04-105000'ti
a
City Federal Way
Community Development Services 'Building - Commercial Permit #: 04 - 105000 - 00 - CO
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -7000 Fax: (253) 835 -2609 Inspection request line: (253) 835 -3050
I �
Project Name: MEDICAL EVALUATION SPECIALISTS
Project Address: 32001 32ND AVE S Suite340
Parcel Number: 162104 9001
Project Description: TI - New walls, doors, relites, ceilings, millwork, and finishes. Plumbingi mechanical and electrical
work to be performed under separate permits.
Owner
Applicant
Contractor
Lender
FOSS REDEVELOPMENT
MARVIN STEIN & ASSOCIATES LI
JMS CONSTRUCTION CO, A DIVIS
FOSS REDEVELOPMENT
PO BOX 94449
2221 5TH AVE
JMSCOC* 150RS (12- 10 -05)
PO BOX 94449
SEATTLE WA 98124
SEATTLE WA 98121
JMS CONSTRUCTION CO, A DIVIS
SEATTLE WA 98124
8575 WILLOWS RD
Includes:
Census category: 437 - Comm #1 #2 #3 #4
Occut)ancv Grout): B
Floor
PERMIT EXPIRES June 8, 2005.
Permit issued on December 10, 2004
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the us will be in accordance with the 1 ws, rules and regulations of the State of Washington and
the City of Federal Way. �
�
Owner or agent: -11 Date:
s g.
City of Federal Way
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 110.2 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: MEDICAL EVALUATION SPECIALISTS Permit number: 04 - 105000 - 00
Address: 32001 32ND S Suite340
Owner FOSS REDEVELOPMENT
Name: PO BOX 94449
Address: SEATTLE WA 98124
Building Official
J PS
Dale
The priorityfocus 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:
Occupancy Load:
Floor Area (Sq. Ft.):
36
3628
Owner FOSS REDEVELOPMENT
Name: PO BOX 94449
Address: SEATTLE WA 98124
Building Official
J PS
Dale
The priorityfocus 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.
I
106 e7 " VO A477 �CGV K
&V14 "Ale, _7XJ14 -2 1-7o•v /51 cc6
THIS CARD IS TOOMAIN ON -SITE
CITY OF ommunity Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 04- 105000 -00 -CO
Owner: FOSS REDEVELOPMENT
Address: 32001 32ND AVE S Suite 340
FEDERAL WAY, WA
This card is part of your required inspection documents. 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.
❑
Footings /Setback (4110)
❑
Foundation Wall (4115)
❑ Drainage/Downspout (4040)
Approved to place concrete
Approved to place concrete
Approved to backfill
By
Date
By
Date
By Date
❑
Plumbing Groundwork (4190)
❑ Slab /Concrete Floor (4255)
❑
Re -steel (4215)
Approved to place concrete or grout
Approved to cover
Approved to place concrete
By
Date
By
Date
By Date
❑
Underfloor Framing (4285)
❑
Floor Sheathing (4105)
❑ Shear Walls (4245)
Approved to sheath floor
Approved to install flooring
Approved to install siding
By
Date
By
Date
By Date
❑
Roof Sheathing (4220)
❑
Fire/Draft Stops (4095)
NOTE: Prior to scheduling a Framing (4120)
Approved to install roofing
Approved
inspection; Electrical, Plumbing & Mechanical
Rough -in and Fire/Draft Stop inspections must be
By
Date
By
Date
signed -off and approved. IBC 109.3.4/UBC 108.5 .4
❑
Insulation (4150)
❑ Gypsum Wallboard Nailing (4130)
Ml
Framing (4120)
Approved to insulate
Approved to install wallboard
Approved to install mud & tape
Bj,<C-j Date Z -4-
By
Date
By /ter Date 6/_/o d51
Suspended Ceiling Grid (4265)
Approved to drop tile
Date
U Final - Public Works (4080)
A proved
B�iDate
Y
❑ Final - Fire Department (4060)
Approved
By gp Date 3 ~7 --
Final - Building (4050)
Approved
By Date a
❑ Final - Planning (4070)
�p ed
v
B G`' Date
Y
—IN REGeIVED
f -I- -I, " 2004
cin aF
FederM - "�SQERAL WAY
COMMUNITYDEVELOP DEPT'
33325 8TM AVENUE SODU'�/'H''•PO BOX 9718
FEDERAL WAY, WA 98063 -9718
253- 835 -2607• FAX 253- 835 -2609
www. atuoffederalway. w
• t�3,v
- _L o
ova
PERMIT SF MF CO ME EL PL DE EN FP
APPLICATION T°
The ollowi is re fired in ormation - an incom fete a tication will not be acce ted. Please rant le ibt in in or
�ry a PROPERTY •. •
SITE ADDRESS ?�( /Q! -5oa w ��wp / yi2jor, SUITE /UNIT # _
ASSESSOR'S TAX /PARCEL # j- ro L 0- +— - --f-- Q Q LOT SIZE (sj)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot I) 566 AirAC R EQ %Ej5T
/Attach separate page for lengthy legal description)
PROJECT
��
TYPE OF PERMIT *BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu)
TwAwr 1NAP aver rig A QAR ttL- a62 - 215PJA cT. Wow caAm rs
PROJECT NAME (Name of Business or Oumer Last Name) NJW ." L- f:-".U.Alu Amll 66CU%i STS'
PEOPLE •- •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
NAME �/J F v� r Y, V1►'►'" i er' 1 (G-.a+ t0) PHONE 2,6 - 14-Q 0
MAILING ADDRESS CITY, STATE, ZIP
11 // FArRVI&W AVE. p(. WA 9 Flo?
COMPANY NAME
J.M.S, COQ 57ncvaN
APPLICANT NAME
JONATHAN SuKAS
OFFICE PHONE
(-fb-) 393 -0241
MAILING ADDRESS
ultu ows teo.+►v
CITY, STATE, ZIP
ono WA ?M s2
CELL PHONE
V1
( N%
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
6 -60 /2-/ 31 /0
FAX NUMBER
(4z.�M88z -3262
_o
CONTRACTORS REGISTRATION NUMBER (copy of card required with each application) EXPIRATION DATE
_Coll jMSCOC*15oRS /2 10 /2005
COMPANY NAME
MARLll)j ST tN �i /aSSoC,
APPLICANT NA
j�4t�1 �tJO LJ_
OFFICE PHONE
(tog 441 -
MAILING ADDRESS
2�a 57H Avnlc
CITY, STATE, ZIP
-rn. W,A 98`111
CELL PHONE
�a-
RELATIONSHIP TO PROJECT
0. rchitect ❑ Tenant ❑ Agent ❑ Other (Describe)
FAX NUMBER
�At.l f
(ZOro)*4-
NAME PRIMARY PHONE E -MAIL ADDRESS
tj wC - coin
EXISTING USE PROPOSED USE
EXISTING ASSESSED /APPRAISED VALUE $_ NIA VALUE OF PROPOSED WORK $ B-76. 0100
SPRINKLERED BUILDING? ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES NO
WATER SERVICE PROVIDER
SEWER SERVICE PROVIDER
• HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
• HIGHLINE ❑ PRIVATE (SEPTIC)
i
•
AREA DESCRIPTION
EXISTING
S . FT.
PROPOSED
SQ. FT.
TOTAL
80. FT.
BASEMENT
❑ YES ❑ NO
BASIC PLAN?
FIRST
EVAPORATIVE COOLERS
GAS LOGS
REFRIG. SYSTEMS
SECOND
FANS
HOODS (commercial(
WOODSTOVES
HIRD rAiUAL. F1, ontZ 7`ENAv rr
FIREPLACE INSERTS
RANGES
628
FOURTH
FURNACES
GAS WATER HEATERS
❑ YES 'o NO
ADDITIONAL FLOORS (DESCRIBE)
GAS PIPE OUTLETS
o YES
❑ NO
DECK (COVERED ?)
GARAGE ❑ CARPORT ❑
SHOWERS
WATER CLOSETS (Toiiep
MISC (Describe)
NUMBER OF FLOORS
sxrsnsO
PROPOSED
TOTAL
TOTAL=MTmosP
TOTAL PaoeossusP
TOTALW
"NEWHOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECFIANICAL
❑ ALTERATION
❑'REPAIR o TENANT IMPROVEMENT
Value of Mechanical Work $
❑ YES ❑ NO
BASIC PLAN?
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS LOGS
REFRIG. SYSTEMS
BBQS
FANS
HOODS (commercial(
WOODSTOVES
BOILERS
FIREPLACE INSERTS
RANGES
MISC (Describe)
COMPRESSORS
FURNACES
GAS WATER HEATERS
❑ YES 'o NO
DUCTS
GAS PIPE OUTLETS
o YES
❑ NO
PLUMBING
BATHTUBS (or TaniSho— rCombo)
SHOWERS
WATER CLOSETS (Toiiep
MISC (Describe)
DISHWASHERS
SINKS
DRINKING FOUNTAINS
GAS PIPE OUTLETS
SUMPS
RAINWATER SYST
WASHING MACHINES
URINALS
HOSE BIBBS
LAVS (Bathroom sinks)
VACUUM BREAKERS
ELECTRIC WATER HEATERS
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 the permit application is made. 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 cluing, which be made by any person, including the undersigned, and filed against the City of Federal Way, but only where such claim
arises out of the relia of the ,including its of ers and mployees, upon t accuracy of the information supplied to the city as apart of
this application.
NAME /TITLE DATE �0 —(J7"
Si�ature) itle)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent Contractor *'Architect ❑ Other
o NEW o ADDITION
❑ ALTERATION
❑'REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY?
❑ YES ❑ NO
BASIC PLAN?
❑ YES
o NO
ZONING DESIGNATION
CHANGE OF USE?
❑ YES
❑ NO
NEW ADDRESS REQUIRED?
❑ YES ❑ NO
UP /SEPA /SU?
❑ YES
0 N
PLATTED LOT?
❑ YES 'o NO
DEMO PERMIT REQUIRED?
o YES
❑ NO
Bulletin 4 100 — August 19, 2004 Page 2 of 4 k\Handouts\Permit Application