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09-100098 •City of Federal Way Plufithing Community Development Services Permit #: 09-100098-00-PL P.O.Box 9718 Federal Way, Fax (253 9718 835- Inspection Request Line: (253) 835-3050 Ph:(253)835-2607 Fax:(253)835-2609 p q Project Name: VIRGINIA MASON MEDICAL CENTER-ORTHO CLINIC Project Address: 33501 1ST WAY S Suite 220 Parcel Number: 926504 0010 Project Description: Adding(11)sinks& (1)instahot hot water electric heater Owner Applicant Contractor VIRGINIA MASON CLINIC STATE MECHANICAL CO STATE MECHANICAL CO 1100 9TH AVE 600 INDUSTRY DR SUITE 8 STATEMC141C7(9/1/09) SEATTLE WA 98101-2756 TUKWILA WA 600 INDUSTRY DR SUITE 8 98188 TUKWILA WA 98188 10 % '- a a� F •' 444 `40k4 ik unii • ''.074E,1" y '40,' 13 x , • Sinks 11 Water Heaters 1 PERMIT EXPIRES Wednesday, July 8, 2009 Permit Issued on Friday, January 9, 2009 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 the City of Federal Way. Owner or agent: xY --7;-/-7,,e7- Date: t _ C (7u1/44. \ .40 4.2) 45' 4/ r DATE INSPECTOR AREA AND TYPE OF INSPECTION . . - lkiiii, • THIS CARD IS TEMAIN ON-SITE . ' CITY OF Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT#: 09-100098-00-PL Owner: VIRGINIA MASON CLINIC Address: 33501 1ST'WAY S Suite 220 FEDERAL WAY, WA 98003 This card is part of your required inspection documents. Scheduled inspections maybe 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. 0 Plumbing Groundwork(4190) ❑ Rough Plumbing(4230) ❑ Gas Piping(4125) Approved to cover Approved Approved to release test By Date By cz, td3 Date2-2idgrecy By Date , - ❑ Final-Plumbing(4075) Approved By L W Date 4k 3- O 7 • For inspector reference only 0 Rough Electrical 0 FINAL-Electrical Approved Approved By Date By Date Federal • `? _ 1 0 00 ?? Federal V1 PERMIT - - COMMUNITY DEVELOPMENT SERVICES SF MF CO ME EL PL E EN FP 33325 6TH AVENUE WAY, SOUTH•PO BOX 9718 J APPLICATION WI FEDERAL WAY,WA 98063-9718 JAN n g ZO�� / / 253-835-2607•FAX 253-835-2609 u,,,t,.,Iwo/leder a4raaroll I The of , , "�L1! ,'',," -an , ,lute a,i,iication LmU not be , • ,ted. Please , • t le!•, - (in ink)or -j,-. • PROPERTY INFORMATION 2 SITE ADDRESS ✓ 50 t Si tutw SUITE/UNIT# a04.k. RCC)r ASSESSOR'S TAX/PARCEL# q ' W 5 0 4 - 0 0 1 © LOT SIZE(s)L->' 2 O LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) • PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING X.PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this permit onl)) /4LD1AKx et*6v&iI Get) S wN KS Amb c! N4 G i) l,.rgT4 i+ T 1401- t,o/}Tc& *act O. CE.-W.060 PROJECT NAME(Name of Business or Owner Last Name) V fil ligO„Ail 0 TZT ti(' CLj c 1 C a PEOPLE INFORMATION PROPERTY PRIMARY PHONE OWNER V n `_►N ,A Ms ' ( ) - ADDRESS CITY, V 5 v t � GJO1 S deaL tAifFe W(r 1800 3 CONTRACTOR COMPANY NAME APPLICANT NAME OFFICPHONEE 5 -76Z)9rAfT Mec HAN ICAC, " 'u 0 (+•�c�ST61 MM,A ll QQAA�c 5 MAILING ADDRESS Q y S TCITY,STATE,ZIP Q (j (� CELLPHONE 41`/�_Jv�,(/v/ / Y4v"CITY OF Fi� RBUSINESS LICENSE NUMBER "J 1 L WA'EXPIRATION7 f 1 i S Fa06 )5 7 S 75 Al - AX NUMBER / / (',t CONTRACTORS REGISTRATIONNUMBER(copy of card required with each application) EXPIRATION DATE 4S T tcT E /KG 1 4 1 C1 C / ! / Oq APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE I-17TM Ale-e.NA N 1 cA4- 'gyp I G(, r sk/t4/ f (o%) 576 - 750:) MAILING ADDRESS CITY,STATE,ZIP CELL PHONE G000 (ND UUTt4 tR.ttg Tv 4,6401 WA 4161 et (docs) 7 ) 575 - 75a RELATIONSHIP TO PROJ FAX.NUMBER CO 0 Architect ❑Tenant ❑Agent ,Other(Describe) JT V'LI ( Mr(,) 675- "isaq CONTACTPRIMARY PHONE E-MAIL ADDRESS SU t ,n 14I.OsT � N fJ r (t )575 - -75X7 aas Kk3s+erne�a a.i.C., LENDER Per RCW 19.27.095: Lender information is NAME required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP PHONE ( ) • DETAILED BUILDING INFORMATION EXISTING USE PROPOSED USE EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ SPRINKLERED BUILDING? ❑ YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES a NO WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE a PRIVATE(SEPTIC) ! • PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ.FT. SQ.FT. SQ.FT. BASEMENT FIRST SECOND THIRD FOURTH ADDITIONAL FLOORS(DESCRIBE) DECK(COVERED?) GARAGE ❑ CARPORT❑ NUMBER OF FLOORS EXIST G PROS® TOTAL TOTAL ESbv.11NG SF Tar PROPOSED w TOTAL Sr **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ FIXTURES Indicate number of each type of fixture to be installed or relocated as part of this project. Do not Include existing fixtures to remain. MECHANICAL Value of Mechanical Work $ AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS BBQS FANS HOODS(commemiau WOODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC(Describe) COMPRESSORS FURNACES GAS WATER HEATERS DUCTS GAS PIPE OUTLETS PLUMBING BATHTUBS(ormb/Shower combo) SHOWERS WATER CLOSETS Irouet) MISC(Describe) DISHWASHERS i SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS LAVS(Bathroom sinks) VACUUM BREAKERS 1 ELECTRIC WATER HEATERS 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 P014, / DATE (Signature) fntle) RELATIONSHIP TO PROJECT ❑ Owner 0 Agent contractor 0 Architect 0 Other FOR OFFICE USE ONLY o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT BUILDING SHELL ONLY? ❑YES o NO BASIC PLAN? o YES ❑NO ZONING DESIGNATION CHANGE OF USE? o YES o NO NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES o NO PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES o NO Bulletin#100-January 1,2006 Page 2 of 4 k\Handouts\Pennit Application