11-104140 4.
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City of Federal W4y' .{{.��
Community Development Services Permit #: 11-104140-00-CO
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: 253
Ph:(253)835-2607 Fax:(253)835-2609 p q ( ) 835-3050
Project Name: WEST CAMPUS FOOT&ANKLE
Project Address: 33801 1ST WAY S Suite 105 Parcel Number: 926504 0160
Project Description: TI-Modifications for new tenant including demolition of partition walls,additional walls,
some acoustical ceiling.Includes plumbing& mechanical.
Owner Applicant Contractor Lender
WEST CAMPUS FOOT&ANKLE SUPERIOR BUILDERS INC SUPERIOR BUILDERS INC
33801 1ST WAYS PO BOX 1849 SUPERBI112D2 (3/4/12)
FEDERAL WAY WA 98003 MILTON WA 98354-1849 PO BOX 1849
MILTON WA 98354-1849
Census Category: 437- Commercial alt/add/conversion
Includes: #1 #2 #3 #4
Occupancy Class: B
Construction Type:
Occupancy Load:
Floor Area(sq. ft.) 2,106 0 0 0
WOW,� a kY z ° Y� 1 �� 01i4 sz,'<c 0
Vi: i%�,� ,r/ <,417 e i a g.4,x�'`� i a�.
Existing Sprinkler System in Building" Yes Mechanical to be Included" No
Number of Stories 1 Permit for Building Shell Only? No
Plumbing to be Included? Yes New/Additional Sq.Feet-Total 0
Occupancy#1 -Use Professional Zoning Designation OP
Services/Offices
tum /� �
tent# $' .. „,
Sinks 3
CONDITIONS:
Subject to field inspection with plans.
PERMIT EXPIRES Wednesday, April 11, 2012
Permit Issued on Friday, October 14, 2011
I hereby certify that the above informal n is correct a that the construction on the above described property and
the occupancy and the u:e ill be i ccord„nce wit, the laws, rules and regulations of the Stat- of Washington
ndt fit of -•- - _ .
Owner or agent: ;ti GC Date: 161 ,O
FI! & L!D 17 11
City of Federal Way • •
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: WEST CAMPUS FOOT & ANKLE Permit#: 11-104140-00-CO
Address: 33801 1ST WAY S Suite105
Includes: #1 #2 #3 #4
Occupancy Class: B
Construction Type:
Occupancy Load:
Floor Area(sq.ft.) 2,106 0 0 0
Owner Name: WEST CAMPUS FOOT&ANKLE
Owner Address: 33801 1ST WAY S
FEDERAL WAY WA 98003
Buildjg 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 sever!),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.
DA FE INSPECTOR AREA AND TYPE 0 NSPECTIOON
//-7-// ,t-F alL -tom J , f7 , -. . ,mss 1vi9C-
'� stip/7 .
THIS CARD IS TO REMAIN ON-SITE • ,
CITY OF
a Construction I ection Record
Federal Way INSPECTION REQ UESTS: (253) 835-3050
PERMIT#: 11-104140-00-CO Address: 33801 1ST WAY S Suite 105
Project: WEST CAMPUS FOOT & ANKLE 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.
O SWM Precon Site Mtg(4400) ❑ Initial Erosion Control(4365) El
Footings/Setback(4110)
Approved To be done prior to breaking ground Approved to place concrete
By Date By Date By Date
❑ Re-steel (4215) ❑ Plumbing Groundwork(4190) El Slab/Concrete Floor(4255)
Approved to place concrete or grout Approved to cover Approved to place concrete
By Date By 2, Date tie,—p27 // By Date
• Underfloor Framing(4285) El Floor Sheathing(4105) Rough Plumbing(4230)
Approved to sheath floor Approved to install flooring Approved
By Date By Date By f144.- Date l49—R7 J/
❑ Fire/Draft Stops(4095) _ ❑ Interim Erosion Control(4370) Prior to scheduling a Framing inspection;
Approved Approved Electrical,Plumbing&Mechanical Rough-in and
Fire/Draft Stop inspections must be signed-off and
By Date By Date approved. IBC 109.3.4
❑ Framing(4120) El Insulation (4150) El Gypsum Wallboard Nailing(4130)
Approved to insulate Approved to install wallboard Approved to install mud&tape
By Date //-- 7—1 If By Date By FLS Date //.---7—1/
❑ Suspended Ceiling Grid (4265) ❑ Final-Fire Department(4060) 0
Final-Planning
Approved to drop tile Approved Approved
By c Date `A---,In „`( By Date By Date
O Final Erosion Control(4375) 0 Final-Plumbing(4075) Final-Building(4050)
Approved Approved Approved
By Date By Date B - Date 1'z t — C t
U Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
1N
• 101_ - 6 . i 0
1 41.
CITY O` PERMIT RECEE r ME PL DE EN FP
Federal Way
COMM NI7YDE ELOPAX 253-835-2609 RES APPLICATION ocr 12 2011 0 C C, —
Lump.cituoffederalwau.com
CITY OF FEDERAL WAY
SITE ADDRESS CDS SUITE/UNIT#
33801 1st Way S., Federal Way, WA 98003 Suite #105
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$27,323.45 2 _2 Q - Q _L 4
TYPE OF PERMIT %BUILDING ❑ PLUMBING ❑ MECHANICAL
D DEMOLITION 0 ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) West Campus Foot & Ankle T.I.
Create additional room for X-Ray machine and developer.
PROJECT DESCRIPTION
Detailed description of work to Reconfigure reception area and enlarge suite.
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER John E. Niemeyer (253) 779-2414
MAILING ADDRESS E-MAIL
15 82nd Dr., #210 hb or oks@neilwalter.com
CITY STATE ZIP
Gladstone OR 97027
S perior Builders, Inc. PHONE53 ) 573-1698
MAILING ADDRESS E-MAIL
CONTRACTOR P.O. Box 1849 jms@superiorbuilders.org
Milton STATE WA8354 ZIP FAX
573-1797
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
SUPERBI112D2 3 / 4 2013 20-00-101346-00-BL
Superior Builders, Inc. PHONE253) 573-1698
APPLICANT MAILING ADDRESS E-MAIL
P.O. Box 1849 jms@,superiorbuilders.org
CITY STATE ZIP FAX
M'1ton WA 98354 (253) 573-1797
PROJECT CONTACT xAME PHONE
(The individual to receive and John Schweitzer (253) 224-4384
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application) P.O. Box 1849 jms@superiorbuilders.org
CITY STATE ZIP FAX
Milton WA 98354 (253) 573-1797
ALTERNATE CONTACT NAME: PHONE E-MAIL
Jeff Schweitzer (253)222-0713 ieffsnsuperiorbuilders.org
PROJECT FINANCING NAME
„/a OWNER-FINANCED
ui
Required value of$5,000 or more
(RCW 19.27.095) MAILING 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 cert(fy that to the best
of my knowledge, the information submitted in support of this permit application is true and correct.I certffy 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 ho h• ss the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in
the investigation•n% . of h claim),which may be made by any person,including the undersigned,and filed against the city,
but only where raci ai aris-. out of the reliance of the city, including its officers and employees, upon the accuracy of the
information sup a , . h':.c' ;+�. of this application.
SIGNATURE:`tlik,GI i lk - .4‘.. -c- ��(i? S 6. r�l ("07(c)fi G (
DATE
PRINT NAME: ?`:1 ) ' L j C i ' Z C
Bulletin#100-January Y1,2011 Page 1 of 3 k:\Handouts\Perniit Application
• •
f
MECR URES
VALUE of MECHANICAL WORK $ 0.00 (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 inch lr1P existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(Commerctaq
BOILERS FURNACES HOT WATER TANKS(cos)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING rT WOODSTOVES
Py,rUMR1NG FixTE*
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or rub/Shower Combo) LAVS(Hand Sinks) TOILh Ib WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS 3 SINKS(Kitchen/Utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES 3 TOTAL FIXTURES
GENERALiNFoRmATios„,,
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
NO Lakehaven Lakehaven $5,000,000.00'+
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
Office 110,207 SF Yes ❑ No ❑Yes No
ESXDEI' TLAL '- NEwTtTION,
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
1310MENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
•
EXISTING PROPOSED TOTAL
Area Totals
*” `mo Omrs"",
ESTIMATED SELLING PRICE$ #OF BEDROOMS
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square Feet Type Stories
NEv,BINIA010
ADDITION
tMME ° -- + � TANT IMPRO�MEN
AREA DESCRIPTION
AreaConstructionGroup(s) Construction #of Additional Information
in Square Feet Type Stories
aFAL BUILDING
TENANT AREA ONLY
PRwFdCTAR "RIX 2,106 % rete ,3 None
Bulletin#100-January 1,2011 Page 2 of 3 k:\Handouts\Permit Application