10-102859 •
' • .! • • Building - Commorciai
City of Federal Way
Community Development Services Permit #: 10-102859-00-CO
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253) 835-3050
,!ton
Project Name: NORTHWES SPI
Project Address: 35002 PACIFIC HWY S Suite A105 Parcel Number: 185295 0050
Project Description: TI-Adding(2) rooms,drywall and paint. No plumbing or mechanical.
Owner Applicant Contractor Lender
FEDERAL WAY CROSSINGS ALL EXTERIOR LLC ALL EXTERIOR LLC
1621 114TH AVE SE SUITE 132 14008 SE 208TH ST ALLEXEL966RN(02/02/11)
BELLEVUE WA 98004 KENT WA 98042 14008 SE 208TH ST
KENT WA 98042
Census Category: 437 - Commercial alt/add/conversion
Includes: #1 #2 #3 #4
Occupancy Class: B
Construction Type: Type Ill -B
Occupancy Load:
Floor Area(sq. ft.) 1,935 0 0 0
00 o
Building Pre-con.Meeting Required9 No Existing Sprinkler System in Building?...... .........Yes
Mechanical to be Included? No Number of Stories 1
Permit for Building Shell Only? No Plumbing to be Included9 No
Special Inspection(s)Required? No New/Additional Sq.Feet-Total 0
Occupancy#1 -Use Clinic-Outpatient Zoning Designation CE
y
No t=ixttt*e$Associatedermit ll
CONDITIONS:
Subject to field inspection with plans.
PERMIT EXPIRES Monday, January 3, 2011
Permit Issued on Wednesday, July 7, 2010
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 'n accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way. /
Owner or agent: Date:
��1 /�
PIN s4 *fo
•
qty of Federal Way S S
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: NORTHWEST SPINE CLINIC Permit#: 10-102859-00-CO
Address: 35002 PACIFIC HWY S SuiteA105
Includes: #1 #2 #3 #4
Occupancy Class: B
Construction Type: Type Ill - B
Occupancy Load:
Floor Area(sq. ft.) 1,935 0 0 0
Owner Name: FEDERAL WAY CROSSINGS
Owner Address: 1621 114TH AVE SE SUITE 132
BELLEVUE WA 98004
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.
Y • THIS CARD IS TO - AIN ON-SITE
CITY OF Construction Ins ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT#: 10-102859-00-CO Address: 35002 PACIFIC HWY S Suite A105
Owner: FEDERAL WAY CROSSINGS FEDERAL WAY, WA 98003
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.
0 SWM Precon Site Mtg(4400) El 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
El Re-steel(4215) `0 Slab/Concrete Floor(4255) El Underfloor Framing(4285)
Approved to place concrete or grout Approved to place concrete Approved to sheath floor
By Date By Date By Date
El Floor Sheathing(4105) �El Fire/Draft Stops(4095) 0 Interim Erosion Control(4370)
Approved to install flooring Approved Approved
By Date By Date By Date
Prior to scheduling a Framing inspection; � Framing (4120) • �0 Insulation (4150) '
Electrical,Plumbing&Mechanical Rough-in and Approved to insulate Approved to install wallboard
Fire/Draft Stop inspections must be signed-off and 71 7
approved. IBC 109.3.4 By Date / By Date
•
•❑Gypsum Wallboard Nailing(4130)' `0 Suspended Ceiling Grid (4265) ❑ Final-Fire Department(4060)
Approved to install mud&tape Approved to drop tile Approved
By 0 ,0. ate7 A 4), By Date By Date
0 Final-Planning(40 0) 0 Final Erosion Control(4375) 0 Final-Building(4050)
Approved Approved Approved
By Date By Date By -*--i____.--Dates L7 /M
•
LI Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
Federal Wad •PERMIT '
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w � •MF CO ME PL DE EN FP
APPLICATION
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CONS V,TV DEVELOPMENT SERV PPLICATIONa��25;-:35-2f07•FAX 253-:35-2609
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SITE ADDRESS - 1 ' SUI /UNIT#
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PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 1/X / _ Z. s_- ces C,-� - — —
TYPE OF PERMIT BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT /
ni
(Terut Name/Homeowner Last Name) �4i S �I 1 til"': .S4 P i ,11 o(�./
7/ 1/�
PROJECT DESCRIPTION
Detailed description of work to c /
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER -( 44r�/ p ,,/ L f� j i,if
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MAILING ADDRESS E-MAIL
CITY ;- - STATE ZIP
� 1,1(r14/ `-4-'A I w-1
NAME/)// e X li t e®r % C- ----- PHONE: .r' ' ., *.
.5 20
MAILING ADDRESJ� err E-MAIL c* •
3e ;i
CONTRACTOR f�v � �� � •l /e.� (-74441`,CITY /� STATE,,) /nJ ZIP ! p
WA STA �pi�CTO �LICENSE� � � � EXPIRATION��E�/ FEDERAL WAY BUSINESS LICENSE#
NAME (/ K ! / PHONE
56yl
feet' . 4.74741/)
APPLICANT MAILING ADD E-MAIL
CITY STATE ZIP
- .9 4 '� FAX
PROJECT CONTACT NAME /7(The individual to receive and ( �respond to all correspondence MAILING ADDREAr ço )_ L
concerning this application) ��/y)) l�L ' �r C t 11 21 �j
CITY /C-C-47- STATE/4 ZIP/'/ q FAX
ALTERNATE CONTACT NAME: ✓ �pg, 53 Oa i, E-MAIL
PROJECT FINANCING NAME /
El OWNER-FINANCED
Required value of$5.000 or more ' � �J I't G�h 1
(RCW 19.27 095) MAILING ADDRESS,CITY,STATE,ZIP PHONE
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 environmental laws.
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,
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 •�,(✓ "C)
. 92,,,,, .
PRINT NAME:
Bulletin#100-April 14,2010 Page 1 of 3 k\1-iandoutsvPermit Application
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•:
' vE C ` ws WORK"o (a copy of bid or estimate must be provided) J
ea type offixture how m y o re to be installed or relocated as part of this project. Do not include - •. g fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(comme. .r
BOILERS FURNACES HOT W: TANKS(Geo)
COMPRESSORS GAS LOG SETS " 'IGERATION SYST
DUCTING GAS PIPING WOODSTOVES
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Indicate how many of each type offixture tobe ' ailed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub Shower combo S(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUN SINKS(Kitchen/Utility) WATER HEATERS(Electuic)
WASHING MACHINES <if'1?1`;A7+L?:1L ''1'iL'}I FIa`:y iiiii:z
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HOSE BIB SUMPS '`� "^�"'
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CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS-
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EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
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AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL F 'OFFICE USE
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FIRST FLOOR (or Mobile Home)
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COVERED ENTRY '
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GARAGE 0 CARPORT 0
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EXISTING PROPOSED TOTAL
Area Totals
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ESTI D SELLING PRICE$ # OF BEDROOMS
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AREA DESCRIPTION Area Occupancy Groups) Construction #of Additional Information
in Square Feet
Type Stories
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ADDITION
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Construction #of Additional Information
AREA DESCRIPTION Area Occupancy Group(s)
in Square Feet Type Stories
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TENANT AREA ONLY
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Bulletin#100—April 14,2010 Page 2 of 3 k:\Handouts\Pernut Application