12-102430City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835 -2607 Fax: (253) 835 -2609
Project Name: BREAST DIAGNOSTIC CENTER
Project Address: 909 S 336TH ST Unit B100
4Building - Commercial
Permit #: 12- 102430 -00 -CO
Inspection Request Line: (253) 835 -3050
Parcel Number: 926480 0150
Project Description: TI - Minor interior demolition, construct new doors, partition walls and new HCP
restrooms. Mechanical and plumbing included
Owner
Al2plican t
Contractor
Londe
OMNI PROPERTIES INC
VICKI SOMPPI
OMNI PROPERTIES INC
909 S 336TH ST SUITE 103
CONNELL DESIGN GROUP
OMNIPI *995BW (8/27/12)
Type V - B
FEDERAL WAY WA 98003 -6311
22002 64TH AVE W SUITE C
909 S 336TH ST SUITE 103
Occupancy Load
MOUNTLAKE TERRACE WA 9802
FEDERAL WAY WA 98003 -6311
Census Category: 437 - Commercial alt / add / conversion
Includes:
# 1
#2
#3
#4
Occupancy Class:
B
Construction Type:
Type V - B
Occupancy Load
Floor Areas . ft.
2,848
1 0
0
0
Additionat.Permit Information
Mechanical Fixtures
Ducting............ ............................... 1
Plumbing Fixtures
Lavatories........ ............................... 6 Sinks................ ............................... 1 Water Closets.. ............................... 2
PERMIT EXPIRES Wednesday, December 19, 2012
Permit Issued on Friday, June 22, 2012
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.
Owner or agent: Date: �� 2=L� ► �
F(WJII/`D alle4lit
City of Federal Way IP
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 110.2 of the International 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: BREAST DIAGNOSTIC CENTER
Address: 909 S 336TH ST UnitB100
Permit #: 12- 102430 -00-CO
Includes:
# 1
#2
#3
#4
Occupancy Class:
B
Construction T
Type V - B
Occupancy Load
Floor Areas . ft.
2,848 1
0
1 0
1 0
Owner Name: OMNI PROPERTIES INC
Owner Address: 909 S 336TH ST SUITE 103
FEDERAL WAY WA 98003 -6311
M1
e o2,y- 1.2
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 severiy 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. .
Cl" OF
Federal Way
PERMIT #:
12- 102430 -00 -CO
THIS CARD IS TO MAIN ON -SITE
Construction In ection Record
INSPECTION REQ TS: (253) 835 -3050
Address: 909 S 336TH ST Unit B100
Project: OMNI PROPERTIES INC FEDERAL WAY, WA 98003
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.
SWM Precon Site Mtg (4400)
Initial Erosion Control (4365)
E]
Footings /Setback (4110)
Approved
Approved to place concrete or grout
To be done prior to breaking ground
Approved to cover
Approved to place concrete
By
Date
By
Date
By
Date
Re -steel (4215)
Plumbing Groundwork (4190)
Final Electrical
Approved
Slab /Concrete Floor (4255)
Right of Way
Approved
Approved to place concrete or grout
Date
Approved to cover
By
Approved to place concrete
By
Date
By5e S Date L _ :Zs-_ -Z
By
Date
Underfloor Framing (4285)
Floor Sheathing (4105)
Rough Plumbing (4230)
Approved to sheath floor
Approved to install flooring
Approved
By
Date
By
Date
By—
,3G S Date 7.4) _
Mechanical Rough -in (4165)
Gas Piping (4125)
Fire/Draft Stops (4095)
Approved
Approved to release test
Approved
B
Date 7 _ 'Z
By
Date
By
Date
Interim Erosion Control (4370)
Framing (4120)
Prior to scheduling a Framing inspection;
Approved
I lectrical, Plumbing & Mechanical Rough -in and
Approved to insulate
By
Date
re/Draft Stop inspections must be signed -off and
approved IBC 1093.4
By�CS Date 7 /O l2
Insulation (4150)
Gypsum Wallboard Nailing (4130)
Suspended Ceiling Grid (4265)
Approved to install wallboard
Approved to install mud & tape
Approved to drop tile
By
Date
By-
CS Date r' l �� Z
By
Date
Final - Fire Department (4060)
Final - Planning
Final Erosion Control (4375)
Approved
Approved
Approved
By
Date 211- 1-2-
By
Date
By
Date
Final - Mechanical (4065)
Final - Plumbing (4075)
Final - Building (4050)
Approved
Approved
Approved
B Date r% �.0 -� z
C� Date - z �- 2
By
I/ Date �%
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
r`,
J
CITY OF ERMIT
Federal Way
COMMU?=DEVELOPMEN RECEIVEIAPPLICATION
253 - 835 -2607• FAX 253 -835 -2609
www. cltuoffederalwau.com
MAY 312012
J. 2. - 1 O Z-4:z_ �
SOF (1�0 ME PL DE EN FP
I - & /zg/ 2,
SITE ADDRESS ' V
33� -G
C 0 h.' re
SUITEMNIT #
B 100
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
O
)ik BUILDING ❑ PLUMBING ❑ MECHANICAL
TYPE OF PERMIT
❑ DEMOLITILON ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
1reaS� N 0
(Tenant Name /Homeowner Last Name)
Q
'm c l y s i r 1
PROJECT DESCRIPTION
dUald 1( d CZ)
Detailed description of work to
r U�� 'ny; V
1
be included on this permit only
PROPERTY OWNER
NAME G Q O nei r7 i �YQ �'�5
Y PHONE
2 O
MAILING ADDRESS
-�►-► Sfire>v� 103
E-MAIL
owls i w I A, •net
STATE
4 03
NAME
PHONE
Omn't c..
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME C ' GrdV
PHONEZS — 670— �!
MAIIdNG ADDRESS ' 1
Z �o %CJ 5k. ZC.
E-MAIL
APPLICANT
CMq
ST-AT1E
ZD?ggog3
FAX
PROJECT CONTACT
NAME
I `t
HoANEG
��� �70 �O
(The individual to receive and
respond to all correspondence
MAILING ADDRESS
22� CD �-2 -. w
AIL
��M�
V t Ck� d V1 tZ $I
concerning this application)
FAX
CM
T A �^
STATEA
ZIP
ALTERNATE CONTACT NAME:
PHONE
E-MA30L
PROJECT FINANCING
NAB C _ I
0 OWNER- FINANCED
Required value of $5,000 or more
(RCW 19.27.095)
MAUMG ADDRESS, CITY, STATE, ZIP
PHONE
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best
in application is true and correct. I certify that I will Comply with
of my knowledge, the information submitted support of this permit
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.
I,further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in
be by any including the undersigned, and filed against the city,
the investigation and defense of such claim), which may made person,
but only where such claim arises out of the reliance of the city, including its gfficers and employees, upon the accuracy of the
information supplied to the city as a part of this application.
DATE 31
SIGNATURE:
PRINT NAME: y
Bulletin #100- April 14, 2010
Page 1 of 3
kAHandouts\Permit Application
1 . Loui
v
w
VALITE OF MECHANICAL WORK $ liV�� (a copy of bid or estimate must be provided)
Indicate how many of each type of fixture to be installed or relocated as part of this project Do not include existing jatures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commemlap
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 existingj%dures to remain.
BATHTUBS (or Tub /Shower Combo)
LAVS (Hand Sinks)
TOILETS WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
_A_ SINKS mitchen/utlltty)
WATER HEATERS (E)ectrtc)
HOSE BIBBS
SUMPS
WASHING MACHINES 1Or
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR
L k kt y
EXISTING /PREVIOUS USE, LOT SIZE (In Square Feet)
(41-,iry / DPI "ri
SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$ j z S j 6-60
EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
o Yes V_No _ e o Yes X� No
Bulletin #100 —January 1, 2011 Page 2 of 3 k:\Handouts\Permit Application