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04-10086910 A City of Federal Way Community Development Services 33530 1 st Way S Federal Way, WA 98003 -6210 Ph: 253.661.4000 Fa.:: 253.661.4129 Ruilding - Commercial Pert #:04 - 100869 - 00 - CO Project Name: BROSSEL DENTAL OFFICE Inspection request line: 253.835.3050 Project Address: 1230 S 336TH ST SuiteB Parcel Number: 926503 0050 Project Description: TI - Tenant improvements to create operatory areas within existing office space, including 3 sinks. No mechanical work allowed under this permit. Owner Applicant Contractor Lender HASSEN PROPERTIES INC KENNETH L. BROSSEL *KENNET} KENNETH L. BROSSEL *KENNETI SOUND BANKING COMPANY *GA 3727 S 194TH ST 1230 S 336TH ST - ---J--Type Occupancy Load: SOUND BANKING COMPANY SEATTLE WA FEDERAL WAY WA 98188 1230 S 336TH ST 6115 MT TACOMA DR SW 98188 -5360 -- - - -- J�- FEDERAL WAY WA 98188 LAKEWOOD WA 98499 Includes: Census category: 437 - Comm #1 #2 #3 #4 Occupancy Group: Construction Type: — B V N - _�- -- - ---J--Type Occupancy Load: l IL Floor Area (S Ft.: ��__ - -- - - -- J�- �� Census Category ............................ 437 - Commercial alt/add Fire Sprinklers.......... - .................... No Mechanical...... ....... _ No Number of Stories.... ...I Permit for Building She] I Only.. ..... ...............No Plumbing...... ....... ...... No Will Certificate of Occupancy be Issued? ......... -Yes Zoning Designation ... .... .......: ............OP Plumbing Fixtures __Description _Quanti scription __Quantity Description __Quantity Sinks CONDITIONS: This decision shall not waive compliance with future City of Federal Way codes, policies, or standards relating to the subject proposal. PERMIT EXPIRES November 1, 2004. Permit issued on May 5, 2004 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 accQlAance with the laws, rules and regulations of the State of Washington and the City of Federal Wa Owner or agent Date: S J 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: BROSSEL DENTAL OFFICE Address: 1230 S 336TH SuiteB Permit number: 04 - 100869 - 00 #1 #2 #3 #4 Occupancy Group: B Construction Type: Type V - N Occupancy Load: Floor Area (Sq. Ft.): Owner HASSEN PROPERTIES INC Name: 3727 S 194TH ST Address: SEATTLE WA 98188 -5360 Building Official Date 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 ofsaid structure or the land upon which it is situated. Such compliance is the responsibility of the owner and/or occupant of the premises. s 1% POSWIS CARD ON THE FRONT OF BUILDANG Ir ' CITY OF Federal Way BUI DIVISION Federal Y INSPECTION RECORD PERMIT #: 04- 100869 -00 -CO OWNER'S NAME: HASSEN PROPERTIES INC SITE ADDRESS: 1230 S 336TH SuiteB ( ) FOOTINGS /SETBACKS. INSPECTION REQUEST PHONE #: 253- 835 -3050 ( ) FOUNDATION WALL DO NOT POUR CONCRETE UNTIL THE ABOVE IS APPROVED O DRAINAGE: Line ( ) Connection DO NOT POUR SLAB UNTIL THE ABOVE IS APPROVED ( ) UNDERFLOOR FRAMING, ( ) ROUGH PLUMBING: DWV (( " Z, '4C) y <::, � / Water piping ( ) ROUGH MECHANICAL O SHEATHING_ () SHEAR WALLS ( ) ELECTRICAL ROUGH -IN O Gas vivi Roof Flocr. FIRE /DR AFTSTOPS ALL THE ABOVE MUST BE APPROV O FRAMING/FIRESTOPPING THE ABOVE MUST, BE APPROVED PRIOP Ditch Cover PR O FRA ING I ECTIOPl, NSULATING OR SHEETROCKING () INSULATION: Floors Walls Attic THE ABOVE UST BE PPROVED PRIOR TO APPLYING SHEETROCK O WALLBOARD NAILING � ( ) SUSPENDED CEILING l' 2 THE ABOVE MUST BE APPROVED PRIOR TO TAPING OR INSTALLING CEILING TILE OELECTRICAL FINAL O - C) Z/ ( ) PLANNING FINAL ( ) PUBLIC WORKS FINAL ( ) FIRE FINAL_ DEPARTMENT FINAL ( ) BUILDING FINAL DO NOT OCCUPY THIS BUILDING UNTIL BUILDING FINAL IS APPROVED ` RECEIVE[ CITY OF Federal Way r 2 2004 CONSTRUCTION iI Y OF FEDERAL ,WAY pkrruvAIWN PAWIDEM. _ * *The fallowing 4w4_" "rmation — Please print (in ink) or type ** APPLICATION Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application. :)ROPFRTY INFORMATIC SITE ADDRESS: /Z,l s t� - 3 - : y rE b ASESSOR 'STAR /PARCEL *:�z(O T-O.�-Q 50- Q,Z ro' i % _ LEGAL DESCR n OF SUBJ CT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): M -si &ffyVJS 06-640 0.4121L D(%/ tDr Z OF D r7t4T P,4F - c,or z;- IC 5.5. 8791o8 !' 717 1 Z6 3c, &7 1 N PROJECT INFORMATION TYPE OF PROJECT (This application): Vf BUILDING o PLUMBING o MECHANICAL o DEMOLITION o ELECTRICAL o ENGINEERING o FIRE PREVENTION SYSTEM ,i MCI JV Alf *AEWAM. M--A ■ PROJECT INFORMATION PROPERTY OWNER: CONTRACTOR: APPLIANT: NAME: DAYTIME PHONE: MAILING ADDRESS (STREET CTTY, STATE, ZIP): .3127 45,114-7 !1' 'ikz, 0A. LJ�IS� 1y0 NAME: DAYTIME PHONE: (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE: - CTTY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER: CONTRACTORIS REGISTRATION NUMBER: EXPIRATION DATE: (may of cmd mgwled) _ _ WDRESS (STREET ADDRESS: CITY, STATE, ZIP): _ St- So4re3 o ARCHITECT ))"TENANT o OTHER( DESCRIBE): CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER XAPPLICANT o CONTRACTOR EXISTING USE: EXISTING BUILDING ASSESSED /APPRAISED VALUATION (Z,C3 ) b(oi -z5q 56-' EVENING PHONE: FAX NUMBER: ( ) (,(,, - Z�3 E-MAIL ADDRESS: ?y© &0000 o� PROPOSED USE: �fa�'lt, PROPOSED VALUATION FOR IMPROVEMENTS: SPRINKLERED BUILDING? NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED: o YES al' o WATER SERVICE PROVIDER: HAVEN o HIGHLINE o TACOMA o PRIVATE (WELL) calwo �Yvrf"C OpAVrHCo. 77LAKKE 1lC YAV1SY n Y?P�YI lr C n 00TWAT9 fd=WrrPI 0 * *NEW RESIDENTIAL CONSTRUCTION ONLY ** OF ESTIMATED SELLING PRICE: ■ PROJECT FLOOR AREAS FLOOR EXISTING SQ. FT. PROPOSED S • FT. TOTAL BASEMENT COMP PLAN DESIGNATION O#W CL BASIC PLAN? ❑ YES R ❑ O SECTION TOWNSHIAV RhNQE FIRST Iff CHANGE OF USE? ❑ YES NO SECOND THIRD FOURTH OTHER FLOORS (DESCRIBE) DECK GARAGE HOW MANY FLOORS? TOTAL: Indicate number of each type of fhdure MECHANICAL AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOGS) REFRIG. SYSTEM(S) BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S) BOILERS) FIREPLACE INSERTS) RANGE(S) MISC. (_ COMPRESSOR(S) FURNACE(S) DUCT(S) _ GAS PIPE OU'nso) HEAT SOURCE: ❑ ELECTRIC ❑ GAS BATHTUB(S) DISHWASHER(S) DRINKING FOUNTAIN(S) GAS PIPE ourLET(S) INTERCEPTORS) PLUMBING LAVATORY(S) RAIN WATER SYS. SHOWER(S) S S IN SUMP(S) URINAL(S) VACUUM BREAICER(S) WASH MACHINE OUTLET WATER CLOSET(S) ]ISCLAIMFR /SIGNATURE BLC WATER HEATER(S) ❑ ELECTRIC ❑ GAS I certify under penalty of perjury that the information furnished by an is true and correct to the best of my knowledge, and further, that I am authorized by the owner of the above promises to perform the work for which the permit application is made. I further agree to hod harmless the City of federal Way as to any claim (including costs, expenses, and attorneys' fees hKwTed in the 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 the reliance of the city, including its officers and employees, upon the accuracy of the information to the city as a art of this application. AIV NAME /TI1LE: DATE: % .- ' U ❑ PROPERTY OWNER }APPLICANT AMMIA&OR. MR nM(V M9 ANLV• 1 47 'if 7 M UT) ❑ NEW w A ❑ ADD O ❑ALTERATION ❑REPAIR TENANT IMPROVEMENT CENSUS CODE: LOT SIZE: TONING DESIGNATI N : BUILDING SHELL ONLY? ❑ Y6 ❑ NO COMP PLAN DESIGNATION O#W CL BASIC PLAN? ❑ YES R ❑ O SECTION TOWNSHIAV RhNQE NEW ADDRESS REQUIREbf YE S ❑ NO PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES NO ni+.•.u�a.a�. nrraa�a'..a•.r.e�.�a- n•.err�n _ + +rnn r+ne -r a•..v ems.. m...v� n..v .r..n _ er -nrn.� •••.v •••. n�n��s earn _ �.r. nom. wMw r.v. �e-�. ��. �. vn