03-101148 # •
S •
clz,rf Fede` Way Building - Commercial Permit #:03 - 101148 -110 -4C0
Community Development Services
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.0O
35.3050
Project Name: VIRGINIA MASON-2ND FLOOR G.I.M.
Project Address: 33501 1ST WAY S Parcel Number: 926504 0010
Project Description: TI-Tenant Improvements to existing,second-floor internal medicine department.No plumbing or
mechanical in this permit.
Owner Applicant Contractor Lender
VIRGINIA MASON CLINIC COLLINSWOERMAN FASTRAK SERVICES,INC VIRGINIA MASON CLINIC
1100 9TH AVE 777 108TH NE,#400 FASTRSI011J3 4/22/04 1100 9TH AVE
SEATTLE WA 98101-2756 BELLEVUE WA 98004-5118 8191 NE SELFORS LN SEATTLE WA 98101-2756
BAINBRIDGE ISLAND WA 98110
Includes:
Census category: 437-Comme #1 #2 #3 #4
Occupancy Group: B
Construction Type: Type V-One-HR
_Occupancy Load:
Floor Area(Sq.Ft.): 5709
Census Category 437-Commercial alt/add Fire Sprinklers Yes
Mechanical - No Number of Stories 1
Permit for Building Shell Only No Plumbing No
Will Certificate of Occupancy be Issued? Yes Zoning Designation OP
CONDITIONS:
All new and refaced signs require a separate sign application and review.(FWCC,Sec.22-335(g)(6))
PERMIT EXPIRES October 19,2003.
Permit issued on April 22,2003
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: '' 2-72-
d3
.
• -40 • • " 4
City,of F:ideral 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: VIRGINIA MASON-2ND FLOOR G. Permit number: 03 - 101148-00
Address: 33501 1ST S
#1 #2 #3 #4
Occupancy Group: B
Construction Type: Type V-One-HR
Occupancy Load:
Floor Area(Sq.Ft.): 5709
Owner VIRGINIA MASON CLINIC
Name: 1100 9TH AVE
Address: SEATTLE WA 98101-2756
notei-dE:31. , Cdn " CL3C—C. -)
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.
r 0 0
INSPECTION LOG
DATE INSPECTOR OK CORR/REJ AREA AND TYPE OF INSPECTION
7- 1- Mi sc.( lot. 4 e.,`ld -f`Gt ivy 5 s 7a.) r4
11 -03 G..-t_"-.� D k " GG. PI el •"Gc 5 .57' Tia% Q..,
POS HIS CARD ON THE FRONT OF BUILD - . . , Ii,
446 CITY OF '
Federal WayBUIL ING DIVISION
INSPECTION RECORD
INSPECTION REQUEST PHONE#: 253-835-3050
PERMIT#: 03-101148-00-CO
OWNER'S NAME: VIRGINIA MASON CLINIC
SITE ADDRESS: 33501 1ST S
() FOOTINGS/SETBACKS () FOUNDATION WALL
llO NOT POUR CONCRETE UN DI,THE ABOVE IS AttAft, i, "
( ) DRAINAGE: Line ( ) Connection
,,,: A . A A., . , fiW� DO NOT POUR SLAB UNTIL THE ABOVE IS APPROVED
( ) UNDERFLOOR FRAMING
() ROUGH PLUMBING: DWV Water piping
( ) RCUGH MECHANICAL Gas piping
( ) `'HEATHING Roof Floor
( ) S:TEAR WALLS
) ELS 2TRICAL ROUGH-IN Ditch Cover
( ) FIRE/DRAFTSTOPS
PALL THE ABOVE MUST DE APPROVED PRIORTO FRAMING INSPECTIO,,, '` it :,`, a,, F
ING/FIRESTOP_�
O 1�RAMw, M WING (c-, - ZS' - �' 3C, kJ
THE ABOVE MUST BE APPROVE))PRIOR TO INSULATING ORSEETROC sl „ ' -;/;2,:'-
(
,F
( ) INSULATION: Floors Walls Attic
THE ABOVE MUST BE APPROVED PRIOR TO APPLYING SIIEETROCK
() WALLBOARD NAILING O SUSPENDED CEILING L O A" ' C'1..
y
THE ABOVE MUST BE APPROVED PRIOR TO TAPING OR INSTALLING CEILING TILE
() ELECTRICAL FINAL g - 4,-03
() PLANNING FINAL
() PUBLIC WORKS FINAL
( ) FIRE FINAL `8 -0.3 e...,_.
7-110*, 40A,:::: . s,,., ....EAPPROVED PRIOR 0 BUILDING DEPARTMENT FINAL
O BUILDING FINAL e - a -- v .,3 -
DO NOT OCCUPY THIS BUILDING UNTIL BUILDING FINAL IS APPROVEL-
• � CONSTRUION PERMIT APPLICATION
444'
CITY o> APPLICATION NUMBER: 03 - 1 01 L kr- cy0 c6
Federal Way r'R 2 5 2003 _
APPLICATION NUMBER:
,:TY OF FEDERAL WAY APPLICATION NUMBER: - -
BUILD!NG DEPT
**The following is required information—Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
■ PROPERTY INFORMATION
SITE ADDRESS: 3350/ /6) (11`') S , ASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
/
• PROJECT INFORMATION
TYPE OF PROJECT(This application): a BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL C. ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): tow4Ai?" Z4//j4ar0MEWVY'if re' EX/JT/N9' /4P4.fL
Mi-P/ci'E OE ,01-"7-44Ef7
Po 'tel h'mt N 6 De h.,t C c.t--E-,i-►.v._ ._.
PROJECT NAME: l/// &,4'/'1 414J O AlF0/' Civ/E/<z - ftD i 39-4 l4//tG1 c-')•/,4i, /t4i4'2L
• PROJECT INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
6q,i 77 -1--, ,Ii'zrfrr/r-c--'t (-6) 4, - .04 33
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
AWit 41'iP_° &3 -FM/ //‘24' Irl,/2W-, / S ,if-rrze, OW 96/i/
CONTRACTOR: NAME: DAYTIME PHONE:
F hr774' A '/Ge f/ /NC. ( i ) A.5-5- - rasa
MNG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
v8/T/I
N� Set-FvpZJ Lh,/ BA-/A, YE 2ZC W.4 le// (2e6 ) 65;5 -Togo
C OF FEDERAL WAY BUSINESS LICENSE NUMBER:— — FAX NUMBER:
-
— _ _ - i e ) 135-S -/7/D
CONTRACTOR'S REGISTRATION NUMBER:
�
XPIRATION DATE:
(copy of card required) a'il. —�� / /
APPLICANT: NAME: DAYTIME PHONE:
cC' /N4 114;e-"44/1-A/ C ,4y& 4 4,e'4/7- (425') 88! - 9-3/6
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
-777 70.S/a4 ,9-b' /VF/ I9£Itr-tiv /GVH- 9e q- ( re--.) '7-7/ - 67117
RELATIONSHIP TO PROJECT: FAX NUMBER:
I2 ARCHITECT ❑TENANT ❑ OTHER(DESCRIBE): (4 -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER in APPLICANT ❑ CONTRACTOR c'15E+9 v vlorbr-°"'"Nf"Wf T-
• PROJECT INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ A/4--
PROPOSED USE: cr/PMW PROPOSED VALUATION FOR IMPROVEMENTS: $ eee" Ot)
SPRINKLERED BUILDING? it YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES o NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN o HIGHLINE ❑ PRIVATE(SEPTIC)
•
**NEW RESIDENTIAL CONSTRUCTION 0 Y**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ. FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
• 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) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC o GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) o ELECTRIC o GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC. ( )
INTERCEPTOR(S) SUMP(S)
■ 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,including the undersigned,and filed against the City of
Federal Way, 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 a part of this application.
NAME/TITLE: R1 64f if??17�" � ��� �� DATE: --5M17,9
❑ PROPERTY OWNER 'APPLICANT ❑ CONTRACTOR
FOR OFFICE USE ONLY:
o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? o YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? o YES o NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES o NO
PLATTED LOT? o YES o NO CHANGE OF USE? ❑ YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.atyoffederalway.corn