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10-101047 r Mr Il►►. 0 0 Numbing City of Federal Way Community Development Services Permit #: 10-101047-00-PL P.O.Box 9718 FILE Federal Way,WA 98063-9718 Inspection Request Line: (253) 835-3050 Ph:(253)835-2607 Fax (253)835-2609 p q Project Name: VIRGINIA MASON-PHYSICAL THERAPY ROOM 220 Project Address: 33501 1ST WAY S Parcel Number: 926504 0010 Project Description: Installation of floor sink and hose bibb. Owner Applicant Contractor VIRGINIA MASON CLINIC STATE MECHANICAL CO STATE MECHANICAL CO 1100 9TH AVE 600 INDUSTRY DR SUITE 8 STATEMC141C7(9/1/11) SEATTLE,WA 98101-2756 TUKWILA WA 98188 600 INDUSTRY DR SUITE 8 TUKWILA WA 98188 ,, Plumbing Fiixt 4 e �.. '.41e) Sinks 1 Hose Bibbs 1 PERMIT EXPIRES Sunday, September 12, 2010 Permit Issued on Tuesday, March 16, 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 accordance with the laws, rules and regulations of the State of Washington and the City of Federal Way. Owner or agent: ! -7>'(/ '7DateA /( o FIt .' 1 :D 4/tq /o THIS CARD IS TO IN ON-SITE , CITY OF • Construction Inaction Record Federal Way INSPECTION REQUESTS: (253) 835-3050 PERMIT#: 10-101047-00-PL Address: 33501 1ST WAY S Owner: VIRGINIA MASON CLINIC FEDERAL WAY, WA 98003-6208 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. 0 Plumbing Groundwork(4190) El Rough Plumbing(4230) ❑ Gas Piping(4125) Approved to cover Approved Approved to release test By Date By Date vIc_ 11._C\-- By Date El Final-Plumbing(4075) Approved By w.+ Date ,—2.,- ?,,_ -;)(C) 0 Rough ElectricalEl Final Electrical Right of Way Approved Approved Approved By Date By Date By Date • Ill A. .{mow/ 1 7 CITY CF M _ _( a ' o D Federal Way PERMIT e --AACOMMUNITY DEVELOPMENT SERVICES MAR 1 62Q10 SF MF CO ME EL DE EN FP 33325 8TH AVENUE SOUTH•PO BOX 97I8APP ATI O N FEDERAL WAY,WA 98063-9718 jj TD 253-835-2607•FAX 253-8 52 OF FEDERAL A The oliowin• is re,wired in ormatlon-an incom•fete a•'lication will not be • .' 'ted. Please 'rint le!ibl (in ink)or -�,•. � � I PROPERTY INFORMATION SITE ADDRESS ` 3 0 ( 9 4 '5 I t+ / -.5 SUITE/UNIT# ASSESSOR'S TAX/PARCEL# 2 Co 5 (3 4 - 0 d ( v LOT SIZE(sf) LEGAL DESCRIPTION(e.g.Acme Estates,Lot l) (Attach separate pagefor lengthy�l desc,4rtbn/ ■ PROJECT INFORMATION TYPE OF PERMIT ❑ BUILDING ■ PLUMBING ❑ MECHANICAL 0 DEMOLITION 0 ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide de ailed description of work included on this permit only) TNsTAL (.OJC.-1 vN E F'Loo(2 Si NV AJ)'r' oni f-k)SE Cat (3 e-( -- e1,4, ?--,)-0 PROJECT NAME(Name of Business or Owner Last Name) V 1 "V ( M ( �a--- B" �-�/5 Iv` I. PEOPLE INFORMATION PROPERTY NAME d ,1 PRIMARY PHONE OWNER V I P•&(N O (*SO/ CLI Ai ( C ( ) MAILING ADDRESS CITY,STATE,ZIP tt0O 9 1 AVG S 11LE, Cil II 1 CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PI-IONE SI& E MFcH/M44L � Ku) E►2fibelA ( 0575 -'7SZ-7 MAILING ADDRESS CITY,STATE,ZIP CELL PHONE C2©o fh'DaS -KY I) #8 1 u(�.c,.Ll9 / fwR `1y/�'g (0575 --752-7 CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER / / ( ) B L CONTRACIDR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE .� T A- ICM (. l 1 S ( Oct V /Q( / 1/ APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE �T67-6 416-cli },f(CAL iD co 'Thite�lA,) (200 )57' - 7527 __ MAILING ADDRESS CITY,STATE,ZIP CELL PHONE 6 (iotusTr2Y pK14g 7'Vi4ic)/i.A, c,J9 9gike ( ) - RELATIONSHIP TO PROJECT FAX NUMBER �G ID ❑Tenant ❑Agent Other(DesCo/VTribe) Co/VT c TV Z ( � 7l�- �5� 1 CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS $U1) (!LOS7Cf 4l N" (20f)57£ - 752 ? (ooa 0 s* -brockk LENDER Per RCW 19.27.095: Lender information is NAME required if project value exceeds$5,000 MAILING ADDRESS COY,STATE,ZIP PHONE ( ) El DETAILED BUILDING INFORMATION EXISTING USE PROPOSED USE EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑ NO WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE 0 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❑ EXISTING PROPOSED TOTAL TOTAL EXISTING SE TOTAL PROPOSED SF TOTAL SE NUMBER OF FLOORS **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ FIXTURES Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing jlxtures to remain. MECHANICAL Value of Mechanical Work $ AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS BBQS FANS HOODS(commcrciap WOODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC(Describe) COMPRESSORS FURNACES GAS WATER HEATERS DUCTS GAS PIPE OUTLETS PLUMBING BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(roues) ` MISC(Describe) DISHWASHERS SINKS DRINKING FOUNTAINS �L[70�' Silt)1 GAS PIPE OUTLETS SUMPS RAINWATER SYST 1.-Uze WASHING MACHINES URINALS t HOSE BIBBS LAVS(Bathroom sinks) VACUUM BREAKERS 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 DATE (Signature) (Title) RELATIONSHIP TO PROJECT 0 Owner 0 Agent 0 Contractor ❑ Architect ❑ Other FOR OFFICE USE ONLY n NEW E ADDITION ❑ALTERATION n REPAIR ❑TENANT IMPROVEMENT BUILDING SHELL ONLY? ❑YES ❑NO BASIC PLAN? ❑YES ❑NO ZONING DESIGNATION CHANGE OF USE? ❑YES ❑NO NEW ADDRESS REQUIRED? ❑YES ❑NO UP/SEPA/SU? o YES o NO PLATTED LOT? n YES NO DEMO PERMIT REQUIRED? n YES n NO Bulletin#100—January 1,2006 Page 2 of 4 k\Handouts\Permit Application