10-100652 Mechanical
City of Federal Way
Community Development Services Permit#: 10-100652-00-ME
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: NW CHIROPRACTIC CENTER
Project Address: 34730 PACIFIC HWY S Parcel Number: 202104 9145
Project Description: Relocate existing ductwork
Owner Applicant Contractor
LORRI NICHOLS CREATIVE DESIGN CONTRACTORS CREATIVE DESIGN CONTRACTORS
33801 1ST WAY S UNIT 281 8305 304TH ST E CREATDC920PM(10/14/10)
FEDERAL WAY WA 98003-6224 GRAHAM WA 98338 8305 304TH ST E
GRAHAM WA 98338
Mechanical Valuation 1600 Is this an Online or O.T.C.application? Yes
Ducting 1
CONDITIONS:
Subject to field inspection without plans.
PERMIT EXPIRES Monday, August 16, 2010
Permit Issued on Wednesday, February 17, 2010
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 accor ance with the laws, rules and regulations of the State of Washington
nd the City of Federal Way.
Owner or agent: Date: c,9
7 /d
ommmommilmsom
THIS CARD IS TO REMAIN ON-SITE
CITY CIF Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 10-100652-00-ME Address: 34730 PACIFIC HWY S
Owner: LORRI NICHOLS FEDERAL WAY, WA 98003-6821
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.
❑ Mechanical Rough-in(4165) 0 Gas Piping(4125) ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
Date"z_26."?txtAY Date By Date
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Rough Electrical Final Electrical ElRighro
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By Date By Date By Date
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Federal way "'PERMIT SF F FP
COMMUNITY DEVELOPMENT SERVICES
253-83.5-2607.FAX253-835-2609 APPLICATION _ .
www.awoffederdaw.com FEB 1 6 2010
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SUITE/UNIT# ZONING ASSESSOR'S TAX/PARCEL BUJ
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NAME OF PROJECT ` l V
(Tenant or Homeowner Name) L o Y- r t ' .J\ C�Q',S Al W G/i(, / C__
❑ BUILDING 0 PLUMBING Or MECHANICAL.
TYPE OF PERMIT
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION
PROJECT DESCRIPTION (2.e I oCG�Q_ o �CA.s in"3 rkx,1—\Y�C�
Detailed description of work to J J
be included on this permit only
is J $
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PROPERTY OWNER NLorr) IUIC�10lS P53)96S-P437
MAILING ADDRESS,ern,,,/STATE,ZIP' S ' ` 1�' E-MAIL
3/730 Pa 6I lC 14,3() S 11 W (�a PROJECT CONTACT
OWNER IS ALSO: ❑ CONTRACTOR (,JJ 0 APPLI
.r \ ,,y,�._ ,nPRIIMMARY PHONE`.�..
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•. NTRACTOR MAULING ADDRESS,CITY,STATE •, FAX
e �330s 3014+-x, S it (rahCem W4 98338 (3(oO )893 -88S.
W�1 STATE C21 TOR'S LICENSE Y EXPIRATION DATE FEDERAL WAY SUSINESS LICENSE Y
ec G q`d0 �Jrn_ /6 /i/ i /o
N /;.rt��Q 2 PRIMARY PHONE
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APPLICANT Atar1C14- ' - •Y' 'fleck_ (a1,3)�S -/tc4JU
MAILING AD RESS,CITY,STATE,ZIP 1 FAX
i ll an�PrIS SI- U 4114, W4 V3 (30 )893 - e852
PROJECT CONTACT N ✓ PRIMARY PHONE
(The individual to receive and I c.l, ICU / lcv I K/C.cL (s3 ).:2-5 - /6
respond to all correspondence MAILING STATE,ZIP FAX
concerning this application) 9ll �
)F O nzG4 9930 ((3k )8'3 - 88s
Q
� r CJ PHONE
py , 11 i-Xl oS3) -1/077() . nC^ . ' ennyh t.fV2+F
PROJECT FINANCING NAME
Required for projects with L. r J Y V I L f) OWNER-FINANCED
value of$5,000 or more MAILING AD�D}RESS, ,(S/��•'A�TE,/Z.I�/p/ ` fj1 ry' r �'/ �/� •� /3�R/�I7J�/�pEtT PHONE
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I certify under penalty of perjury that I am the property owner or authorized agent of the✓property owner.I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
/further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred
in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the
city, but only where such claim arises out of he reliance of the city, including its officers and employees, upon the accuracy of the
information suppli-• • the city as a part of t , application.
I
SIGNATURE: `._ / A _ / _ DATE a —/ 7 /
n
PRINT NAME: £ !Mr/ 1W.
Bulletin 1/100—January 1,2010 Page 1 of 4 k:\Handouts\Permit Application
Value of Mechanical Work$ �f'/n
(A COPY OF BID OR ESTIMATE MUST BE PROVIDED)
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS/Commercial)
BOILERS FURNACES HOT WATER TANKS(ore)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
PLUMBING PIT .< .
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tab/Shower combo) LAYS Hand Sines) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS patches/utility) WATER HEATERS(®eeedq
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
PRgJECTVALDATION WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
/r O�—_
E US O/PREVIOUS USE LOT SIZE(In Square Feat) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes ar No ❑ Yes s No
eli/;c/ 07a I o8 / -
I
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL
FOR OFFICE USE
iEMSN7
FIRST FLOOR(or Mobile Home)
• SGCONt)I +f?C3It's .
COVERED ENTRY
13ffiCIf>
GARAGE ❑ CARPORT ❑ -�
Area Totals > �� ' L,
ESTIMATED SELLING PRICE$ #OF BEDROOMS
+C(}MMEI GI ►L NE :i. DITI(
AREA DESCRIPTION Area Construction #of
in Square Feet Occupancy Group(s) Type Stories Additional Information
NEW BUILDING
ADDITION
I� 1 I RRl ODELITE AN II II +�T
AREA DESCRIPTION Area Construction #of
in Square Feet Occupancy Groups) Type Stories Additional Information
..Tf>•fAL.iBtaitFlYNQ
TENANT AREA ORLY
PRdtiNG°114R$'AONLY
Bulletin#100—January 1,2010 Page 2 of 4 k:\Handouts\Pennit Application