with 10 mil vapor barrier. Base slab would be 6" of reinforced
concrete and the wearing slab would be 5" thick with #3 grade 60
rebar 18" o.c.e.w. Concrete would exhibit 3000 psi at 28 days.
Curbs shall be poured around the entire perimeter inside the box
and shall be 6" wide X 12" high with $?3 grade 60 dowels 24" o.c.
into the wearing slab and two (2) #3 grade 60 horizontal bars thru
the curbs. Due to the bottom of the wall panels presently resting
on the base slab we would not recommend trying to lower the floor
slab elevation at this time. If the floor slab elevation was to
be the same it would require lowering the entire box by the
thickness of the floor insulation and the wearing slab. We
estimate the time for completion to be 6 weeks from the start of
work.
We estimate this work to cost $ 157,985.00.
If awarded this project CNI will provide all design drawings,
permits and full time on -site supervision.
We appreciate this'opportunity to submit this proposal and hope we
will be chosen to be of service to you on this project.
Sincerely,
_ .L.
P. W. Lacked
cc: Lee Simon
Enclosures
PWL:ap
1
Charles Needham
N D U S T R I E S
4201 Janada Street Fort Worth, Texas 78117
P. 0. Box 14248 (817) 281.5121
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Charles Needham
I N D U S T R I E S
4201 Janada Street Fort Worth, Texas 76117
P. Q. Box 14248 (617) 281.5121
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City of Tukwila
FIRE DEPARTMENT
444 Andover Park East
Tukwila, Washington 98188 -7661
(206) 575-4404
Gary L. VanDusen, Mayor
November 7, 1988
Fire Department Review
Control. Number 88 -338
(512)
Re: Foodmaker - 18151 Segale Park Drive "B" - Tukwila,
Wa.
Dear Sir:
The attached set of building plans have been reviewed by
The Fire Prevention Bureau and are acceptable with the
following concerns:
I. All modifications to sprinkler systems shall have the
written approval. of , the Washington Surveying & Rating
Bureau, Factory Mutual Engineering or Industrial Risk
Insurers, then by the Fire Department. No sprinkler .work
sluil.l commence without approved drawings. (City Ordinance
411.11) (NFPA 13, 1 -9.1) (UFC 10.307)
All sprinkler drawings shall be prepared by companies
licensed Lo' perform this type of work. Drawings shall
first be approved by the Washington Surveying & Rating
Bureau, Factory Mutual Engineering or Industrial. Risk
Insurers, then by the Tukwila Fire Department. No
sprinkler work shall commence without approved
drawings. (City Ordinance #1141 & NFPA 13, 1 -9 . 1 )
(UFC 10.307)
Maintain sprinkler protection for all enclosed areas.
(NFPA 13, 4- 1.1.1) (UFC 10.302)
2. All electrical work and equipment shall conform .
sl.rietly to Cho• standards• of the National Electrical Code.
(NFPA 70) (UFC 1.0 . 104 )
All electrical wiring is to be inspected by the State
Eieotricai Inspector, Washington State Department of
Labor &. industries. (UGC 10.104)
1
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Charles Needham
I N D U S T R I E S
4201 Janade Street Fort Worth, Texas 76117
P. 0. Box 14248 (817) 281.5121
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Charles Needham
I N D U S T R I E S
4201 Janade Street Fort Worth, Texas 78117
P. 0. Box 14248 (817) 281.5121
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Charles Needham
I N D U S T R I E S
4201 Janada Street Fort Worth, Texas 78117
(817) 281.5121
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Charles Needham
I N D U S T R I E S
4201 JMadi Street Fort Worth, Texas 78117
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«Charles Needham Industries
P. 0. Box 14248 • 4201 Janada Street • Fort Worth, Texas 76117 • 817 / 281-5121
June 2, 1988
Mr. Bill Boncher
Foodmaker
P.O. Box 783
San Diego, CA 92112
RE: Foodmaker
Seattle, Washington
Dear Bill:
FILE
Enclosed please find some sketches concerning the floor
modifications at the above referenced project.
We are submitting two (2) proposals and they are as follows:
Phase I
Phase I is based upon the removal of the top wearing slab, curbs
and floor insulation. We would inspect the base slab and if found
satisfactory then install a seamless piping glycol system on top
of the base slab then apply 6" of 2 1b. density eps (R28.6) with
10 mil vapor barrier. We propose a 5" thick concrete wearing slab
with a single mat of #3 grade 60 rebar 18" o.c.e.w. Concrete
shall exhibit 3000 psi at 28 days. Finish shall be hard troweled.
Curbs shall be poured around the entire perimeter inside the box.
Curbs shall be 6" wide by 12" tall with tt3 grade 60 dowels 24"
o.c. into the wearing slab and two (2) #3 grade 60 horizontal bars
thru the curb.
All curbs shall have a rubbed finish. No sealer is included on
the floor at this time due to the concrete not being at least 30
days cured. If your desire is to have a sealer applied to this
floor we will investigate the possibility of other types of
products which may be used. Upon completion of the floor work we
will adjust all doors and checpanels for leaks. We e imate the
time for completion to be weeks rohe start of work This
plan does not require any panels to be remove • except those
required to gain access to the project by equipment used in the
demolition process.
We estimate this work to cost $ 96,203.00.
Phase II
Phase II is based upon removal of the top wearing slab, curbs and
floor insulation. Upon inspection of the base slab if it is found
to be unsatisfactory we would remove the base slab and excavate
all frozen or unsuitable soils and remove them from the site.
This quotation is based upon excavation of 6 feet of soils in the
entire cooler /freezer area. Upon completion of the excavation,
select backfill would be brought. An underground PVC vent system
would be installed as detailed in sketch FB -01 and would be
connected to a gas fired forced air unit located inside the dry
warehouse. Warm air would flow thru the vent system piping and
vent to the outside. We include core drilling the existing
concrete stem walls and applying screens on the ends of the pipes
to eliminate the removal of the exterior wall panels, the base
slab would be saw cut approximately 6" inside the wall line as
shown in our attached sketches. We would need to remove the
partition wall and reinstall it after completion of the concrete
work. We have included all electrical and mechanical work in this
proposal. Floor insulation would be increased to 10" of 1 lb. eps
with 10 mil vapor barrier. Base slab would be 6" of reinforced
concrete and the wearing slab would be 5" thick with #3 grade 60
rebar 18" o.c.e.w. Concrete would exhibit 3000 psi at 28 days.
Curbs shall be poured around the entire perimeter inside the box
and shall be 6" wide X 12" high with #3 grade 60 dowels 24" o.c.
into the wearing slab and two (2) #3 grade 60 horizontal bars thru
the curbs. Due to the bottom of the wall panels presently resting
on the base slab we would not recommend trying to lower the floor
slab elevation at this time. If the floor slab elevation was to
he the same it would require lowering the entire box by the
thickness of the floor insulation and the wearing slab. We
estimate the time for completion to be 6 weeks from the start of
work.
We estimate this work to cost $ 157,985.00.
If awarded this project CNI will provide all design drawings,
permits and full time on -site supervision.
We appreciate this'opportunity to submit this proposal and hope we
will be chosen to be of service to you on this project.
Sincerely,
P. W. Lacked
cc: Lee Simon
Enclosures
PWL:ap
all frozen or unsuitable soils and remove them from the site.
This quotation is based upon excavation of 6 feet of soils in the
entire cooler /freezer area. Upon completion of the excavation,
select backfill would be brought. An underground PVC vent system
would be installed as detailed in sketch FB -01 and would be
connected to a gas fired forced air unit located inside the dry
warehouse. Warm air would flow thru the vent system piping and
vent to the outside. We include core drilling the existing
concrete stem walls and applying screens on the ends of the pipes
to eliminate the removal of the exterior wall panels, the base
slab would be saw cut approximately 6" inside the wall liras as
shown in our attached sketches. We would need to remove the
partition wall and reinstall it after completion of the concrete
work. We have included all electrical and mechanical work in this
proposal. Floor insulation would be increased to 10" of 1 lb. eps
with 10 mil vapor barrier. Base slab would be 6" of reinforced
concrete and the wearing slab would be 5" thick with #3 grade 60
rebar 18" o.c.e.w. Concrete would exhibit 3000 psi at 28 days.
Curbs shall be poured around the entire perimeter inside the box
and shall be 6" wide X 12" high with #3 grade 60 dowels 24" o.c.
into the wearing slab and two (2) #3 grade 60 horizontal bars thru
the curbs. Due to the bottom of the wall panels presently resting
on the base slab we would not recommend trying to lower the floor
slab elevation at this time. If the floor slab elevation was to
be the same it would require lowering the entire box by the
thickness of the floor insulation and the wearing slab. We
estimate the time for completion to be 6 weeks from the start of
work.
We estimate this work to cost $ 157,985.00.
If awarded this project CNI will provide all design drawings,
permits and full time on -site supervision.
We appreciate this'opportunity to submit this proposal and hope we
will be chosen to be of service to you on this project.
Sincerely,
(,I n
P. W. Lackey
cc: Lee Simon
Enclosures
PWL:ap
CITY OF TUKWILA
Building Division
6200 Southcenter Boulevard
Tukwila, Washington 98188
(206) -433 -1849
Site Address
i
BUI! `ING PERMIT APPLIC,'"
je k (`5"
N Control # `fib • •3 3 k/
Suite# Floor#
Project Name /Tenant /--‘20,0(4014
Valuation of Construction 576,2_63 Assessors Account#
Property Owner S 4:-"� 0C�3r --5 5 o i-4-- Phone S-7,5-- 3,2 c9 D
Address /-"o X$,-,j i0 5 p / !J IT Gl1 !ir- Al 4 1p 7 a- , a
Applicant pvpi p;l_ C-13.4.b ' C-, i mac. Phone $7$ - 4/79'7
Address 'Po G3o,, 913180 Pes And•yhes W y Zip 9 AI 9 SI
Architect /Engineer )1.2D Ale • Phone
Address Zip
ContractorMa.) el_ C.0mr Co /{.L License #fr) VS' c 3Yo 02 Phone $ ?E4 -4/797
Address?e, 3oae ' &2.gO Dcs i•o,..ies tv U Zip 913/ 98
Class of Work: ❑ New ❑ Addition [ Tenant Improvement ❑ Remodel (residential) ❑ Reroof
❑ Demolition 21 Interior Demolition ❑ Other
Describe work to be done /T i 4,p2 �� (~=-47 F'E -(' }9) /7 l /T t2
/? F.� / c, 1/21 -`"S i o U, )' k: /- 6 2,. /spy /,C.1.7 4= /•-DD c /7�
1„1.-1../ 7= 4 Type of Const. (UBC) Occ. Group (UBC)
Square footage of entire building a of b 00 Square footage of tenant space
Building Use ,9/, 5 7fi /3'1.7.6,4/ Will there be a change of use? ❑ Yes I No
If yes, describe change of use, including square footages of changed areas
Will there be storage or use of flammable, combustible or hazardous materials on the premise or
area of construction? ❑ Yes 2 No If yes, explain
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND
CORRECT AND THAT I HAVE THE PROPERTY OWs AUTHORIZATION TO DO THIS WORK.
Applicant /Authorized Agent ( si gnatu ei, t..5, Date /c,-- / 7^ 8q3
(print n.uL ,j Ma.2 e ;i1_,
Contact Person (please print) �o vL- A (f v1 b� 1= 2_. Phone �"7 �+--� 7137
OFFICE USE ONLY
FEES: Building Permit Fee (000/322.100) $ 4:„22,0-1) Receipt# ‹;-973c3 Date Paid /,, -/ - j(
Plan Check Fee (000/345.830) c / -y/ w Receipt# Date Paid
Bldg Code Sur Charge (000/386.904) 3.50 Receipt# Date Paid
Energy Sur Charge* (000/386.907) Receipt# Date Paid
Other ( ) Receipt# Date Paid If
*New construction only TOTAL /C) 2 `'j. Z ;7(OWES: $ -6-' )
SQUARE FOOTAGE /BUILDING USE INFORMATION Square Footage of Entir
Building:
.
TOTAL
OCC.
USE /Occ Type
SQ.FT.
UGC
LOAD
USE /Occ Type,
SQ.FT.
OOC
LOAD,
USE /Occ Tvo
SOFT.
OCC
inAn
TOTAL
SQ.FT.
,FLOOR
TOTAL
TRACKING
DEPT.
DATE IN
DATE OUT
COMMENTS
BLDG
10-19 "
Approved for Issuance. Type of Const.
To Mahan: Date Approved: g-9,-as
FIRE
/
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11 -1 -t
Approved (Initials) `a Per letter dated ,i -i. U
Fire Protection: Sprin ers ❑ Detectors 511.,'
PLNG
Approved (Initials) O BAR
ELAND USE /SEPA CONDITIONS
Zoning Setbacks: N S E W
Parking stalls required for: Site Tenant Space
Parking stalls provided: Site Tenant Space
ADDITIONAL PARKING STALLS REQUIRED:
PWD
Approved (Initials) Per letter /plans dated