22-104022' 1
City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Plumbing
Permit #:22-104022-00-PL
Inspection Request Line: (253) 835-3050
Project Name: TWIN LAKES VETERINARY HOSPITAL
Project Address: 1060 SW 320TH ST Parcel Number: 072104 9202
Project Description: BLUEBEAM - Plumbing and medical gas for veterinary hospital.
Owner
MARGARET MIZUMOTOTWIN LAKES
VETERINARY HOSPITAL
1060 SW 320TH ST
FEDERAL WAY WA 98023
Applicant
MIKE SATKO
PO BOX 1496
MAPLE VALLEY WA 98038
No Fixtures Associated With This Permit 11
Contractor
LOCAL PLUMBING (PLUMBING)
LOCALPC79107 (9/2/23):
PO BOX 1496
MAPLE VALLEY WA 98038
PERMIT EXPIRES Wednesday, 14 June, 2023
Permit Issued on Friday, December 16, 2022
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
Was' o . andf0e .City of Federal Way.
Owner or agent: date:
r
CITY OF
Federal Way
PERMIT #: 22 104022 00
THIS CARD IS TO REMAIN ON -SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
Address: 1060 SW 320TH ST
Project: MARGARET MIZUMOTO FEDERAL WAY WA 98023-4707
Scheduled inspections may be failed if this card is not on -site. DO NOT LOSE THIS GIRD. 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.
1❑ Plumbing Groundwork (4190)
2� Rough Plumbing (4230)
s❑ Final - Plumbing (4075)
Approved to cover
Approved
Approved
By Date 1 23
By Date
By N Date
Rough Electrical
LlFinal
Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
Medical Gas Services
918 S Horton St, Suite 917
Seattle, WA 98134
medsasservices.io
(425) 894 5918
Veterinary Oxygen Verification Report
Date: July 7, 2023
Job Number: 83
Contractor: Local Plumbing Co.
Date(s) / Time(s) of Testing: July 7th, 2023 —1300 hrs.
Facility: Twin Lakes Veterinary Clinic
1060 SW 320th ST
Federal Way, WA 98023
Scope of Work: Installation of new veterinary oxygen system, inlets/outlets and distribution system.
Our firm certifies that the verifier named in the report is properly trained and certified to perform the
activities required. All testing and measurement equipment are properly calibrated and maintained. As a
representative of Medical Gas Services, LLC, the verifier named in this report has conducted testing and
verification of medical gas piping systems and related equipment to certify the following on the above
date.
I. General Findings:
A. Veterinary oxygen is in compliance with NFPA 99(2012ed):
Category 3 veterinary
B. Veterinary oxygen meets oxygen concentration.
C. Veterinary oxygen meets pressure and flow requirements.
D. Most veterinary oxygen system components in area tested are in compliance with NFPA
99(2012ed):
Category 3 Dental (See Note, Comments and Recommendations)
E. Initial Line Pressure Test: PASS
F. Piping Purity Test: PASS
G. Permit #: 2210402200 / City of Federal Way
83-7.7.23-VR Pg. 1 of 2
(Medical Gas Services
918 S Horton St. Suite 917
Seattle, WA 98134
medsasservices.io
(425) 894 5918
II. Veterinary Oxygen:
A. Static Line Pressure: 92 psig
B. Concentration of Oxygen: 99.64%
III. Particulate Line Testing: PASS
IV. Odor: None —PASS
V. Brazier: Jose Villagrana
A. Brazier Number: VILLAJ*849PO
B. Plumbing Contractor: Local Plumbing Co.
VI. Recommendations:
A. Install a master alarm to monitor oxygen high, low and changeover.
B. Install emergency shut offs on each header bar of the oxygen manifold.
Tested By: Joel A Scanzon — Medical Gas Technician
Reviewed By: David Pomeranz — ASSE 6030 Verifier
83-7.7.23-VR Pg. 2 of 2
(Medical Gas Services
918 S Horton St, Suite 917
Seattle, WA 98134
medgasservices.io
(425) 894 5918
Veterinary Gas Outlet Evaluation Worksheet
Facility: Twin Lakes Veterinary Clinic Job #: 83 1 Date: 7.7.23
Area Tested: Gas Manifold Room, Vet Clinic Inlets/Outlets Verifier: JS
Zone Valve - ❑ None ❑ Not Required ® New ❑ Existing
Labeled As: Medical Gas Closet ZV Brand: Amico
Gas 3 Part Valve DL Gauge Ga. PSI Act PSI Comments:
OX ® Yes ❑ No ® Yes ❑ No 52 51.8
Outlets & Inlets - ® New ❑ Existing
Outlet / Inlets Brand: AMICO
Location:
Ceiling/Wall
Quick Connect: Chemetron / DISS
Area / Room / Door
Gas
Flow
Delta
Conc. %
Part.
Comments:
SCFM
Flow
Treatment Rooms
>10
<5.4
99.64
.000
HHC 0 // GHC 25
1
OX
>10
<5.4
99.64
.000
Ceiling DISS
2
OX
>10
<5.4
99.64
.000
Ceiling DISS
3
OX
4
<5.4
99.64
.000
Wall Chemetron
4
OX
>10
<5.4
99.64
.000
Wall Chemetron
Surgery Room
1
OX
>10
<5.4
99.64
.000
Wall Chemetron
Dental Treatment Room
1
OX
>10
<5.4
99.64
.000
Ceiling DISS
2
OX
>10
<5.4
99.64
.000
Ceiling DISS
MG-83/7.7.23 Page 1 of 1