03-100182 n
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City of Federal Way
Community Development Services Building - Commercial Permit #:03 - 100182 - 00 - CO
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: FEDERAL WAY PEDIATRIC CLINIC
Project Address: 32124 1ST S Suite300 Parcel Number: 926450 0060
Project Description: TI-Non-structural interior alterations or new office space. Includes plumbing and mechanical.
Owner Applicant Contractor Lender
Gail Allen Properties LLC THEODORE BRIDGE CLOYD CONSTRUCTION COMPA1s Gail Allen Properties LLC
13707 16TH AVE SW 1014 S 320TH ST 13707 16TH AVE SW
SEATTLE WA 98166 FEDERAL WAY WA 98003 3016 SW 325TH PL SEATTLE WA 98166
FEDERAL WAY WA 98023-2531
Includes:
Census category: 437-Comm #1 #2 #3 #4
Occupancy Group: B
Construction Type: Type V-N
Occupancy Load: 16 ,■
Floor Area(Sq.Ft.): 1590
1st Floor Proposed Sq.Feet 1590 Building Pre-con.Meeting Required No
Census Category 437-Commercial alt/add Fire Sprinklers No
Mechanical Yes Number of Stories 1
Permit for Building Shell Only No Permit for Foundation Only No
Plumbing Yes Special Inspection Required No
Total Proposed Sq.Feet 1590 Will Certificate of Occupancy be Issued? Yes
Sensitive Areas? No Zoning Designation PO
Plumbing Fixtures
Description ,",;.„ Quantity Description -” rQuantity .Description `Quantity
Lavatories 3 Sinks 5 Water Closets 3
Mechanical Fixtures
Description : .:: Quantify; i` . " Description Quantity Description Quantity]
Air Handling Units 7 Ducts 7
CONDITIONS:
1.All new and refaced signs require a separate sign application and review.(FWCC,Sec.22-335(g)(6)).
2.This decision shall not waive compliance with future City of Federal Way codes,policies,or standards relating to the
subject proposal.
PERMIT EXPIRES July 14,2003,IF NO WORK IS STARTED.
Permit issued on January 15,2003
I hereby certify that the above information is correct and that the construction on the above described propertyand
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: ' • • • P-t��'rC{� Date: f t S F
•
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: FEDERAL WAY PEDIATRIC CLINIC Permit number: 03 - 100182-00
Address: 32124 1ST S Suite300
#1 #2 #3 #4
Occupancy Group: B
Construction Type: Type V-N _
Occupancy Load: 16 _
Floor Area(Sq.Ft.): 1590
Owner Gail Allen Properties LLC
Name: 13707 16TH AVE SW
Address: SEATTLE WA 98166
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 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.
POS THIS CARD ON THE FRONT OF BUILDING •
CRY Of = -,11
ED L BINDING DIVISION
VV
FI)/ INSPECTION RECORD
INSPECTION REQUEST PHONE#: 253-835-3050
PERMIT#: 03-100182-00-CO
OWNER'S NAME: Gail Allen Properties LLC
SITE ADDRESS: 32124 1ST S Suite300
( ) FOOTINGS/SETBACKS ( ) FOUNDATION WALL
V- ' 1 DO NOT POUR CONCRETE'IfiNTILsTIYE ABOVE IS APPROVED
( ) DRAINAGE: Line ( ) Connection
N^ ` DO"NOT,POUR SLAB UNTIL'I'HE ABOVE ISAPP,ROVELI ,
( ) UNDERFLOOR FRAMING
( ) ROUGH PLUMBING: DWV Water piping
( ) ROUGH MECHANICAL Gas piping
( ) SHEATHING _Roof Floor
() SHEAR WALLS
( ) ELECTRICAL ROUGH-IN Ditch Cover
( ) FIRE/DRAFTSTOPS _
i, ALL THE ABOVE ST.J E APPROVED PRIOR TO FRAMING INSPECTION ,,,_ _d„_"
( ) FRAMING/FIRESTOPPING
t TIIEABOVE MUST BE APPROVED PRIOR"TO INSULATING OR SHEETROCKING s , „ R_
( ) INSULATION: Floors Walls Attic
THE ABOVE USTE APPROVEDPRIOR FO APPLYING SHEETROCK R .
( ) WALLBOARD NAILING ( ) SUSPENDED CEILING
`THE ABOVE MUST BE APPROVED PRIOR TO TAPING OR INSTALLING'CEILING tIEE ` ,
( ) ELECTRICAL FINAL
() PLANNING FINAL
( ) PUBLIC WORKS FINAL
( ) FIRE FINAL
THE ABOVE MUST BE APPROVED PRIOR TD BUILDING DEPARTMENT FINAL ._ '
( ) BUILDING FINAL
DO OT OccUPY THIS BUILDING UNTIL BUILDING FINAI IS APPRO D�
A •ECEIVED
_-4, a.Of G CONSTRU ION PERMIT APPLICATION
r vV L_ APPLICATION NUMBER: 0, - /� ,
Ur2 - od CO
JAN 1 5 2003
APPLICATION NUMBER: - _ _
CITY OF FEDERAL WAY APPLICATION NUMBER: _ -_ _ _ _ _ _ - _
BUILDING DEPTinformation following is required —Please print(in ink)or type** 1) CK),
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application. V
` /i4 • PROPERTY INFORMATION
SITE ADDRESS: 32124 IST /Q- ' 4-304 ASSESSOR'S TAX/PARCEL#: q 2- 6 4 50 - 00 C/O� -02
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): (J 4'14-- 2O 31 u PS+ ix,
r
,�ti r�o V1n I h\U 111/I • '('v Q. q• - . Gi VS ,. • ..0.; t L VI • r� � A lirA I(11 1/`4M.$
. . Zq-30 1 . 102- ' • ' V• I . 22 . ' A vn et,I dei i . . •0 16-11 i
• wo aa-ot ro Re Co - 1 - F -'O 2 _ 068= •
,-; ■•PROTECT INFORMATION
TYPE OF PROJECT(This application): Ei BUILDING NCPLUMBING laMECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
C
1 �
PROJECT DESCRIPTION(Provide detailed description): �'t`I✓V'
-1/ i,O r v—Qw`t.,�O C ' r A I VY�¢'Cl 1 CC(
• i C--e., LA 0/1/41l 1/1 •l LA. ,' + (4,.,_(:),- + l t,�s � r�
2I O c ct'k c,vv .
PROJECT NAME: r •2..r-o Wu. L l cc-k--r1 c- CAI v L .
■ 'PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
L e.6 4-er-( Cjot•11 A( 1e v► Pro pe,---i--C e_s L.l_C (2g3) 941 - oG7-3
Ow tel�-- MAILING ADDRESS(STREET ADDRESS;CITY,StATE,ZIP): ( (p 41.13707 ( C+- Ave_- S ), S est-44 e, W i4 Rg -
CONTRACTOR: NAME: DAYTIME PHONE:
Z-e r ry C o y d (z53) CC 1 - 7173
MAILING ADDRESS(STREET ADDI(ESS;CITY,STATE,ZIP): EVENING PHONE:
?o1CP S.W. 327--t''' ' (.0c.,.--e , -F Way T023 (253) (06( - 7173
CITY OF FEDERAL WAY - -BUSINESS LICENSE NUMBER: FAX N7B� :� - O �
Fti.� CYO `/
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(may of card required) C.G /.._,c7 y D C C O W DIA 3 / 12 / 0 3
APPLICANT: NAME: -063 �C�\eDAYTIME PHONE: X15/73
MAILING l e DRESS(STREET OURE. ( r 3)CITY,STATE,ZIP): Oc I
10144- S• 3 ZO 4,FQ-�-P.v-e W«, v WA Q R oo 3 (70c..) 6.`e40 - 55' Q�er
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT IZI TENANT CI OTHER(DESCRIBE): ( Z53) q - I - (OQ
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER SAPPLICANT ❑ CONTRACTOR Ted '‘14'uo1*'Go1.'7
•::DETAILED BUILDING INFORMATION -
EXISTING USE: (7)'cC 1 G0--- EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ ICI I/ GO 0
PROPOSED USE: N1 2-d ICO. . O'T'C ICe PROPOSED VALUATION FOR IMPROVEMENTS: $ 6 , DOCS
SPRINKLERED BUILDING? ❑ YES 151-NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ' NO
WATER SERVICE PROVIDER: ® LAKEHAVEN CI HIGHLINE CI TACOMA CI PRIVATE(WELL) ����`"`
SEWER SERVICE PROVIDER: CA LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
51590 1 QC)
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL: IST( 0 1 6r O
IN FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
•
BBQ(S) FAN(S) HOOD(S) WOODSTOn(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) 7 MISC.( L1-Szr-s)
COMPRESSOR(S) FURNACE(S) \ia lam, . 730
yL S DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: U ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) 3 LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) 3 WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
M DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and
further,that I am authorized by the owner of the above premises to perform the work for which the permit application is made. 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,induding the undersigned,and filed against the City of
Federal Way,but only where such claim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
of the information supplied to the city as a part of this application.
NAME/TITLE: (v Y-.9t L .•= ' DATE: l/�/03
CI PROPERTY OWNER El APPLICANT CI CONTRACTOR
I
FOR OFFICE USE ONLY:
❑ NEW- ❑ADDITION ❑ ALTERATION ❑;REPAIR - ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION: BUILDING SHELL ONLY? '.❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES`' ❑ NO
SECTION; TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES 0 N
PLAITED LOT? ❑ YES 1 ❑ NO CHANGE OF USE? ❑ YES CI NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
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Construction Permit Fee Calculation Sheet
*******PLEASE NOTE: ALL FEES MUST BE VERIFIED BY CITY STAFF PRIOR TO ACCEPTANCE OF PAYMENT.
CHECKS FOR INCORRECT AMOUNTS WILL NOT BE ACCEPTED!*******
Building,mechanical,and fire prevention system fees are based on the following schedule.
TABLE A
TOTAL VALUATION FEE FACTOR
(1)$1.00 to$500.00 (1)$24.25
(2)$501.00 to$2,000.00 (2)$24.25 for the first$500.00 plus$3.27 for each additional$100.00 or fraction thereof,to and including$2,000.00
(3)$2,001.00 to$25,000.00 (3)$71.46 for the first$2,000.00 plus$15.00 for each additional$1,000.00 or fraction thereof,to and including
$25,000.00
(4)$25,001.00 to$50,000.00 (4)$403.61 for the first$25,000.00 plus,fIQ.82 for each additional$1,000.00 or fraction thereof,to and including
$50,000.00.
(5)$50,001.00 to$100,000.00 (5)$664.35 for the first$50,000.00 plus$7.50 for each additional$1,000.00 or fraction thereof,to and including
$100,000.00.
(6)$100,001.00 to$500,000.00 (6)$1,025.55 for the first$100,000.00 plus$6.00 for each additional$1,000.00 or fraction thereof,to and including
$500,000.00
(7)$500,001.00 to$1,000,000.00 (7)$3,337.23 for the fist$500,000.00 plus$5.09 for each additional$1,000.00 or fraction thereof,to and including
$1,000,000.00.
(8)$1,000,001.00 and up (8)$5,788.23 for the first$1,000,000.00 plus$3.91 for each additional$1,000.00 or fraction thereof.
Bold number is the base fee for the specified increment
Italicized,underlined number Is the fee per additional specified increment
PLUS: Add 65 percent of the base building permit fee for plan review fee.
Add 25 percent of the base mechanical permit fee for mechanical plan review fee.
Add 15 percent of the base building permit fee for Fire District#39 surcharge,commercial only.
Add$4.50 for WA State Building Code Coundl,plus$2.00 per unit for duplex&above.
** Electrical,plumbing,and mechanical fees are calculated separately**
■ BUILDING
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number: (a)Base Fee:
(b)Additional Increment Fee:
Estimated Permit Fee: (1)
Estimated Plan Review Fee: (2)
Estimated FW Fire Department Surcharge: (3)
(COMMERCIAL ONLY)
■ MECHANICAL `;'
PROPOSED VALUATION: 'P "7 57)
FEE FACTOR FROM TABLE A: Number: (a)Base Fee:
(b)Additional Increment Fee: -
Estimated Permit Fee: (4)
l Estimated Plan Review Fee: (5)
■ FIRE PREVENTION SYSTEM . ...
t PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number: (a)Base Fee:
(b)Additional Increment Fee:
Estimated Permit Fee: (6)
Estimated Plan Review Fee: (7)
■ PLUMBING
Base Fee Number of Fixtures
$21.00+{ X$7.00/fixture}= (8)Estimated Permit Fee
Estimated Permit Fee
X .65 = (9)Estimated Plan Review Fee
Miscellaneous Fixture Charge:(10)
Sub Total (Page one): Line(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10) = (11)