11-101582City of Federal Way
Applicant
Community Development Services
Lender
P.O. Box 9718
FILE
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax (253) 835 -2609
JEFFREY STROCKBINE,
Project Name: GROUP HEALTH
Project Address: 301 S 320TH ST
03uilding - Commercial
Permit #: 11- 101582 -00 -CO
Inspection Request Line: (253) 835 -3050
Parcel Number: 172104 9105
Project Description: TI - Construction of interior walls to create training space within existing office. Includes
mechanical for ductwork and diffusers. No Plumbing.
Owner
Applicant
Contractor
Lender
GROUP HEALTH
JEFF STROCKBINE
G L Y CONSTRUCTION INC
12501 E MARGINAL WAY S UNIT
JEFFREY STROCKBINE,
GLYCOI *01809 (9/30/12)
Type V - B
TUKWILA, WA 98168 -2560
ARCHITECT
PO BOX 6728
Occu anc Load:
911 WESTERN AVE SUITE 307
BELLEVUE WA 98008 -0728
Floor Areas . ft.
SEATTLE WA 98104
0
1 0
Census Category: 437 - Commercial alt / add / conversion
Includes:
#1
#2
#3
#4
Occupancy Class:
B
Construction Type:
Type V - B
Occu anc Load:
Floor Areas . ft.
519
0
1 0
1 0
Existing Sprinkler System in Building ?' ................Ye!
Number of Stories .................... ..............................1
Plumbing to be Included? .......... .............................No
Occupancy # I -Use ...........:.... ............................... Professional
Services/Offices
Ducting........................................... 1
Mechanical to be Included? ......... ` ........ ..:::...Yes
Permit for Building Shell Only? .............................No
New / Additional Sq. Feet - Total...:...... .. .............:. 0
Zoning Designation .................. .............................OP
PERMIT EXPIRES Sunday, October 23, 2011
Permit Issued on Tuesday, April 26, 2011
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 a ipfdance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: Date: 44COA;0I1
CITY OF
Federal Way
PERMIT #:
Project:
• THIS CARD IS TO.REMAIN ON -SITE
Construction I ection Record
INSPECTION REQU TS: (253) 835 -3050
11- 101582 -00 -CO Address: 301 S 320TH ST
GROUP HEALTH FEDERAL WAY, WA 98003 -5200
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)
Initial Erosion Control (4365)
Slab /Concrete Floor (4255)
Footings/Setback (4110)
Approved
Approved
Approved
To be done prior to breaking ground
By
Approved to place concrete
By
Date
By
Date
By
Date
0
Re -steel (4215)
0
Slab /Concrete Floor (4255)
Approved
Underfloor Framing (4285)
Approved
Approved to place concrete or grout
By
Date
Approved to place concrete
Date
Fire/Draft Stop inspections must be signed -off and
Approved to sheath floor
By
Date
By
Date
By
Date
Floor Sheathing (4105)
Approved to install flooring
By Date
0 Mechanical Rough -in (4165)
Approved
By Date
Gas Piping (4125)
Approved to release test
By Date
Fire/Draft Stops (4095)
Interim Erosion Control (4370)
Prior to scheduling a Framing inspection;
Approved
Right of Way
Approved
Approved
Electrical, Plumbing & Mechanical Rough -in and
By
Date
By
Date
Fire/Draft Stop inspections must be signed -off and
Date
approved. IBC 109.3.4
Gypsum Wallboard Nailing (4130)
Framing (4120)
Insulation (4150)
Approved to insulate
Approved to install; wallboard
Approved to install mud & tape
By
Date T-N. —, S
By
Date
By y Date "t
Suspended Ceiling Grid (4265)
Final - Fire Department (4060)
Final - Planning
Approved to drop the
Approved
Approved
By
C� Date _ LAS
�',� Date . -�-���
By Date
Final Erosion Control (4375)
Final - Mechanical (4065)
Final - Building (4050)
Approved
Approved
Approved
By
Date
By
Date
i� �
By /2;0. ' Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
�* PERMIT
F ay
COMMUNnYDEVELOPMEWO 0 , , 'LICATI0N
253 - 835- 2607• FAX ZS3- 835.2609
tutuw.clluoffederal�vau.rom �Gb
OF SUS
icco o SF MF PL DE EN FP
0"rew
SITZ
3 ADDKVW
%,A -6' i�
SUITE /lo i
PROJECT(VVALUATION
ZONING
ASSESSOR'S TAX/PARCEL 9
TYPE OF PERMIT
*WBUMDING ❑ PLUMING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
('Tenant Name /Homeoumer Last Name)
LL ''' �
�• rQ ✓`� r'•�.CA.� p � `' ` r-c- A w t � � 0 0-�—
may` 1 ` t
PROJECT DESCRIPTION
Detailed description of work to
P
be included on this permit only
PROPERTY OWNER
NAME
�L �•� /G� Q �'f �'C.
�•+
PRairARY Pa�vE
MAWNO DRESS
E•MAIL
C
STATE
ZIP
NAME v
0^
PHO
r 1• ETC 7
MAIIdNG D Vf• 44 n
MAD
CONTRACTOR
CITY
tJ`C.
STATE
ZIP
I
FAX
' ip V0
WA STATE CONTRACTOR'S LICENSE N
L G
ERPIItATION DATE
FEDERAL WAY BUSINESS LICENSE M
a
MSP o
PHONE
23•
MAILING ADDRESS
E-MAIL
wk4r- fie
APPLICANT
w
�58c p
A'
PHONE
PROJECT CONTACT
AME
(The
e individual to receive and
-sei 1
MADAYO ADDRESS
L
respond to all correspondence
concerning this application)
&44erL
'S c...
STATE
v.iia
z� 100 -
�`
ALTERNATE CONTaT NAME:
PHONE
E-MAIL
etG C
fia 4sAr 1-77L
PROJECT FINANCING
NAME
�
JW OWNER - FINANCED
Required value of $5,000 or more
MAII tN0 ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
I certM 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 ir{formation submitted in support of this permit application is true and correct. I certify that I will comply with
all applicable City of Federal Wag regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owners 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 clainV, which may be made by any person, including the undersigned, and filed against the city,
but only where such claim arises out of the relignee of the city, including its gUicers and employees, upon the accuracy of the
i>4jormation supplied to hLcfa, ap of is pifcation.
SIGNATURE: DATE
PRINT NAME:
Bulletin #100 - January 1, 2011 Page 1 of 3 k:\Jiandouts\Permit Application
1•wo
■
• •
VALUE OF MECHANICAL WORK $ V77 00 ! (a copy of bid or estimate must be provided)
Indicate how marry of each type o fixture to be installed or relocated as part of this project Do not include existingfbctures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (Coimnerciai)
BOILERS FURNACES HOT WATER TANKS (Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
Indicate how many of each type offixture to be installed or relocated as part of this project Do not include existing jlxtures to remain..
BATHTUBS (or Tub/Shower Combo) LAVS (Hand Sinks) TOILETS WATER PIPING
a
DISHWASHERS RAIIVWATER MS URINALS OTHER (Describe)
DRAINS SHO VACUUM BREAKERS
DRINKING FOUNTAINS SINKS (Kitchen /Ututy) WATER HEATERS Wecwc)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FLrrUREB
CRITICAL AREAS ON PROPERTY? WATER P^URVEYOR SEWER PURVEYOR VALUE OF EXISTING IIMPROVEMENTS
%4% 0% -Ct / C
- ` , 4T $
EXISTING /PREVIOUS USE LOT SIZE (in Square Feet) EXISTING FIREISPRINELER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
es ❑ No ❑ Yes ❑ No
v.�.,c.� G c.1 i v�• �
Area Construction I # of Additional Information
AREA DESCRIPTION in Souare Feet Occupancy Group(s) Tvve Stories
ADDITION
.
AREA DESCRIPTION
Area
in ware Feet
Occupancy Group( *)
Construction
# of
Stories
Additional Information
TENANT AEiLTA ONLY
+5 3 1 -7 +
'�
V • �/
L
Bulletin #100 - January 1, 2011 Page 2 of 3 k:\Handouts\Permit Application