13-105211City 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: GROUP HEALTH CLINIC
Project Address: 301 S 320TH ST
Plumbing
Permit #: 13- 105211 -00 -PL
Inspection Request Line: (253) 835 -3050
Project Description: Install (3) backflow devices - (2)@ 2" and (1)@ 1 -1/2"
Parcel Number: 172104 9105
Owner
ARRlican
Contractor
GROUP HEALTH COOP
MACDONALD MILLER FAC SOL INC
MACDONALD MILLER FAC SOL INC
12501 E MARGINAL WAY S
(GENERAL)
(GENERAL)
TUKWILA WA 98168
7717 DETROIT AVE SW
MACDOFS980RU (12/31/13)
SEATTLE WA 98106
7717 DETROIT AVE SW
SEATTLE WA 98106
Plumbing Fixtures
Other Plumbing Fixtures ............... 3
PERMIT EXPIRES Monday, May 19, 2014
Permit Issued on Wednesday, November 20, 2013
1 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: .2 Date: t �2d 13
FINALLV
CITY OF
Federal Way
PERMIT #:
13- 105211 -00 -PL
THIS CARD IS TO IN ON -SITE
Construction In ection Record
INSPECTION REQUE TS: (253) 835 -3050
Address: 301 S 320TH ST
Project: GROUP HEALTH COOP FEDERAL WAY, WA 98003 -5200
Scheduled inspections may be failed if this card is not on -site. DO NOT LOSE THIS CAIN. 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.
Final - Plumbing (4075)
Approved
By Date VVA-IV
Plumbing Groundwork (4190)
Rough Plumbing (4230)
Final Electrical
Approved
Gas Piping (41 5)
Approved to cover
By
Approved
Approved to release test
7
By
Date
By
Date
By
Date
Final - Plumbing (4075)
Approved
By Date VVA-IV
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY Of
Federal Way
COMMUNITY DEVELOPMENT SERVICES
253 - 835- 2607•FAX 253 -835 -2609
u;ice,^ +aorta (C'cdlol.cmn.
PERMIT SF MF CO ME (DDE EN FP
APPLICATION RECEIVE®
NOV 2 0 2013
SITE ADDRESS 301 S 320TH STREET FEDERAL WAY, WA 98003 CITY OF FEDERA
WH ,'UN11T #
CDS
PROJECT VALUATION
ZONING
ASSESSOR'S TAR /PARCEL #
$ 109,100.00
LOT 1 KCLLA
1 7 2 1 0 4 _ 9 1 0 5
❑ BUILDING ❑ PLUMBING QR MECHANICAL
TYPE OF PERMIT
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
ITenantName /Homeowner Last Name)
GROUP HEALTH COOP - FEDERAL WAY
INSTALL 3 BACKFLOW DEVICES - 2 2" AND 1 1 1/2 ".
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRDQARY PHONE
PROPERTY OWNER
CBRE GLOBAL CORPORATE SERVICES
MAD,INGADDRESS 12501 E MARGINAL WAY S
E-MAIL
CITY
STATE
ZIP
TUKWILA
WA
98168
NAME MACDONALD MILLER
PHONE (206) 768 -4278
MAILING ADDRESS
E-MAIL
7717 DETROIT AVE SW
darla.doll @macmiller.com
CONTRACTOR
CITY SEATTLE
STATE
Wq
ZIP
98106
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIIiATION DATE
FEDERAL WAY BUSINESS LICENSE #
MACDOFS980RU
12 / 31 /13
20 -03- 100372 -00 -BL
NAME
PHONE
DARLA DOLL
(206) 768 -4278
APPLICANT
MAILING ADDRESS 7717 DETROIT AVE SW
E-NLVL
darla.doll@macmiller.com
CITY SEATTLE
STATE
N)q
ZIP
98106
FAx
PROJECT CONTACT
NAME TYLER NELSEN
PHONE
(206) 330 -3151
(The individual to receive and
MAILING ADDRESS
7717 DETROIT AVE SW
E -MAD. tyler.nelsen
respond to all correspondence
concerning this application)
macmiller.com
CITY SEATTLE
STATE
WA
ZIP
98106
FAX
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
DARLA DOLL
(206) 768 -4278
darla.doll @macmiller.com
PROJECT FINANCING
NAME N/A
OWNER FINANCED
Required value of $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I cert(fy that to the best
of my knowledge, the information submitted in support of this permit application is true and correct. I certify 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.
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 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
information supplied-to the city as apart of this application.
SIGNATURE: DATE 11/20/2013
PRINT NAME: DARLA DOLL
Bulletin #100 — January 1, 2011 Page 1 of 3 k:Ulandouts\Permit Application
VALUE OF MECHANICAL WORK $
16,500.00
(a copy of bid or estimate must be provided)
Indicate how many of each type of fvcture to be installed or relocated as part of this project. Do not include existing fxtures to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS 2 OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS
HOODS (commercial) SPLIT SYSTEMS
BOILERS
FURNACES
HOT WATER TANKS (Gas)
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 7Lb /shower Combo)
LAVS (Hand Sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
-1 OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
Backflow Devices
DRINKING FOUNTAINS
SINKS (Khchen /Umay)
WATER HEATERS (Eiwnc)
HOSE BIBBS
SUMPS
WASHING MACHINES
3 TOTAL FIRTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
EXISTING /PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No
❑ Yes ❑ No
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet a Stories
NEW BUILDING
ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet a Stories
TOTAL BUILDING
TENANT AREA ONLY 200 sq ft
PROJECT AREA ONLY
Bulletin #100 -January 1, 2011 Page 2 of 3 k:\Handouts\Permit Application