00-100777City of Federal Way Building - Commercial Permit 0 - 100777 - 00 - Co
Community Development Services ° 253.661.4140
15530 1st Way S Inspection request line:
Federal Way, WA 98003 -6210
Ph-.253.661.4000 Fax: 253.661.4129 (3.30pm cut -off for next day inspections)
Project Name: F.W. CLINIC (TI) Parcel Number: 212104 9048
Project Address: 2025 S 341ST
Project Description: COMPLETE & FINAL WORK AUTHORIZED UNDER PERMIT #BLD9 (TENANT
IMPROVEMENT AND INSTALL EXHAUST FAN) AND UNDER PERMIT T #B LD94 -0732
(PLUMBING WORK), SUBJECT TO FIELD INSPECTION
Owner Applicant
Contractor Lender
Galen E Rogers F.W. CLINIC BOB PEARSON CONSTRUCTION P NONE
3444 CAMINO DEL RIO N #20 2025 S. 341 ST PL
SAN DIEGO CA FEDERAL WAY WA 98023 1407 WILLOWS RD E
FIFE WA 98424 NONE
92108 -1712
Includes: #t #2 #3 #4
Census category: 437 - Comm
Occupancy Group: B
Construction Type: Type - N
Occupancy Load: 43 3
Floor Area (Sq. Ft.): 4340
437 - Commercial alt/add; Mechoca ;...... ..« .... No
Census Category........... ......... k IM
Yes
Permit for Building Shell Only......... No
Plumbing ........... ...............................
Total proposed Sq. Feet ....... ... .4340 Will Certificate of Occupancy be Issued ?.•.••.••••••Yes
Zoning Designation .................................... BP
Plumbing Fixtures
1
1 Sinks 1 0 Water Closets
Lavatories
Mechanical Fixtures
,: Ct d188Cr1 ionI x
Fans 1
CONDITIONS:
1. PREVIOUSLY APPROVED PLAN MUST BE ON -SITE AND AVAILABLE TO THE INSPECTOR
PERMIT EXPIRES August 28, 2000, IF NO WORK IS STARTED.
Permit issued on March 2, 2000
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 .
Date:
Owner or agent:
City of Federal Way
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 109 of the Uniform 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: F.W. CLINIC (TI)
Address: 2025 S 341ST
Permit number: 00 - 100777 - 00
Owner Galen E Rogers
Name: 3444 CAMINO DEL RIO N #20
Address: SAN DIEGO CA
92108 -1712
r
Building Official Date `+ V
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 severely
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.
#1
#2
#3
#4
Occupancy Group:
B
Construction Type:
Type V - N
Occupancy Load:
43
Floor Area (Sq. Ft.):
4340
Owner Galen E Rogers
Name: 3444 CAMINO DEL RIO N #20
Address: SAN DIEGO CA
92108 -1712
r
Building Official Date `+ V
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 severely
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.
e
PLEASE PRINT
W.
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BU[WWG D1vmoN
RECEIVED 33530 First Way South
Federal Way, WA 98003
R i� F, °: (253) 6614000
MA
Fax (253) 6614129
C1 6UILDING DEPT.
APPLICATION FOR BUILDING PERMIT
APPIlrATION # O /nb l 0-0
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Site address v2 5 5. 3 , s-- toL•
Tenant name ` 1, u S
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Lot #
Assessor's Tax #
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Building Owner's Name W. / • r 1 C-L• , o-egAs
Address 3+0-c4mimo 496L
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State GA—
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Description of Work z--c- "ro zllvl;;GAz- O - O.5 -f bLri
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Parlorcl Wav Phicinacc I irancP #
Company Name
Name (F,M,U
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Address
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Phone
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Contractor's # (cord must be presenW)
Expiration Date
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Parlorcl Wav Phicinacc I irancP #
Company Name
Address
City
State
Zip
Contact Person
Phone
Fax
Contractor's # (cord must be presenW)
Expiration Date
Verified ❑ Yes Cl No
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Namer
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Address
City
State
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Contact Person
Phone
Fax
LEGAL DESCRIPTION
a
IV
For ne w residential only - Pr 0 ose
d selling cost: : $
Name
Address
i i Use
Address
[Proposed Use
Contact
Permit includes:
State
❑ Building
❑ Plumbing
❑ Mechanical
❑ Other
Type of Work:
❑ Residential
❑ Commercial
❑ New
❑ Addition
❑ Remodel
❑ Repair
❑ # of bedrooms
❑ Garage
❑ Dock
❑ Shed
Enter 1 st Floor
Area Basement
sq ft
sq ft
2nd Floor
Decks
sq ft 3rd Floor sq ft
sq ft Garage sq ft
Existing Floor Area
Proposed Total Area
sq ft
sq ft
Water Availability
❑ Sewer Availabilit
❑ On -Site Septic System Availability ❑
Project Valuation
Is
Zoning
Lot Size
Existing Bldg Valuation
Is
For ne w residential only - Pr 0 ose
d selling cost: : $
Name
Address
City
Address
City
Contact
Phone
State
Zi
1rtl
1.)/r.
Contractor Name
Address
City
State
Zip
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
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Contractor Name
Address
City
State
Zip
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
Bathtubs Dish Washers Drinking Fountains ' Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Tt .4: F) XiUt ...C4ut1t ................... .
MECHANICAL EVALUATION ONLY 8
Air Handling < 6 1 0,000 CFM 7 5 -30 Ton
Air Handiino > - 10.000 CFM 1 30 -50 Ton
Furn > 100 BTUs
Fans
Miscellaneous
Fuel TanKs
Gas Hwt
Hood
Boilers
Above Ground
Conv Burner
Duct Work
0 -3 Tons
Underground
aan•.
Wood Stoves
3 -15 Tons
TixXa! %l?hiti�vtrtr . .
DISCLAIMER: I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further, that I am authorized by the owner of
the above premises to perform the work for which permit application is made. I further agree to save harmless the City of Federal Way as to any claim (including costs, expenses, and
attorneys' foes incurred in investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the City of Federal Way, but only
where such claim arises out of 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.
i
Owner /Agent: Date: 4 •0
.AK 14 aY L 1912 C" rT fEC7-
RmSE0 5118199