12-102652City of Federal Way
Community & Eoon. Dev. Services
33325 8th Ave S
Federal way, WA 98003 5
Ph: (253) 835-2807 Fax: (253) 8352809
Project Name: US HEALTHWORKS .,
Project Address: 1300 S 320TH ST
iuilding - Cdknmtrcial
Permit #: 12- 102652 -00 -CO
Inspection Request Line: (253) 835 -3050
Parcel Number: 082104 9241
Project Description: TI - Expansion into adjacent space including construction of partition walls, acoustic
ceiling, plumbing & mechanical work.
Owner
WAYNE MASON
AR lln cant
CHRIS AMONSON
Contractor
J M S CONSTRUCTION CO
Lende
OWNER IS LENDER
US HEALTHWORKS
FREII-IEIT & HO ARCHITECTS
JMSCOC* 150RS (12/10113)
Permit for Building Shell Only ? ............................
25124 SPRINGFIELD CT
5209 LAKE WASHINGTON BLVD N
8575 WILLOWS RD
VALENCIA CA 91355
KIRKLAND WA 98033
REDMOND WA 98052
Occupancy Load-
Census Category: 437 - Commercial alt / add / conversion
Includes:
#1
#2
#3
#4
Occupancy Class:
B
Permit for Building Shell Only ? ............................
No
Plumbing to be Included ? ........... ............................Yes
Construction Type.
Occupancy # 1 - Use................ ...............................
Professional
Occupancy Load-
Services/Offices
Zoning Designation .................... ...........................CC
Floor Area ft.
7,012
0
0
0
Additional Permit Information
Existing Sprinkler System in Building? .................No
Mechanical to be Included ? ....... ............................Yes
Number of Stories ................... ..............................1
Permit for Building Shell Only ? ............................
No
Plumbing to be Included ? ........... ............................Yes
Occupancy # 1 - Use................ ...............................
Professional
Services/Offices
Zoning Designation .................... ...........................CC
-F
Mechanical Futures
AirHandling Units ........................
3
Ducting .......................................... 1 Fans................. ...............................
1
Gas Piping ....... ...............................
1
Plumbing Fixtures
Laundry Washer Outlets ............
1
Lavatories ....................................... 1 Sinks................
............................... 12
Water Cl osets .. ...............................
3
Water Heaters.. ...............................
2
PERMIT EXPIRES Sunday, May 19, 2013
Permit Issued on Tuesday, November 20, 2012
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.
Owner or agent � Date:
MIN
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TIHS CARD IS TO REMAIN ON -SITE
CITYOF i Wa Construction In -xction Record
INSPECTION REQU,,,o CS: (253) 835 -3050
PERMIT 4: 12- 102652 -00-CO Address: 1300 S 320TH ST
Project: WAYNE MASON FEDERAL WAY, WA 98003 -5340
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.
Insulation (4150)
SWM Precon Site Mtg (4400)
0
Initial Erosion Control (4365)Footings/Setback
Approved
(4110)
Date
Approved
By
To be done prior to breaking ground
1By
Approved to place concrete
By
Date
By
Date
By
Date
Insulation (4150)
Re -steel (4215)
0
Plumbing Groundwork (4190)
Approved
Slab /Concrete Floor (4255)
Date
Approved to place concrete or grout
By
Approved to cover
By
Approved to place concrete
By
Date
Date
By$Cc;;t Date (2_
By
Date
Insulation (4150)
Underfloor Framing (4285)
0
Floor Sheathing (4105)
Approved
Approved to sheath floor
Date
Approved to install flooring
By
Date
By
Date
Approved
By
Date
Approved
By
Mechanical Rough -in (4165)
Gas Piping (4125)
By
Approved
Bye
Approved to release test
By
Date
By
Date �3
Interim Erosion Control (4370)
Prior to scheduliug a Framing inspection;
Approved
Electrical, Plumbing & Mechanical Rough -in and
By
Date
Fire/Draft Stop inspections must be signed -otf and
approved. IBC 1043.4
Insulation (4150)
Rough Plumbing (4230)
■
Approved
By
Date
Right of Way
By
Date _ ,,
Fire/Draft Stops (4095)
By Date 5 1'ri �.,?
Approved
By
Date
Approved
By
El
Framing (4120)
By
Approved to insulate
Bye
Date S_V5 _
Insulation (4150)
❑ Gypsum Wallboard Nailing (4130)
■
Approved to install wallboard
Approved to install mud & tape
Right of Way
By
Date _ ,,
By Date 5 1'ri �.,?
�f
0 Final -Fire Department (4060) Final - Planning
1 E] Approved Approved
By Date By Date By
Final - Mechanical (4065)
Approved
By C Date
Final - Plumbing (4075)
Approved
By tiAr Date rx v
Approved to drop tile
Date G_- ?�/3
Approved
Date
Final - Building (4050)
Approved
By Date tt? S J 3
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
e
Fed PERMIT RECEf � /
Feral Way O E PL DE EN FP
CO253 835 2607- PA 253-8 SERMES APPLICATION JUN 11 201U r .
253835 -2607• FAX 253 -835 -2609
munu.rx��ey7e.�rnpgm_ yvm
CITY OF FEDERAL WAY
SITE ADDRESS
/ 3o v 5 3 Zoe F� � t- U,A u�A �l tCOo3
SUITE /UNIT #
A
PROJECT VALUATION
$ �c�a®
ZONING
cc' -F
ASSESSOR'S TAX /PARCEL #
I �LL -q- -?, -i-o4-
TYPE OF PERMIT
BUILDING W PLUMBING D(MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
rrenant Name/Homeoumer Last Name)
US �r
PROJECT DESCRIPTION
Detailed description of uaork to
�—�
be included on this permit only
PROPERTY OWNER
NAME
„� - iy ,.��,
PRIMARY PHONE f
C1 'n� I-7
G ADDRESS
E-MAIL
CITY
STATE
ZIP
NAME
nso
PHONE
MAELEM ADDRESS
LMAD,
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
PHONE
MAnMG ADDRESS
2S I %Lx:> c'f • jyu t-
E -MAD,
1-4F 1'
APPLICANT
CITY
UAL- rr, Q e, t N
STATE
G' A,
ZIP
111 5
FAX
PROJECT CONTACT
rlhe individual to receive and
respond to all correspondence
concerning this applicatiord
14AM i3�.15
� )
PHONE
ZS - -gZ -v oo
°FAILING ADDRESS
20,01 `AV F,
�MnIL
A&A'!M'`, 1^' Gi'
CITY
D r-4
STATE
LOA
ZIP
b -3
F
- --Mr-G"41
ALTERNATE CONTACT NAME:
PHONE
�( -
FiMAIL
'( S ha.Y'aja. u
PROJECT FINANCING
NAME
1GT OWNER- F16110ED
Required value of $5.000 or —re
(RCW 19.27.095)
•'Y
MAILIN G ADDRESS, CITY, STATE. ZIP
I certify under penalty of perjury that I am the property owner or authorized agent of the property oumer. I cert(fy that to the best
of mg knowledge, the Irlronnation submitted in support of this permit application is true and correct. I certjfy 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.
]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
irlformation supplied to the city as a part of Chi application.
]
SIGNATURE: A, �'�'ti1- --` DATE c�1 ,1 �� �• t�'� I Li
7 1 / s
PRINT NAME: �,l-'Clxl -l1 AC!li. -)J
1' l
Bulletin #100 - January 1, 2011 Page I of 3 k:lHandoutslPennit Application
A. UW
ti-•
VALUE OF MECHANICAL WORK $ (a copy of bid or estimate must be provided)
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include exist fixtures to remain.
AIR HANDLING UNI18 FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (cwnmor )
BOILERS FURNACES HOT WATER TANKS (Gae)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
Indicate how many of each type of fixture to be installed or relocated as part of this project Do not include existing fixtures to remain.
BATHTUBS (or' b /ShowerC mbo)
, LAVS [Harm Sinmi
3_ TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
PROPOSED FIRE SUPPRESSION SYSTEM?
_
DRINKING FOUNTAINS
12- SINKS (mehen /uwrty)
._/
_ �• WATER HEATERS lnrrwd
❑ Yes K No
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FEETURES
CRITICAL AREAS ON PROPERTY?
WATER PURVE77
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
'eip X ri minis
a� )( k _fie
_ _..-
�
EXISTING /PREVIOUS USE
LOT SIZE (In Sgiwe Feet)
EXISTING FIRE SPRURRLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
Construction
# of
Stories
❑ Yes < No
❑ Yes K No
M" L CAI, a"av-,
32 1394
r�idT" `= v.myii
£�+
tY i'
�� �UQ -^�•
-- �ryilxk —
'eip X ri minis
a� )( k _fie
_ _..-
�
AREA DESCRIPTION
�a
Occupancy Group(s)
Construction
# of
Stories
Additional Information
in Square Feet
NLW B'IULD]fE
777 -
-
-
ADDITION
ad n i M,
i
_
_
DESCRIPTION
AREA DESCR
Occupancy Group(s)
Construction
#
Stories
Additional Information
in are Feet
in care
TENANT AREA ONLY
L Z
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Bulletin #100 —January 1, 2011 Page 2 of 3 k: 11andoutAPermit Application